Afib with a normal heart rate.

I was first diagnosed with Afib in 2018 and pretty sure I was dealing with it prior to that. For the past year and a half I have been in NSR, or was I?
Tonight I almost passed out which I think, as did the doctors, that it was unrelated.I am aware that it could be. After that I noticed my heart rate was extremely high, at least 130 and probably higher before they put a monitor on it, I was advised to go to the ER. As they tried to bring my heart rate down they repeatedly told me I was not in afib. Once I had Afib, it always is a concernso I needed to know. When they finally brought the rate down is when they noticed that I was going in and out of NSR. They felt that was not common so I need to bring that question here to know if that is a fact or not. If this has been occurring for a while I clearly did not notice. But I have noticed the past few weeks that my rate has been faster than normal. Thanks always for the wealth of knowledge provided here.

I'm having a hard time understanding what you're asking. For example, the heart rate of 130. You've had an ECG done while in this tachycardia? I guess not or you'd be able to tell us what the arrhythmia was. Going in and out of NSR isn't unusual or any sort of big deal for most people, so I'm not sure what they tried to communicate to you but I don't think the communication was successful. And why is being in afib a particular concern?

Yes I had an ECG and they did say tachycardia. When the rate came down is when the irregular beat was discovered and not during the rapid rate. They felt that was an unusual time to notice it.They felt they would notice any irregular beats during the tachycardia I just want to know if that is an accurate. assumption from them

Well, that might be a little unusual but it's not alarming. Afib often comes with very individualized patterns, and very frequently with a mix of other atrial arrhythmias such as atrial flutter. I wouldn't read too much into what they said. They're not misinterpreting anything.

I'm new here, but I have been dealing with AFIB for a long time now. Keep in mind, I am not a doctor, I don't even play one on TV (nor do I want too). But from my experience, if you are almost passing out, get with your doctor ASAP. The reason for it doesn't matter, it needs to be addressed first thing.

As for the high heart rate and seemingly being in NSR, I have noticed in the past my heart rate would climb as high as 140+ and appear to be in NSR and then drop. Sometimes I would appear to be in NSR, but sometimes I was in AFIB. Either way, when my HR came down, I was in AFIB. Not sure if this normal or not, but I also did not have an EKG/ECG done at the time. With your heart rate getting that high you should also contact your cardio and EP as well. If you don't have an EP, find a good one in your area quickly. You can always look for someone else to do any procedures you may need at a later time.

This is probably not reassuring in any way, but it is what I would do.

JDfib said they believe and their doctors believe the near-syncope episode was unrelated to the afib.

It may not be directly related, or they could not tell at the time. But syncope is very related to the circulatory system and should be addressed. Not all the causes are, but a majority are. It may not have been related, but is just as likely to cause an increase in HR and BP after the fact and trigger an AFIB episode. Like I said, this is based on my experiences and dealing with these issues. Yours or others might not be the same.

[my.clevelandclinic.org]

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kliving
But syncope is very related to the circulatory system and should be addressed.

Of course. I would never suggest otherwise. In fact, I would consider the near-syncope the more serious issue if it keeps happening, but a single episode is hard to do much with.

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kliving
It may not be directly related, or they could not tell at the time. But syncope is very related to the circulatory system and should be addressed.

I have Dysautonomia so near syncope is very familiar (drop in BP) though when I was in Afib I was also often close to syncope even though my BP was high. Complex interactions between several systems I'd guess.

I have had only one episode of syncope. It was last year while my physical therapist daughter was visiting with her toddler son. I had been in and out of AF and was in line for an ablation, still three months away. I had bent over, while seated, to pick up something, maybe to arrange some magazines on the carpet at my feet. Then, I stood and walked toward my study. After about ten paces, I 'heard' a loud, machinegun-like, hammering inside my head and realized I was probably going to pass out. I made myself fall backwards against the wall, but I wasn't in full control. and fell heavily onto my backside.

This, I think, was pure orthostatic syncope, but not without some help. My heart's propensity to turn to AF or flutter, and I have a history of both, probably made for a slow heart beat, too slow, due to the metoprolol I had been taking to keep the rate lower when I did go into AF/FL. Many here report that as their dosages of metoprolol rise to deal with the evolution of their arrhythmia(s), their resting heart rates enter well into the bradycardia zone of less-than-50 BPM. Mine, at the time, was closer to 40 BPM, and it was recorded at 30 BPM when I presented at the local ER. In fact, there were long pauses, as noted by my EP later when he discussed my case history with me after my second ablation with him.

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Daisy

I have Dysautonomia so near syncope is very familiar (drop in BP) though when I was in Afib I was also often close to syncope even though my BP was high. Complex interactions between several systems I'd guess.

It's not very fun when it happens. Sadly, I am having syncope or near syncope nightly because of medication (I think) I need to get with my doctor and figure it out. I am going to set up BP cuff and pulse ox to see if it is BP or HR dropping. I just realized this recently and would like to minimize the effects if I can. We are supposed to start dropping medication in January to see if my ablation worked as well as we had hoped it would or if we need to do a second one as we think is going to be needed.

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kliving
It's not very fun when it happens. Sadly, I am having syncope or near syncope nightly because of medication (I think) I need to get with my doctor and figure it out. I am going to set up BP cuff and pulse ox to see if it is BP or HR dropping. I just realized this recently and would like to minimize the effects if I can.

Here is how my autonomic specialist taught me to test this at home. Take a baseline of BP and HR while sitting after resting for 15 minutes or so--note it down. Then stand and with the arm with the BP cuff supported at heart level, take a reading every minute for 10 minutes. If your systolic BP drops 30 or more points, that a recognized form of autonomic dysfunction--neurally mediated hypotension or syncope (it has several other names). And, if your HR goes up 30 points or more that is also a recognized form of dysfunction--POTS or postural orthostatic tachycardia syndrome. Of course if you start to faint, sit down! You could show your log to your doctor and it could give them useful data.

I had syncope often in 2004. My scalp is a road map of stitches. I had a positive tilt table test. Not a fun test. The test got my BP down to 44/27.
I tweaked the timing of my drugs and it went away until two days ago while in afib while I’m not taking the drugs I had before.

I’m staying in someone’s basement in the east coast until things calm down where I live and I suspect a CO issue. When I leave the house I am ok but when I stay downstairs I’m very dizzy, coughing and a new tachycardia I never had since my last ablation. That’s where we sleep and eat and spend our time the past month. I’m buying a CO detector.

So syncope can be caused by many factors not related to afib.



Edited 1 time(s). Last edit at 11/05/2023 08:33PM by susan.d.

At a follow up test to my recent ER appearance it was determined that I am also dealing with flutter. When my rate returns to to an appropriate level is when afib is noticed but at such a different irregularity than I first experienced when the fun began in 2018. I have had flutter symptoms in the past week and still don't feel my near passing out was related. It did bring to my attention the flutter piece to the puzzle so I guess its not all bad.