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Trimaster61, April 21,  2019  1:25pm EST

Trying to figure it out

Approximately 2 weeks ago, I woke up with tightness in my chest and a ~158 HR.  I went to the ER and was diagnosed with Afib.   It took 18 hours to come out of Afib naturally.  HR climbed as high as 189 and came back down, hovering in the 158 range with meds.    Prior to this episode, I was experiencing odd things like: 1) HR would skip beats irratically but I never really felt that bad; and 2) when I worked out on my Pelaton, periodically (especially with high internval training) my HR would suddenly jump from  158 on average to 180-190s and then decline back with deep breaths in about 20 seconds.   This would happen once during a 30 minute workout.   

After the ER visit, they put me on a different Beta blocker (already had HBP), added Metoprolol and Eliquist.   I walk to work every day (10K steps or so) and now with the meds, my HR drops as low as high 50s and once it did the spike thing into the 128 range while walking.   For the most part my symptoms are irregular heartbeat (beat 30 times, skip, then beat 6 times and skip, then 3 times skip and then back to 30-40 beats before skipping).   I have been doing workouts with slower ramp ups and not doing high interval training and I have not experienced the high racing HR since the ER visit.

I saw a specialist for Ablation (best in Boston) and I have scheduled the surgery for November.     My cardiologist has asked if this is too soon and if one major Afib episode is enough to warrant an Ablation now.   In the interim, I am seeking to lose 20 lbs and have cut out coffee, wine, and salt as much as possible.   I am 223 lbs and around 6 feet.   I have had high blood pressure since I was  18.     The good news is that my heart tests revealed no other issues other than the Afib.

Is an Ablation really necessary now?  THe Metoprolol makes me feel weird and my BP drops pretty low and makes my chest feel like I cant get air when my Heartbeat skips when walking to work.   I cut the amount in half and it helped.   

Any thoughts?

  • Heartfe6878
    Heartfe6878, April 21,  2019  1:42pm EST

    Did you work up your thyroid? and any infection in the body? Finding the triggers are one of the important things....I drink gerosteiner water each day for tth minerals and electrolytes....The flip side of metropolol is the cardizem and potassiussm.....It is another avenue for rate control....Acupuncture can be helful to help relax the body....But the hydration is one of the big pieces....Getting a second opinion before any surgery is a good idea.....Just bits and bob that might help...

  • windward
    windward, April 21,  2019  2:05pm EST

    May I ask who your Boston Ablation specialist is?  I know it is not much fun taking the drugs as most of them have side effects but since this is your first Afib event you may want to drop the weight, cut the coffee, wine and salt first and see how that works out. I wouldn't rush into an Ablation.  Good luck on your decision,


  • Arline3366
    Arline3366, April 21,  2019  2:59pm EST

    Hi -- Metroprolol caused me to have shortness of breath -- any exertion, walking, working in yard, etc. and I was out of breath very quickly.  There are other beta blockers.


  • TexyMexy
    TexyMexy, April 21,  2019  5:30pm EST

    One episode of AFib and you are rushing to an Ablation.  Give it time to see how it turns out.  The meds might control it just fine.  I would wait to see what happens.  Sometimes an Ablation does not work..and you have to repeat them.  Your body will adjust to the meds too.

  • Trimaster61
    Trimaster61, April 21,  2019  9:58pm EST

    Noted!   Thanks for the responses.   It seems a bit pre-mature on the Ablation, but both docs seemed to suggest that I was a good candidate given my age (58) and they stated it will only get worse as I become older.   I am going to see how much I can address Afib by diet, no salt, achohol, and coffee.   

    I do have one other question.   When my heart rate falls into the 50s, I get this little pain in my chest that never happened before.   Is this a side effect from the medication?

    Thanks all.   Any additional thoughts are appreciated.  



  • DkinAA
    DkinAA, April 22,  2019  7:08am EST

    Also, it’s a good idea to get a sleep study to check for apnea - treating this can help a lot with afib together with weight loss. 

    My afib seems pretty well controlled so I’m not looking to an ablation yet, but I gather from various experts available through this site that doing ablation vs rate control is mainly a quality of life issue - 

  • shafiq48
    shafiq48, April 22,  2019  9:37am EST

    As a general principle the EPs try controlling AF by medicines. In case it doesn’t effect sufficiently then they go for ablation as a second option. Ablation is a good alternative  but preferably after exhausting medicines’ option 


  • Heartfe6878
    Heartfe6878, April 22,  2019  2:01pm EST

    Any things that you note about your pain  etc should be shared with a EP or cardiolgist...Have they done a 2 week Zio Patch on your or a e patch study that shows how many times you are in and out of afib and will also show other arrythmias? Good idea....Also. I would get the Alivecor app on my phone and get a recording of anything out of the ordinary so you can email your EP and also have a record and start tracking your afib...It is worth the money...Also ther eis a Apple $ watch that is worth looking into....

  • Thumper2
    Thumper2, April 23,  2019  8:50am EST

    Trimaster61, in addition to the good advice already offered here, I'll repeat my mantra -- in my AFib experience, I had few symptoms and was on meds for some years.  By the time I got to an EP and had ablations, they did no good.  My heart had remodeled itself in negative ways.  Ablations are not surgery (they are a "procedure") and sometimes do not even involve an overnight hospital stay.  All the best!

    Thumper2 (Judy)

  • Jfilleti
    Jfilleti, September 15,  2019  3:10am EST

    Hi, I’m located in Boston and had to ask who the specialist you are seeing is as I’m only seeing a cardiologist and want to seek out an EP. 



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