A bit of advice needed please!

Hello - this is my first post in the AF section and I'm hoping for some advice. Almost 4 years ago I had a sudden and frightening SVT which resulted in me being in hospital for a few days. I had a heart scan which showed a moderate mitral regurgitation and was diagnosed with PAF. I was started on 2.5 bisoprolol and aspirin & told the SVT was probably caused by my potassium levels being 'through the floor'

After a shaky few months when the bisoprolol was raised temporarily to 5 I settled on a dose of 2.5.

I've had the occasionally 'odd' feeling and often at night get a faster heart beat but have generally been well.

Yesterday I was having lunch with a friend when I experienced a strange sensation that started in my chest and raised up to my ears- I felt that if it reached the top of my ears I would pass out.. Apparently I turned grey! My heart started racing so I tried to control my breathing and had a glass of water but the sensation came back. We left the cafe but I couldn't get beyond the ground floor and my friend bundled me in a cab and up to a&e. By the time we got there my whole body was shaking uncontrollably and I felt terrible. I had an ECG which showed it wasn't an SVT this time & blood tests but they were clear except the potassium was 'borderline low' I was kept in for a few hours and when my heart rate dropped and the shaking stopped I was discharged & told to see my gp today.

My gp checked my pulse & bp - both fine - and has increased the bisoprolol by 1.25 up to 3.75.

I'm due to go on holiday tuesday to majorca & am wondering if I should go? The doctor just told me to let the insurance company know to check I'd be covered. My main concern is if I felt like I did yesterday while I'm mid air!! I started taking a magnesium supplement last week and wonder if this could have caused it? The a&e doctor said I'd probably never know the cause!

Sorry to write at length .. Hope someone can help!

16 Replies

  • Magnesium should help arrhythmias but low potassium can exacerbate things. Question is was your fast rate regular in which case it isn't AF or a very irregular pulse which probably is. SVT and AF whether paroxysmal or persistent are quite different with one being fast and regular and the other totally chaotic.

    Second point is that IF it is AF then aspirin is not the right thing unless you have other heart problems as it has very little stroke preventative abilities for AF. You need to discuss the need for proper anticoagulation.

    Thirdly , and you won't like this, unless you have a proper diagnosis of the problem I think you will find that the travel insurance people will refuse cover. Normally they like to know what they are covering before they agree to it. Much as i always say don't let it rule your life and go enjoy the holiday this is something that you need to check VERY carefully. Good luck and if they will cover you. go and hang the consequences.


  • If this was me I would up my magnesium and add potassium and taurine.

    Magnesium and potassium go hand in hand. I would take as much magnesium( not mag oxide) as I could bear, splitting the dose between morning and night and add a taurine supplement twice a day too.

    Also, seriously think about buying an Alivecor monitor for your phone. You will be able to see what's happening when it's happening This will help you and you can show your consultant.


    I know this link is for iphone4 but there will be one for you as long as you have a smart phone or iPad.

    Tell your insurance company what you are actually diagnosed with, if it's just PAF then tell them that. They will also want to know if you are awaiting any tests. If you have any trouble

    these are my Insurers, try them;


    I think you'll be fine. Majorca has good hospitals so don't worry and you're only up in the air for two hours, There's no reason why those two hours will be any different to any other two on the ground.

    Go and have a lovely time.

    (A lovely day trip tip is to take the train from Palma to Soller. )

    I wish I was coming with you.


  • Magnesium Citrate

    After reading the recent posts on magnesium supplements I purchased magnesium citrate capsules ( 150 mg) and am taking one per day as a starter. This was the only product available where I shopped.

    Are there more effective options?

  • I agree with Bob. It is a difficult one for us to advise as you say this time it wasn't diagnosed as a an SVT. For sure, you need to check with your insurance as if you need medical attention abroad you will need it and don't forget that you will have to pay up front in Spanish hospitals for some care and then claim it back. I have flown several times and had AF and nothing bad happened, the main thing is to keep calm, however it's not be recommended.

    you haven't said whether or not your GP referred you to a cardiologist. If not, why not? If you have PAF you should be seeing an EP - Electrophysiologist who is a cardiologist with special training in the electrics of the heart.

