I have atrial fibrillation, and my reports say narrow QRS. Kindly help me.

Hi doctor,

I have atrial fibrillation, and I recently had an ablation. I first had atrial fibrillation on three years ago. I was put on blood thinners and cardioverted a month later. I did not have another episode until last year and cardioverted again. I had another cardioversion after four months and then again this year beginning. I went into atrial fibrillation again two months ago and was in the hospital for three days as I would not cardiovert back. Eventually did and moved up the ablation list. I had an ablation last month. I am having symptoms after ablation in reaction (I thought) to Rythmol. I went off Rythmol, and the symptoms did not end. I had tests (stress, echocardiogram, Holter, blood) done. I do not understand the reports completely, but I am scared they are wrong. I am taking Edoxaban 60 mg and Paxil 10 mg. I am attaching the reports. Kindly help me.

Hi doctor,

Thank you. All the medicines are just Edoxaban 60 mg and Paxil 10 mg. That is it except for Vitamins. In my Holter report, What is "narrow QRS"? Is it good or bad? What are non-specific ST abnormalities? Is it good or bad? The RR variability numbers are low. The SDNN and especially the pNN50. These things make me feel very uneasy and like I am a candidate for a heart attack soon. Kindly give your opinion.

Hi doctor,

Thank you. But the internet says low HR variability is a risk of death. What about non-specific ST abnormalities? I know this is bad, but how bad? RR variability that is low like mine is bad so says the internet. It says low is a high risk for death. Also, non-specific ST abnormalities? I know that is bad, but how bad? Kindly give your opinion.

Hi doctor,

Thank you. On the echocardiogram, it says that my EF is 76%. That is too high. This is a sign of a type of heart disease. Also, the report at the top says everything is normal, but there are quite a few things outside normal. For instance, the IVSd is 12 (normal is 6 to 10). How is this not a problem? My symptoms that I believe are heart-related are light headed after climbing one flight of stairs. Stay that way and maybe have a bit of headache for five to ten seconds. I can do Stairmaster for 15 minutes and stationary bike for half an hour and hike all day with no problem. If I stop a vigorous exercise, I may feel lightheaded. I believe it is either my blood pressure. I have always had a little high blood pressure (135/87) until I lost 35 pounds in the last six months, and since then, my blood pressure has dips low sometimes (110/70 mmHg) or even down to (90/60 mmHg), and this is not enough pressure for me maybe. After a strenuous bike ride, it will drop below 90/60 mmHg for a little while. My heart rate does not go up like a normal person's. I am very out of breath, but I am doing a heavy workload (more than most others do), but my heart will not go past about 130. And then it does not recover very quickly (see HRR on stress test was only 6). It might be 8 when I measure it. My resting is 75 to 80 bpm since my ablation. It was 60 to 65 bpm before ablation. My heart used to go up to 135 bpm prior to ablation (and maybe prior to COVID time and gyms being closed). Can some of my troubles be related to the ablation and recovery. The cardiologist did not tell me anything about recovery and side effects. He does not tell me anything. I did take Rythmol for three weeks post-ablation but was taken off it due to apparent side effects. Dizzyness (that did not go away), double vision, multiple visual migraines (I still get three a week. I got 10 in the eight days post-ablation). I am somewhat out of breath sometimes, too that does not seem natural. Kindly give your opinion.

Thank you doctor,

Thank you. So, my low heart rate variability and low heart rate recovery is not a big deal. I read online that low values in those 2 things are bad signs and predictive of death. I think they are related because they both rely on the vagal nerve. I catch my breath quickly after vigorous exercise and I am breathing normally in 15 to 20 seconds , but my heart rate does not come down. It takes about 10 minutes to get from 130 beats per minute to 90 beats per minute. Also, I have taken Bisoprolol in the past, but my blood pressure and heart rate go too high. My resting heart rate will not go too low as it is higher since the ablation. What other things could cause dizziness when I get up and go up to the stairs? A nurse at the clinic suggested that I may have a clogged Carotid artery?? Heart rate went too low on Bisoprolol. But now maybe it will not become low due to raised resting heart rate due to ablation. I just received another Holter Result five months back. It is attached. I am concerned with "Second degree AV Block Mobitz 1 and 2:1 Av Block seen sleeping" and "There were no pauses greater than 2 seconds" and the it says "longest pause 2.306 seconds" and further down it says 33 pauses less 2 secs.

Thank you doctor,

Why are the pauses particularly alarming? Now on the most recent holter, I had no pauses and no av block. Why? Where did the pauses go? Where did the av blocks go? This holter was before the first one I originally sent you. Did my afib ablation make them go away? Why are pauses worrisome? They were at night when my heart went down into 40 seconds. Could I die in my sleep from pauses? The holter I just sent you is done five months back. It is prior to my ablation. The first holter I sent you is after my ablation. Why are there no pauses on my newer holter and no more av block? And you say “high degree” block. What do the type I have to do to me and what does a high degree do? Will mine become a high degree?

Thank you doctor,

On my blood work, my platelets were 445 ×103/µL. This is high. What does this mean? Should I be worried? Does it raise my stroke risk because blood is more likely to clot?

Thank you doctor,

What do you think? I should ask my doctor regarding my lightheadedness upon climbing a flight of stairs and upon standing up.