Age: 68.0
Sex: M
Vaccine: COVID19-2
Symptoms: Sleep disorder
Clinical narrative: On 9/20/2022, I woke up to three alerts on my smart watch from 2:30AM, 4:30AM, and 6:30AM indicating that I was in possible atrial fibrillation. This was the first time it had ever happened. I stayed in atrial fibrillation until about 10:24AM that morning. I reported this to my cardiologist. I saw my cardiologist on 10/20/2022; I underwent an EKG, and no atrial fibrillation was indicated. However, my heartrate was elevated. The cardiologist didn't want to prescribe anything for atrial fibrillation without seeing indications of it, so it would have to be detected on an EKG first. He told me that if my watch ever detected possible atrial fibrillation again, I could come to his office and undergo an EKG. On 11/09/2022, I began to get possible atrial fibrillation alerts at 9:15PM. At 9:47PM, I used my watch to run an ECG, and it indicated that I was in atrial fibrillation. I ran a series of these until the morning of 11/10/2022. At 10:15AM that morning, I was still in atrial fibrillation. I went to my cardiologist's office to undergo an EKG, and by the time I had made it there, the atrial fibrillation was gone. On 1/26/2023, I got possible atrial fibrillation alerts starting at 4:45AM. The last time I took an ECG that morning was at 9:57AM. I assumed that the atrial fibrillation went away about then, because I didn't get any more alerts that day. On 2/4/2023 at 2:45AM, I began getting atrial fibrillation alerts again. This time, they didn't go away by 10:30AM. I continued to get warnings for possible atrial fibrillation. I made an appointment at an urgent care, where I underwent an EKG and was diagnosed with atrial fibrillation with atrial flutter. I was advised to then go to the emergency room. At the ER, I underwent an EKG and was diagnosed with atrial fibrillation. I was hooked up to monitors; during this time, my heartrate jumped from around 110 to around 163. I later found out that I was in danger of a heart attack, stroke, or heart failure. I was given diltiazem and Eliquis. When my heartrate didn't go down quickly, I was given another infusion of diltiazem. I had also been given diltiazem to take orally with the first infusion. After the second infusion, my heartrate went below 100. They decided that my condition was stable enough that it was safe to release me to go home. On 3/5/2023, I switched from Eliquis to Xarelto. On 3/6/2023, I saw my cardiologist. He told me I should undergo a sleep apnea test, which I am scheduled to complete in the near future. He instructed me to continue with my current medication and said that he would see me for a follow-up in three months. When I was put on the diltiazem, I was taken off of amlodipine, which I had previously been taking. They told me that diltiazem and amlodipine don't interact well with each other. I asked my cardiologist if I would be on the diltiazem forever, and he said, "We'll see." He would also like to learn over the next few months what my atrial fibrillation burden is. From the time I got the first alert on my watch to the time I ended up in the ER, I never had any physical symptoms of atrial fibrillation or heart problems. If it weren't for my smart watch, I wouldn't even be aware of it.