    If you have PAF you are much more likely to have a stroke, that is why you should be on anticoagulants and not Asprin which is an antiplatelet but if you have another condition with your heart then Asprin is used and very occasionally both are used, but you need a definitive diagnosis. That can be difficult with AF if you only have occasional episodes as you can only prove you have AF through an ECG whilst you are in an episode,

  • I know a lot of people recommend magnesium supplements but it doesn't suit everyone, I cannot take magnesium without encountering serious weakness. It is quite dangerous to take Potasium without being prescribed as it is easy to take too much which will effect your kidneys, especially in older people. (Sorry I don't know how old you are).

    You could safely increase the amount of Potasium by eating more foods rich in Potasium. The one supplement that everyone recommends and I found very useful i COQ10

  • Sorry I also meant to say or Ubiquinol which the refined version of the active ingredient and I find more effective, but more expensive. About £30 a bottle.

    I would also endorse the Alivecor, I bought one of the first edition, they are now at third edition, and it literally saved my husband's life by picking up not only PAF but another condition, he was fitted with a pacemaker after being fast tracked after his GP saw the print out of the Alivecor ECG.

    There are very effective treatments for PAF so if this is what you have the sooner you have treatment, the better. Bisoprolol is a beta blocker so will slow your heartbeat, this can sometimes prevent an episode of fast AF but can also slow the heart down too much. I couldn't tolerate Biso at all, although very strangely it did improve my very low BP.

  • Hi... Sorry to hear about your troubles, it sounds as if you've had a very strange turn and it's hard I guess for the doctors to know whether your heart started racing because of your worry about the way you were feeling, or whether the heart racing caused the problem, and indeed if the shaking was your very understandable reaction to feeling so odd. I used to get panic attacks when I was younger (really the onset of a dust allergy) that made me feel absolutely dreadful and my heart used to pound like anything.

    It certainly sounds as if your GP is treating it more like a 'one off' issue than a recurrence of AF, I wouldn't even know how to describe what you experienced to a travel insurance company, 'funny turn' doesn't cover it... It could even be an allergic reaction to something, or the low potassium causing the feeling, a thousand different things I'm sure, the body is a complex thing as we all know all too well.

    It sounds as if unless it keeps recurring, which we have to hope it doesn't, the doctors won't go looking for a cause so I guess that means they aren't overly concerned at the moment. All you can do insurance wise is report what A&E said, potassium is borderline low and it wasn't an SVT, and see what they say I think. Certainly if they're okay with it I wouldn't worry about the trip - two hours on a plane is nothing, and perhaps a lovely holiday in the sun somewhere with good hospitals will relax you after what sounds like a horrible experience.

  • I think I recognise the sensation you describe, in my case it was put down to a spasm of one of the arteries which feels like angina but isn't caused by furring up. I have had the night speedup too. I also have mitral valve regurgitation and PAF.

    I also have IBS, much improved funnily enough by the meds I am on now, propafenone plus a big dose of Diltiazem as I can't have a beta blocker.

    If I were you I would really want to know what caused the low potassium. Maybe a food diary would help? I guess use of laxatives or frequent upset digestion is too obvious a culprit.

    I can recommend the Alivecor as well, really worth it if you have PAF or any other occasional arrhythmia.

    Sorry, probably not really helpful but I thought you would like to know there is someone who knows what you are going through....

  • Thank you everyone for your comments and for taking the time to share your knowledge with me! I should've said that I'm 62 this month and have an underactive thyroid - im sure this is linked with AF!

    Since my first episode 4 years ago I've been more or less trouble free until this one. I see a heart consultant privately on my health insurance but I'm not sure he's an EP. I'll check! He couldn't see me at his weekly clinic yesterday but I'm booked in for 3 weeks time & he okayed the increase in bisoprolol & said I'd be fine to go away. I flew to New York when newly diagnosed and still not feeling well so I'm sure a short hop will be fine and a week in the sunshine will be a tonic!

