How will I know if it's A-fib?

[a_dalhouse]

I'm 7 weeks out from a minithoracotomy mitral valve repair and have been experiencing a heart rate mostly in the 90's. At first I wasn't feeling the pounding/racing heart sensations that I had before surgery. But I lost a bit of blood and assume now that I'm building it back up I am able to feel things a bit more severely?? I can again see my heart beating through my clothes - it is quite strong and fast.

Last week after walking 4 miles and resting for 15 minutes, I sneezed and it sent my heart rate to 169 for about 5 minutes. But then it went back down to the lower 90's. My cardiologist's nurse called today to say the echo I had last week looked good and when I told her about that episode she had me come in to get an event monitor. As I was getting it today and the technician was getting a baseline on me, she was shocked to hear/see/feel my hr at 100.

So other than feeling annoyed by this pounding heart and a bit funky from it (it feels like I "swallowed my heart" - kind of that hollow feeling in your throat and the pit of your stomach), how will I know when or if it's a-fib. I'm a bit paranoid that it's happening and I'm refusing to believe it. 1.) because i feel like my doc thinks I just run in there with any little complaint, so I'm trying not to this time - and she says I will for sure know if I'm in a-fib and 2.) I just really don't want to be in a-fib

If anyone can give me some insight into how it feels and how I might distinguish a fast heart rate from actual a-fib I would greatly appreciate it!!

 

[Bina]

Hi, my post op HR was just like yours and freaked me out, so I asked for Metoprolol to slow things down while the heart remodels itself.

One night while in hospital (7th or 8th day) I woke in the middle of the night with a HR of 170.....doc gave me Sotalol and the HR calmed down again... Awful.
What I have is called SVT (supra ventricular tachycardia) and for me, it has stayed a part of my life. Earlier I went to the ER a few times for it.

A-Fib can have a much faster HR to the point that the atria begins to vibrate and doesn't pump the blood out properly- so the blood can pool and cause trouble, which is why many
A-Fibbers are put on a med like Coumadin/warfarin.

Good Luck with the result of your event monitor.

 

[AZ Don]

I had a couple bouts of A-fib after my surgery. They felt similar to brief palpitations that I have had occasionally thru my life, but a-fib just keeps going, for hours. The first time I was advised to take an extra dose of metoprolol and when that didn't work after an hour, to go to the ER - it stopped as soon as they gave me meds to slow my heart. The second time the Metoprolol stopped it after about an hour. To me A-fib feels like my heart is dancing. It's not a regular beat at all. I have a watch with a heart rate monitor. When I was in A-fib it was reading 120-150. When I was first hooked up in the ER with A-fib the monitor read 220.

FYI, there are a number of things that may stop Afib: Metoprolol (check w/ your Dr.) Washing your face with cold water. Cough. Rub neck by carotid artery. Vasalva maneuver (something those that have had aortic aneurysm should generally avoid).

A fast heart rate is common after surgery. It took about 3 months to get back to normal and I'm still on metoprolol, so without it may still be high.

 

[epstns]

My experience may be different than others - considering the various complications I had post-op, but the last significant instance of afib I recorded (my pacemaker does that for me) was just about 4 weeks post-op. When the incident took place, I simply could not stay awake. It was nap time. . . period. We were in the audience at a play and I just slept through about 15 minutes of the second act. Didn't miss much, and didn't assign any special importance to the event. My pacemaker kept the important things happening, but apparently my heart was so inefficient at pumping that I didn't get enough oxygen to stay awake. Scary in hindsight, but I didn't even know it was afib until a couple of months later at a pacemaker interrogation.

At least I know that if I do have any subsequent afib, the pacemaker will record the time, date and duration for me. For over 2 years now, all I've ever had were a couple of instances lasting only seconds. I think I'll go knock on some wood. . .

 

[a_dalhouse]

Thanks y'all! I am already on Metoprolol (before and after surgery). It's a low dose, 12.5 mg, twice daily. I'm wondering if I need to increase that. I had another scary bout about an hour ago, much like last week's. I came in from walking and about 20 minutes after stopping I got up from sitting down, was really dizzy and my heart started racing. Luckily I had the monitor so i could record it. My wrist monitor showed my HR at 177. It lasted about 15 minutes then went back into the 90's again.

I'm really looking forward to the day my hr gets back in the 60's or 70's. I'm really hoping that this high rate is just a temporary thing after surgery. It really helps to hear from others that they've gone through the same thing and all ended well

 

[Bina]

My doctors appreciated that I had written down on my daily agenda my HR and BP as well as any 'episodes' for further reference or discussion.
Hang in there.

 

[epstns]

Andrea - What is your blood pressure? If it is low, that can cause the light-headedness and dizziness when you stand. I would not change any dosages until you get to discuss it with your doc - especially metoprolol, which may lower your blood pressure even more.

 

[a_dalhouse]

Thanks Bina and Steve. Yes I do have lowish blood pressure - especially during the rapid HR episodes. My surgeon decreased my Metoprolol to only once a day a few weeks after surgery and then my cardiologist brought it back up to twice a day when she saw my HR. But your right, I wouldn't increase it without speaking with my doc.

And as I was just typing, the nurse called me to tell me that the recordings show that I have "atrial flutter" and they are sending me to an electrophysiologist. I'm hoping I can get in soon - waiting on a call from their office - as this is really starting to freak me out :-/

 

[Mister_James]

A fast heart rate is not necessarily afib.
If you have a mechanical valve you should be able to hear irregular heartbeats, if it is fast and the rhythm is completely off then it is afib and it is not the skipped beats that you feel like an elevator dropped. you may/may not have palpitations. it is very closely related to atrial flutter.

If you have one of those apps that can measure your pulse you will notice that they will not be able to pick it up because it is very irregular. Listen to your valve and feel your pulse if they are in sync, you just half a fast rate, if they are off sync you are fibrillating.

In any case, the big fear of afib is a stroke, if you are on coumadin and in the therapeutic range, that risk is mitigated and it is a question of getting you back into sinus rhythm.

I can trigger afibs with a quick cold drink and the longest I have had them was 3 days continuous, shortest 5 minutes.

 

[Luana]

You most likely will not be able to determine if you're in afib unless you've had it before and know what it feels like for you. If you're experiencing any irregular beats, particularly if you're short of breath or light-headed, have someone drive you to the ER or call 911.