Atrial Fibrillation

Hi all. I’ll try to keep this as short as possible.

History: Female, age 27
Frequent ventricular ectopic beats - many in consecutive runs of upto 9
Two sets of 5-day holter monitoring revealed short bursts of atrial and ventricular fibrillation
Continuous resting heartrate of 100-105 BPM
Consistent history of low blood pressure
Waking in the night with heart racing - 177 BPM recorded
Frequent attacks of STV, palpitations and bradycardia (figures for brady unknown)
Occasional night-time attacks not yet recorded but basically syncope symptoms

Have had Implantable Loop Recorder for 7 weeks

A few days ago, I woke around 9am, feeling very unwell. Completely unable to get out of bed without passing out. Profuse sweating, retching (without vomiting), a feeling of moving in different directions even though stationary. Most worryingly, heart at times felt very slow and other times very fast. Fighting consciousness throughout.

Took 3 hours to get out of bed. Phoned GP & received home visit. Speech slurred, still drowsy/battling to stay conscious. GP called ambulance & subsequently assessed at A&E and admitted to coronary care.

Bloodwork generally ok. Have been getting chest pains/discomfort intermittently for several weeks but worse over the week prior to admission.

Cut to the chase…

Info downloaded from IRL reveals "nothing of clinical significance" according to the doctor in CCU, however info from the device shows that on that particular morning, my fastest heartrate was in the 140s and the lowest was 62. The doctor claims that anything between 40-200 is normal.

Given that the RESTING heart rate is 100-105 as a permanent thing, and I was in bed throughout - how can an increase of 40 BPM and a decrease of 40 BPM be normal?
Formely_Bob. Thank you for your input. I doubt a stroke is likely as the slurred speech wore off after a couple of hours; There was no weakness or numbness in either side of my body. I assume CCU would have taken any possibility of a stoke into consideration and investigated the liklihood?
Stephen, thank you also for your contribution. I feel it’s significant but the doctors are telling me that nothing significant is going on… and yet the symptoms and heart rates/rhythms contradict that. With regards to thyroid function, YES that’s been very much on my mind lately. For 3-4 months my face burns after eating - usually in the evening and even after a small amount of food such as an apple. I’ve mentioned this countless times to doctors but it has been repeatedly shrugged off even though my Mum has had hyperthyroism at my age, developed a goitre which was subsequently removed along with half her thyroid and now has hypothyroidism and is on thyroxine for life.

I haven’t heard of sick sinus syndrome but will investigate. I’m due to see my own cardiologist in the next few weeks and will endeavour to get some answers.
Gangadharan nair, Thank you also for your input. I’d never heard of POTS until you mentioned it and it all sounds horribly familiar. That said, a lot of heart conditions sound familiar, particularly Long QT (I forgot to mention in the OP that I apparently have a prolonged QT interval). I’ll discuss it with my cardiologist. Thank you.

What’s normal for a population may have little relevance about what’s normal for you, but i think what the doc probably meant is that the observed pulse rates would not be a plausible cause of your symptoms. Your symptoms look like you might have had a mini stroke. The loop recorder would not directly detect a stroke, but a stroke could certainly cause a sudden change in the pulse rate. Ask your GP about the possibility of a stroke and also if it might be worthwhile to see a neurologist.

Additional info: A transient ischemic attack is a stroke that has temporary symptoms that do not last more than a few hours. Since these are minor stokes to begin with, the symptoms can something as subtle as sudden dizziness and fatigue that goes away within a few minutes. People commonly have no more than a few of the possible symptoms at one time.

There would have been no diagnostic symptoms of a TIA by the time you went to the CCU except possibly abnormal EEG pattern in the brain. If they did not hook up an EEG, they would not have detected a TIA. Also, everything reported to the CCU was probably assumed to be a cardiac event, TIA-type symptoms were gone, and its possible no one even considered a stroke. Anyhow, it makes sense to me that a group of people focused on a cardiac event might not even consider this, since a TIA is a neurological event. It still might be worth mentioning to your doc, but at this point, there is no way to know if you had a TIA or not. If i were in your situation, i would to make sure the docs looked into a potential clotting problem. The neurological symptoms of TIA and sick sinus syndrome are identical since they both cause a blood shortage to the brain - just different reasons.