Would afib cause near fainting?

Before I got my pacemaker a year ago, I had had several episodes where I almost fainted while on the golf course. I would get dizzy and very light headed. They finally diagnosed it as Tachy/Brady syndrome and since getting the pacemaker that situation did not recur. That is, until a couple of months ago. They put me on a month long heart monitor in October but nothing happened during that month - just one shortness of breath incident. Today on the golf course I got the same near faint situation as before the pacemaker. My annual pacemaker check was last week and I was told all looked good. I had a number of occurrences of afib during the year but with 2 exceptions they were of very short duration. My question now is would afib (which I almost never notice when happening) still cause these episodes where I feel like I am not getting enough blood flow or oxygen to the brain? Shouldn't my pacemaker stop that from happening? My settings are 60 low and 130 high. Is 130 maybe not high enough? I am 65 years old and otherwise in good health and exercise or golf daily.

2 Comments

About afib and medication

by Theknotguy - 2014-11-09 08:11:06

Your question reminds me of when I was talking with my sleep doctor. I was asking if the sleep apnea was causing a blip on the graph. He pointed out my heart disease was causing a problem and the CPAP was recording the event. So the cause was something else other than sleep apnea.

Your afib doesn't cause dizziness per se, but doing an activity at the same time you have afib means you don't get a good heartbeat can cause dizziness. The dizziness can be caused by a lack of blood flow to the brain and a decrease of blood pressure. Both of which are results of afib. So if you were to quickly stand up at the same time the afib prevents your heart from getting a good beat, you'll get dizzy - real quickly. A corresponding drop in blood pressure at the same time you are doing some activity can result in an out of breath feeling. Once again, the afib doesn't cause the feeling but the effects of afib create the problem.

I suffer from afib too. My sessions in afib last anywhere from four hours up to 24 hours at a time. I'm also one of those rare people who can feel when they go into afib. I can also feel when I am in afib, can recognize the kind of afib, and can tell when it stops. Have gotten into discussions with doctors when they tell me something and it doesn't correspond with what I feel.

Unfortunately the PM by itself won't stop afib. Your questions about a low setting of 60 and a high setting of 130 have nothing to do with your afib sessions. For me, the same settings are fine. However you have a Medtronics which can be programmed with APP (Atrial Preference Pacing) It's a software setting that will create a counter beat and help reduce your afib. I had my APP turned on in May, 2014 and it has reduced the number of afib sessions I had. APP isn't an instantaneous fix, I felt it was reducing my afib sessions over the months but wasn't able to confirm that until I had my PM reading in November.

The next item to discuss is your Flecanide. I'd have a serious talk with your EP/cardiologist. If you look at some of the studies on Flecanide, it can have some nasty side effects. Flecanide works with electrolites. I was on Flecanide and started passing out.

I had had two previous sessions where I passed out while on the trail. First was a down/up session where I went down but got right back up. Second session I was trying to figure out why I was hearing crickets in my bedroom when I figured out I was lying on the trail. That's when I discovered I had passed out. Don't know how long I was out. Dogs were licking my face. I talked with my cardiologist - he didn't seem concerned and tested me for mitral valve regurgitation. Since he didn't seem too concerned, I wasn't concerned. Shoulda paid more attention. This all happened before I had my PM.

I was dehydrated before starting the last walk with the dogs. Was fighting off some kind of mild flu or bug. Made it 3 1/2 miles with the dogs. Last thing I remembered was seeing two bewildered dogs. Next thing I knew they were waking me up in the hospital after six days. The doctors said I had a "heart event". Nearest thing I can figure out was that my electrolites went wacko, then I went into ventral fib. Heart rate was 20 when they got to me with no blood pressure. Ventral fib will kill you - I died in the ambulance - died again in the ER. They said I wouldn't have survived except for the amount of exercise I had been doing. Needless to say, doctor took me off Flecanide.

My wife is on Flecanide - doctor says she doesn't have to worry about the side effects I had but I'm watching. So I'd suggest you have a serious discussion about Flecanide. In looking what you have written, the near fainting spells set off all sorts of red flags for me.

In the meantime I'd make sure I was well hydrated before going out on the golf course. I'd also have the exits charted from the golf course to the closest hospital. I'd also have my friends aware of the situation and have the local EMT's alerted. The PM will stop a complete heart stoppage, but I'm not sure of other side effects.

Hope they can find out what is happening to you.

Thank you to Theknotguy

by mkaz03 - 2014-11-10 11:11:40

Thank you for your input. I did not expect the pacemaker to stop my afib but I did think by keeping my heart rate at 60 I would no longer have those near faint conditions. I now see that this is likely due to low blood pressure. I am already naturally on the low side 100/70 so it is probable the beta blocker I am on for the afib (Sotalol) is causing it to go even lower. I also took Benadryl for allergies on the day this happened and I now see where that is contraindicated when one is on Sotalol and Eliquis. I have a cardiology appointment on Friday to hopefully get to the root of this. Thanks again for your insight.

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