I am a 56 old male with lone paroxysmal atrial fibrillation and usually get AF once a week for about 12 hours. I totally failed rhythm control and am now on rate control which at least allows me to be normal most of the time. Two nights ago I had af all-night which I always find very uncomfortable and much more noticeable when trying to sleep. When I did get to sleep I was awakened four times struggling to breathe, sweating, moderate chest pain and mild nausea. I managed to measure my pulse on waking from one of these episodes and it was 60 and rising fast but I suspect it was a lot lower before I got the monitor on. It was certainly scary enough to get the adrenaline flowing and push my heart rate way up (120). I went to the doctor in the morning, back in rhythm of course (hate disturbing people at night) who sent me to hospital where they put me on an overnight monitor to see how low my pulse rate was going. The only problem was that every time my rate droped below 47 the bradycardia alarm would go off and wake me up. The cardio was not impressed next morning. At least I got a stress test while I was in hospital which showed that there was no problem at all with my heart. I'm due for a cryo ablation in about four months and most of the time coping pretty well. This site has been a real help but boy AF can still be frightening in the middle of the night.
Cardio wants me to call an ambulance if it happens again so they can monitor while it's happening.
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kakapo
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What drugs do you take? Does your heart go very fast when in AF? My AF is where my heart goes out of rhythm and never goes above 95 in a resting state. I was wrongly given Bisoprolol
And Flecainade by the cardiologist because he assumed I had the fast type. I nearly died but for the fast action of a nurse in Sainsburys. My new GP has taken me off all medication I feel much better my resting heart is now around 68 instead of in the 50s. I had an AF yesterday but got rid of it by playing badminton! By increasing my heart rate to over 100. I think mine type is more unusual. I have had it since a teenager on and off.
I think the cardio is quite right. Any sweating and chest pain should be investigated. I do hope you are on adequate anticoagulation as I am sure that you know that stroke is a major risk in AF. You didn't say which rate control drug you are on, but sadly this sort of thing happens sometimes where slowing the heart down works rather too well.. I have heard of patients being put on say bisoprolol and then when their heart rate dips to sub 40 doctors talk about pacemakers. DOOOH? Stop the bisoprolol and try something different.
Hi Kakapo, The stories here are all so different, but one thing I have learned is that the cardios are all different too! Not one of the four I've seen say the same thing. Keep going - "bothering" until you find what feels right.
First AF episode (3 years ago) they wanted me on Tenormin (Betablockers) everyday 2x day - after one episode. I said I'd prefer to see how things go, he replied, "in that case no point in coming to see me." Needless to say I didn't go back. Episodes coming more often I started researching again and saw a new cardio who said it was "just my little palpitations". I finished that night in ER with 180BPM and 9 hour AF. They put me on a killer dose (for me) of flecainide 150mg 2x day. I stopped until I saw the cardio on Monday who agreed it was a dose for a horse, went down to 50mg 2x day and still too much. AF Episodes coming now about 1-2x per month with tachycardia (the small ones I am not sure how often) but I am sustaining a rate of 85-100 all day when I am usually about 75bpm. In June they tried everything starting with Magnesium, Lopressor, Belok, Digoxin, finally Flecainide 100mg IV worked.
All that said, after three years and being told it was just little palpitations I have tested myself on a borrowed event monitor and see that my heart rate varies often and then the occasional very disturbing AF sessions with tachycardia. I am now being offered an ablation, which the 2nd doctor said, oh these are serious procedures, shouldn't be done lightly. The third said he could do it next week (a bit fast for me when still studying the problem). The fourth has studied my case well and thinks ablation is the right path. I like him, trust him and he is one of the best. Still trying to get the nerve to do the ablation.
No one agrees on medications either, all I know is you must be your own advocate, and we must abandon the idea we are bothering people. I too used to stay home and sit out the episode alone, breathing, staying calm. I am so good at it I surprise the doctors in ER as I am very calm. I had a repeat the night before Christmas (you can read my poem on this site!) and I did what the last doctor recommended which was to start with Metoprolol and add in Flecainide. It took about 2 1/2 hours but it worked, I cardioconverted for the first time at home in less than 9 hours! We cannot "try" meds based on what others do as each of our types of SVT or AF are different, you must find a doctor who can see your ECGs or monitor reports. My Holter monitors never showed anything, which is why I finally chose to go to the hospital to get the darn recording of the episodes - and my case has been given it's proper attention now.
It is our quality of life that is effected and we must make that understood, it isn't whining, it isn't a minor detail. Keep seeking until you find what you need.
Do not get discouraged. And believe me I know that is easier said than done. I had cryo done last March and have not had an episode since. I do get skip but never go into AFib. I am on no heart meds. Had a seizure and that is when I was diagnosed with AFib when my pulse went up to 202 and very erratic. So my point in telling you that is that I am on seizure meds, Pradaxa and Xanax for anxiety. Oh and a small dose of Lipitor. Before the cryo ablation, I was on lots of stuff. So there is a light at the end of the tunnel. Good luck.
I am on digoxin metoprolol diltiazem and aspirin.chad score zero. I tried to exercise my way out of the last attack but stopped after a couple of minutes when my heart rate went up to 200. My cardiologist wants me to increase the dose to keep the heart rate down during AF but when I was on the higher dose I just couldn't function.. I don't normally go below 45 but have been down to 37 and he says that's fine, but it doesn't feel that way.
Sorry about the grotty weather in England at the moment. It was 33° Celsius yesterday which is actually a bit too warm.
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AF query
What happens next please?
cardio version 
When to dial 999 and/or go to A & E - and when to just ride it out at home?
