I thought this might be worth sharing with you.

About two weeks ago my wife felt like her heart was bounding. May or may not be significant, but I was an EMT for quite a few years, and when I took her pulse, it was indeed both strong and tachycardic. I’ll add, at this point, we both wear an Apple Watch. She began receiving notifications of episodic Atrial Fibrillation. She called the clinic (affiliated with Colorado University Med Center) and got an appointment with a cardiologist set for less than a week away.

The Cardiologist was great. They ran an EKG and confirmed that she was in Afib right then and there. He scheduled an outpatient appointment down in Loveland, CO, for “first available” opening. That meant that he wouldn’t be the doctor working on her, but he wanted her seen quickly—again, just under a week.

Yesterday, she had TEE, Transesophageal Echocardiography. Without going into an anatomy lesson. The heart has four chambers: two atrium and two ventricles. The ventricles pump blood either up to the lungs for oxygenation (R ventricle), or out to the body after receiving oxygenated blood from the lungs (L ventricle), the atriums are the “staging area” (my description, and I know we have a cardiologist who’s an active member) that loads the ventricles.

In Afib, the atrium is not contracting effectively. It’s contracting weakly and rapidly, or quivering and not really contracting at all. The TEE involves an ultrasound device, being inserted in the esophagus, adjacent to the upper chambers of the heart to obtain really clear images of the atriums. Probably the biggest risk of Afib is the formation of clots in blood pooling in the atrium because the chamber wasn’t effectively cleared.

“Because she acted quickly,” her atriums were clear of clots. BTW, her cardiologist immediately put her on Eliquis, an anticoagulant, and Metropolol, to control the tachycardia (only partially successful).

Because she was determined to be clear of clotting, the cardiologist then performed “Cardioversion.” An electrical shock delivered (in her case) through patches on her chest and back to shock the heart into sinus rhythm. It was described to us as a rather mild shock, but she does have a mild burn where the patches were placed.

When she started the procedure, her pulse rate was 93 bpm. As soon as the shock was delivered, her pulse rate fell to 73. It was slightly lower than that this morning.

I’m sharing this because the anesthesiologist (she was given the same drug that you receive for a colonoscopy) told her that there seems to be “almost an epidemic” of Afib. She was also told by everyone involved that her quick action in seeing a doctor was a big factor in her upper chambers being clear, and the success of the Cardioversion. She was further told that more than a few patients ignore the signs of Afib, and that they often see patients who have had symptoms for a year or more. That sort of neglect doesn’t produce good outcomes.

It happens that my wife is very fit, and always has been. She’s almost 64, but very attuned to her body. I think people who carry too much weight, or reach a certain age, begin to think that when they experience something like tachycardia, that it’s just age or general health. Learn to take your pulse, or wear a watch that monitors your pulse and can provide further information on your heart (like Afib).

Thank you for sharing this. I’m glad she’s doing well, and was attentive to her body signals.

When I was in paramedic training I had the chance to defibrillate an Army helo pilot who developed Afib.

30ish years later that experience proved helpful when my cardiologist defibrillated my Afibing heart.

Worked perfectly. No recurrence in nearly four years, two of which involved hard physical training.

I developed AFib a few years ago as a result of untreated sleep apnea, I'd get hit with it anywhere from 5 minutes to 40 minutes at a time and it's a crappy feeling. Luckily not persistent like some people have, I can't imagine that.

With the sleep apnea being treated, it's virtually gone away although it may give me a twinge here and there if I'm not careful to stay hydrated.

Did the doc give his thoughts on why it's an "epidemic" now?

quote:

Originally posted by PASig:
I developed AFib a few years ago as a result of untreated sleep apnea, I'd get hit with it anywhere from 5 minutes to 40 minutes at a time and it's a crappy feeling. Luckily not persistent like some people have, I can't imagine that.

With the sleep apnea being treated, it's virtually gone away although it may give me a twinge here and there if I'm not careful to stay hydrated.

Did the doc give his thoughts on why it's an "epidemic" now?

Had a good talk with the cardiologist who treated her yesterday. My wife has almost none of the risk factors that would seem to make her a candidate for Afib. Both he and the doctor we saw up here can’t really say why. Her dad had a bad heart, became a stroke patient, and died young, but we have no knowledge that Afib Was a factor, he suffered his first MI in his early 40s, had another later, and I think, the heart attacks were the source of the clots that produced his stroke. My wife’s condition remains unexplained. I heard the story of the “epidemic” after talking to the cardiologist, when we (kids and I) went into her room after recovery. We’ll have to ask her cardiologist here about that.

TMats:

It may be worthwhile having your wife do a sleep study for sleep apnea. Who knows, it may be a side effect of that and she doesn't even realize it. There are lots of people who have it and don't even know, they just think that's how they are.

quote:

Originally posted by PASig:
TMats:

It may be worthwhile having your wife do a sleep study for sleep apnea. Who knows, it may be a side effect of that and she doesn't even realize it. There are lots of people who have it and don't even know, they just think that's how they are.

Acknowledged

quote:

Originally posted by PASig:
Did the doc give his thoughts on why it's an "epidemic" now?

Perhaps the increased popularity of wearing a heart rate monitoring device like the Apple Watch is causing more people to seek treatment?

