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Pixie5545, June 7,  2018  2:49pm EST

Heart rate during an Afib episode

When in Afib, I was told to take my heart rate once an hour (a 1 minute read) and if was 110 or more for 4 hours to call the clinic.  My husband uses a stethoscope to check this hourly.  I don’t understand how that 1 minute reading per hour gives me a good feel on whether rate control is working for me,  I rarely had a reading over 110.  I had a holter monitor recently and it showed a rate of 150.  I was stunned by that number,because we never got close to that.  Obviously rate control is not working and I thought it was.    How are you recording your heart rate during an episode.  I am so upset about this and don’t even know what to ask my EP anymore!

8 Replies
  • Jeanamo815
    Jeanamo815, June 7,  2018  3:29pm EST

    I have always checked my heart rate with my blood pressure monitor.  If you do not have one, there are good ones available at a pharmacy or on Amazon.   I was once told that if my heart rate stayed at 140 or more after taking an extra rate control pill (beta blocker) and continued at that rate for a while, then I should go to the ER.  There was almost never any time that I was in a-fib that my heart rate did not get really fast.  I had to go to the emergency room because it would be as fast as 200- 250 BPM.  A few times it came down after taking an extra pill so that I did not have to go to the ER.  You can have your blood pressure monitor checked (take it with you) when you see your doctor to be sure you are getting accurate readings...the same as in the doctor's office.  i've had 3 ablations and the last one has kept me in normal sinus rhythm so that I no longer am taking a rate or rhythm control medicine.  I do still take Eliquis in case the a-fib comes back...and I will continue to do so.

    You may want to ask your EP about when you should be concerned about your heart rate...what to do when it is fast...and at what point you may need to go to the ER. Some people try to "ride it out" longer than others do.  Mine would be so fast, I never really had a choice.

    Wishing you the best,


    (My A-fib Experience Community Leader)

  • Edhammer
    Edhammer, June 8,  2018  12:13pm EST

    I have an app for you phone called heart rate pro which does a pretty good job of taking my pulse. I’m one of those who has had the good fortune to ride out many episodes. My cardiologist and EP both agreed that as long as my heart rate was less than 140-150, I had no chest pains, didn’t pass out, etc. and didn’t last more than 8-10 hours, I could ride it out. My rate hardly ever goes above 140. The highest it’s registered was 173 at the ER. I’m on anticoagulants and rate control. I had an ablation 3 weeks ago and have had 2 minor episodes, which were not unexpected.

    talk to your EP or EP nurse.

    good luck

  • Spencer
    Spencer, June 8,  2018  3:30pm EST

    I wish that I had that heart rate when I was in AFib.  My limits were SVt > 2 Hrs with HR >200, or AFib for 6 hours with HHR >180.  I commonly every day see my HR north of 180, especially when I climb a flight of stairs.    My rate control drugs didn't do anything at for me.  

    My recording regime is daily EKG via Kardia and then hourly if I am in AFib.

    Are you using a Kardia EKG?


  • Edhammer
    Edhammer, June 8,  2018  5:49pm EST

    I just got a Fitbit last week that seems to do a good job with rate. Fortunately, I haven't had a episode since I got it, so I can't prove that it's working. It is clueing me in on some post ablation increased rate with exercise. Before ablation, seldom above 85 or so. Now the FItbit is saying high 90's low 100's, which doesn't come close to Spencer's rate..... there's a competition no one wants to win.

    I can understand Pixie's concern. Big difference between 100bpm and 150bpm. If I continue to have episodes after this ablation is healed, i might well invest in that Kardia device. It seems that folks that use it are satisfied with its performance. My suggestion about talking to the EP or EP nurse might help clear up some of your concerns.  

  • madeoymary
    madeoymary, April 26,  2019  7:00pm EST

    I am a female 67 years old with paroxymal AFib. I had an AFib episode a couple of weeks ago lasting about 25 hours. It came and went during this time. Went to ER and when they took chest X-ray there was some fluid outside of my lungs. I have AFib with RVR. The RVR  of course causes the heart to beat out of control. Never had this happen before. I guess I just waited too long to go to ER. They didn't give me a diuretic...the fluid dissipated on its own. I went to see nurse practitioner at my EP office and started Flecainide 50 mg 2x/day and diltiazem 120 mg ER 1x/day. Still on Eliquis 5 mg 2x/day. I was just taking the Eliqquis and Metoprolol 25 mg 2x/day. She took me off of the Metoprolol. I am doing pretty good on the new meds. My burning question is do I have permanent heart failure or was  this just because of the AFib episode? The NP did not mention it. This scares me so much. Note; At the hospital I converted to NSR in 3 hours. Heart failure is something that to me is very, very frightening. SCARED!!   

  • Thumper2
    Thumper2, April 27,  2019  8:46am EST

    madeoymary, I agree that the phrase, "heart failure," is scarey.  However, I think you might benefit from going on-line and reading about it on, say, Wikipedia, the Mayo Clinic site, and similar sources.  Use such information to formulate questions for your NP and EP.   Tell them you need to know what your prognosis is.  Let us know!

    One other thought:  have you  been tested for sleep apnea?  Do you use a CPAP?  AFib is negatively affected by sleep apnea.

    All the best,  Thumper2 (Judy)

  • MellanieSAF
    MellanieSAF, April 27,  2019  11:45am EST


    Who told you that you have heart failure and how did they determine it? I'm not sure they can know without an echocardiogram or cardiac MRI.

    Having a lot of afib can cause the heart to go into heart failure, but surgery or ablation to stop the afib can reverse it.


  • madeoymary
    madeoymary, April 28,  2019  7:55am EST

    Thanks everyone. Mellanie I feel much better knowing if in fact it is heart failure it can be reversed. Judy I do not have sleep apnea. Just this change to RVR with the Afib. Everyone 's kind replies have helped so much. 

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