Do I feel breathless and heaviness in the chest due to atrial fibrillation diagnosed in my late thirties?

Question

Hi doctor,

I was born with a hole in my heart (ventricular septal defect) and a murmur. I never had it closed, and the hole is small now. In my late thirties, I was diagnosed with atrial fibrillation, as my heart kept suddenly speeding up (it took a while because it was not constant, so I had a loop recorder). Since then, it has been pretty well controlled with Bisoprolol 5 ml and Flecainide 100 mg. I am now 51-years-old, and my heart has been doing weird things for me for the last few weeks. It has been going out of rhythm for long periods and having multiple ectopic beats. These make me breathless, with heaviness in my chest. They also wake me up and leave me feeling dreadful. Like I have been run over by a truck. My cardiologist keeps fobbing me off. In the end, he told me to go to the emergency department. Of course, when I got there, my heart was back to normal. And my ECG is always normal. He wants to put me on a Holter monitor. My physician put my Flecainide up to three days, twice a day, which helped for a week, but these unusual episodes have started again. I took Flecainide for four days, twice a day, but that made me feel dreadful. I am frightened. Kindly help.

Answer 1

Hi,

Welcome back to icliniq.com.

I understand your concern. It seems you have episodes of paroxysmal atrial fibrillation as per your history. It will have been better if you have uploaded ECG (electrocardiogram). Tablet Flecainide is used for paroxysmal atrial fibrillation in an otherwise normal heart without structural and functional abnormality. In my opinion, Holter monitoring is a must to see arrhythmia. In place of tablet Flecainide, I suggest tablet Dilzem CD (Diltiazem) 90 mg once daily started, continue tablet Bisoprolol (Bisoprolol Fumarate) 5 mg. If it is still not controlled, the Bisoprolol dose is titred to 7.5 mg. I also suggest a 2D echocardiogram and Holter monitor. Finally, an electrophysiology study by an electrophysiologist to find if there is any abnormal pathway. Therefore, radiofrequency ablation is suggested after the results. Kindly revert in case of further queries.

Answer 2

Hi,

Welcome back to icliniq.com.

I understand your concern. I think the diagnosis of the type of arrhythmia is required. For that 2D echocardiogram and Holter monitor are suggested. Seven days of real-time Holter monitoring devices will pick up your abnormal episodes. There are some arrhythmias like VT (ventricular tachycardia), NSVT (non-sustained ventricular tachycardia), VF (ventricular fibrillation), which can be fatal, so we need to rule them out. I also suggest tablet Amiodarone if required in your case. I hope you get well soon.

Do I feel breathless and heaviness in the chest due to atrial fibrillation diagnosed in my late thirties?

Ask your health query to a doctor online

Company

Customer Care

Get iCliniq