My case in point:

On my 69th birthday, I made an appointment with my PCP, something that I had neglected for 26 years. During the physical he hooked me up to an EKG, read the result, and sent me straight to the ER. Yup, AFIB. I was not feeling at all bad in any way, I had no discernible symptoms at all so I have no idea of how long it had been going on.

This was on a Thursday, and as many of you know, nothing happens in a hospital over a weekend. The following Monday I got a cardioversion and I am pretty sure that I have not had another episode in the subsequent five and a half years. But without symptoms, how would I know? I am on Metoprolol and Eliquis, and make yearly visits to a Cardiologist who does not seem particularly concerned with my situation.

My point being that sometimes you don't know you have something until you go looking for it. And that ubiquitous heart rate monitors simply provide a more convenient way of looking for it. This is plenty of explanation for a perceived "epidemic."

I think that this phenomenon applies to many other "epidemic" diseases as diagnostics have improved and awareness of prevalence has increased. A positive feedback loop.

Over the past 30 days I am in a similar boat, but much worse.

I couldn't breath since before Christmas. I mean winded walking 20 feet. Not sleeping. Not eating and always gasping for breath.

Finally went to Urgent Care thinking it was pneumonia, they'd do a chest x-ray and I'd leave with an Rx for an antibiotic. Nope. One look at the x-ray and they sent me straight to the ER for admission.

I HAD pneumonia and beat it on my own but when hooked up to the machines, it was Afib with CFH. Bad CFH but low cholesterol, no diabetes, sleep apnea or anything other than I was drowning in fluid. That 64 oz a day of water is not good when you can't pump it out.

They tried the TEE but discovered a clot so that was a bust.

Now, I'm on 13 different pills a day and the leading thought from cardiologist is that the CHF is influenced by the Afib. The POA is meds to clear clot, lower heart rate, really lower the BP and in 90 days, come back and if the clot is gone, as expected, then they'll do the TEE. The ejection rate should improve once the procedure is done.

Apparently I've had Afib for decades but it was never limiting. Only discovered through the visit to urgent care.

The meds are kinda nasty, I'm limited to 1.5L of total water consumption a day, I piss every 90 mins during the day like clockwork. Side effects are fatigue, lack of forceful concentration and a dry cough.

My advice as someone currently going through Afib with complications, buy the watch that has the heart and other health features, including pulse ox. They aren't medical devices but you'll get a good idea of your heart health for you to act on.

Cardio treatment is amazing but you need to get the hospital alive for them to help you.

Glad to hear she is doing better. A-fib is not something to mess around/wait with. If anyone has a new/old onset of A-fib/rapid A-fib, especially with signs/symptoms, go to the e.r. as soon as you can. I have seen many people have heart rates greater than 150 and needed treatment asap.

Gave my dad who's in his late 80's an apple Watch a few years back, after about a year it began to signal AFIB moments, enough so we got him eventually admitted and tested, 90% blocked on the Widow Maker artery.

The Apple watch is a good idea for anyone.

I have had asymptomatic AFib for years and have been treated for it. Cardio versions to get me back in sync over the years. Last year I posted how I was going to start the Dofetilide (Tykosyn) drug treatment option over the Amioderone drug I had been on for years with no apparent good success.

Tykosyn requires a 3-4 day hospital stay so they can monitor you. Mandated by FDA apparently. On the 4th day still in AFib, 6th cardio version before discharge and almost 6-months later NO AFib. Appears Tykosyn, knock on wood, is working.

Everyone is different but I am putting my plug in for the Tykosyn drug regime as it seems to be working for me..finally.

I use the Kardia device to check the EKG and it is easy to use. I think they're $79 on Amazon.

Good thoughts and keep us posted

quote:

Learn to take your pulse, or wear a watch that monitors your pulse and can provide further information on your heart (like Afib).

Don't forget your blood pressure, too.

quote:

Originally posted by 229DAK:

quote:

Learn to take your pulse, or wear a watch that monitors your pulse and can provide further information on your heart (like Afib).

Don't forget your blood pressure, too.

True. My wife said on the way home that she’d like to buy a BP cuff. I’ve still got a good quality stethoscope from my days as an EMT.

I am surprised no one mentioned the Watchman for afib. It is a minimally invasive procedure that eliminates the need for expensive meds like Eliquis or Xarelto.

The WATCHMAN Implant is a safe, minimally invasive, one-time implant for people with non-valvular atrial fibrillation (AFib) that reduces your stroke risk
link: https://www.watchman.com/en-us/home.html

quote:

Originally posted by ZSMICHAEL:
I am surprised no one mentioned the Watchman for afib. It is a minimally invasive procedure that eliminates the need for expensive meds like Eliquis or Xarelto.

I was going to bring this up. I would imagine the TEE would have determined if it would be right for Mrs. TMats. ?
Do they do this if her Afib is under control?

I would assume so. The Watchman has been out for some time and has a high success ratio. Like anything else I am sure there are contraindications.

Here is Stanford's approach. It explains things very well. No general anesthesia which is a big plus.
LINK: https://stanfordhealthcare.org...e-closure/risks.html
These guys even offer you an online second opinion.

I’ll check it out, thanks

Tom.
Hoping for the best outcome for your wife.
Prayers sent.

PC