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What causes persistent high blood pressure when diagnosed with atrial fibrillation?

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Posted on Wed, 28 Dec 2016
Question: I had a Holter monitor a year ago and it was normal. I have high blood pressure and for the last 2 months was put on new medication to control my blood pressure but it's still high(160's). The medication had many side effects. My Cardiology gave me another Holter monitor and it showed Atrial Fibrillation. He took me off the medication and started new ones. He want me to use pacemaker. I think it's the medication.
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Answered by Dr. Rishu Saxena (1 hour later)
Brief Answer:
No its not the medication ,its hypertension and other risk factors

Detailed Answer:
Hi
Have noted all your details


Atrial fibrillation is an abnormal heart rhythm characterized by rapid and irregular beating. Often it starts as brief periods of abnormal beating which become longer and possibly constant over time called chronic or persistent atrial fibrillation.

High blood pressure and valvular heart disease are the most common alterable risk factors for AF.You are a hyptensive and was on medication for that,Hypertension as i said is one of the most common risk factor for atrial fibrillation.
I have noted details of all the antihypertensives you were on for two months and none of them have atrial fibrillation as a side effect ,Zetia 10mg causes palpitation in few cases but atrial fibrillation as such is not caused by it in most of the cases.So in my opinion medicines you were on are not responsible for your problem.
Now lets come to treatment part ,
The cornerstones of atrial fibrillation management are rate control and anticoagulation and rhythm control ,The clinical decision to use a rhythm-control or rate-control strategy requires an integrated consideration of several factors, including degree of symptoms, likelihood of successful cardioversion, presence of comorbidities.Most of the patients can be managed succesfully by medication.
Pacemakers are used to treat a slow heart rate (bradycardia) that can happen in people who have atrial fibrillation.
Pacemaker is a indication when

1)You have atrial fibrillation that comes and goes. And you have a fast heart rate when you are in atrial fibrillation and a slow heart rate when you are not in atrial fibrillation. This is called tachy-brady syndrome.

2)You had an AV node ablation procedure that destroyed the AV node in your heart.

3)You have a problem with the natural pacemaker of the heart (AV or SA node).

4)You take a medicine for atrial fibrillation that slows your heart rate too much.

As your holter reports and ecgs are not attached with the question i can assume that you must be having either of the four problems stated above ,thats why your cardiologist wants you to have a pacemaker .

Thank you!!
feel free to ask dear
Dr Rishu Saxena
Resident Cardiologist
(India)
Above answer was peer-reviewed by : Dr. Remy Koshy
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Dr. Rishu Saxena

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Practicing since :2012

Answered : 696 Questions

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What causes persistent high blood pressure when diagnosed with atrial fibrillation?

Brief Answer: No its not the medication ,its hypertension and other risk factors Detailed Answer: Hi Have noted all your details Atrial fibrillation is an abnormal heart rhythm characterized by rapid and irregular beating. Often it starts as brief periods of abnormal beating which become longer and possibly constant over time called chronic or persistent atrial fibrillation. High blood pressure and valvular heart disease are the most common alterable risk factors for AF.You are a hyptensive and was on medication for that,Hypertension as i said is one of the most common risk factor for atrial fibrillation. I have noted details of all the antihypertensives you were on for two months and none of them have atrial fibrillation as a side effect ,Zetia 10mg causes palpitation in few cases but atrial fibrillation as such is not caused by it in most of the cases.So in my opinion medicines you were on are not responsible for your problem. Now lets come to treatment part , The cornerstones of atrial fibrillation management are rate control and anticoagulation and rhythm control ,The clinical decision to use a rhythm-control or rate-control strategy requires an integrated consideration of several factors, including degree of symptoms, likelihood of successful cardioversion, presence of comorbidities.Most of the patients can be managed succesfully by medication. Pacemakers are used to treat a slow heart rate (bradycardia) that can happen in people who have atrial fibrillation. Pacemaker is a indication when 1)You have atrial fibrillation that comes and goes. And you have a fast heart rate when you are in atrial fibrillation and a slow heart rate when you are not in atrial fibrillation. This is called tachy-brady syndrome. 2)You had an AV node ablation procedure that destroyed the AV node in your heart. 3)You have a problem with the natural pacemaker of the heart (AV or SA node). 4)You take a medicine for atrial fibrillation that slows your heart rate too much. As your holter reports and ecgs are not attached with the question i can assume that you must be having either of the four problems stated above ,thats why your cardiologist wants you to have a pacemaker . Thank you!! feel free to ask dear Dr Rishu Saxena Resident Cardiologist (India)