    My original diagnosis was PAF which is what ive told the insurance about - the SVT was a regular exceptionally fast heartbeat (230bpm) whereas on Wednesday it was irregular and all over the place! I've got a heartbeat app on my phone but will look at alivecor now - could be my birthday present!!

    Many thanks!

  • On a different note to the others I would phone up your travel insurance company and ask do they want to just pay for the holiday cancellation or will they take the risk on needing to pay for treatment for you whilst abroad. Spanish hospitals can get seriously expensive and many refuse the EIB card even though they are supposed to accept it.

  • Hi there, so sorry to hear you have been having problems. Your experience sounds very similar to my first full blown episode, I too was in a cafe and ended in A&E, exactly 6 years to the day (yesterday) as you. I was diagnosed with PAF. (SVT kicked in a couple of years later just to add to the mix).

    One month later I flew to Spain, I was concerned but had a wonderful holiday with no return of symptoms. To be honest my travel insurance company were ok with it perhaps because I had already got an annual insurance in place before diagnosis and a letter from the hospital confirming the diagnosis. These days things have tightened so your insurers may or may not be happy to cover you.

    I also had an episode a number of years later which put me in hospital the night before we were due to fly to Majorca so had to cancel. They paid out without a squeak from them.

    I have a friend who had his first AF episode while on holiday in Majorca. The hospital there were brilliant, diagnosed him did loads of tests and kept him for two days to ensure he was back to health. He has been to Majorca many times since as he was so comfortable to be there if he needed medical care again.

    So in essence if your insurers are ok with it and you feel able to go then go for it. Stress is the work thing for you so you will need to keep calm, well hydrated on the flight and get your feet moving on board, all the normal things we would be expected to do on board a plane.

    Anticoagulation is a must hope they have you on an anticoagulant.

    Sorry you are going through this and the timing is a bummer too. Take care, be well.


  • Just to add a bit more....

    What you described sounded like a 'pause'. When I was finally diagnosed with PAF (my previous GP practice - saw 2 different doctors over a period of time - did not pick it up), the GP I saw whilst on holiday in Scotland explained that the AF can also cause the heart to pause for a few seconds which results in the symptoms you described. She got me into the local hospital who agreed with the PAF diagnosis and transferred me to Aberdeen Royal Infirmary where the heart specialist confirmed it. They fitted me with a pacemaker which stopped the pauses completely. The AF is 'controlled' by Bisoprolol but it does not stop it fully. I am on the maximum dose and still get an occasional 'blip' of AF but find that exercise usually brings my heart rate back to normal.

    I think the thing to remember is that PAF in itself is not life threatening provided it is controlled by medication, although it's a bit alarming when it happens.

    Just a word of warning about magnesium and potassium. Magnesium has been discussed quite a lot on this forum so I thought it might be worth trying. I spoke to my pharmacist and her reaction was to be careful. She suggested that I should discuss it with my GP before proceeding, since taking a supplement when your magnesium level is OK can cause side effects. I haven't got round to talking to my GP but will raise it with him when I net go for a check up.

  • If it was me i wouldnt take any supplements until you have a diagnosis and your medications are working for you messing with electrolytes and salts could promote other problems. I know a lot of people do use them but err on the side of caution until you know whats what

  • Once again a huge thank you to you all for taking the time to reply and give me something to think about. I'll be making notes for when I see the cardiologist in 3 weeks time as he's usually keen to usher me out of the room before I've barely sat down!! I'll be asking about anticoagulants and will also mention the 'pauses' and maybe ask for a heart monitor..

    I've checked with my travel insurance & fortunately because the holiday was booked before this happened it doesn't affect my cover (phew!) and I'd disclosed ny medical history. I think I'll stop the magnesium supplements until I've seen the cardiologist

    Ive tried to track down an alivecor for iPhone 6 without success - any suggestions?

    Thank you for being so supportive and informative - what a lovely bunch you are 😊

  • alivecor.com/home Will give you all the info and the cheapest to buy will be on Amazon, price depending upon which version you buy - up to £74, don't pay more. AA - Arrythmia Alliance had a link as did the AFA Atrial Fibrillation ASsociation - if you buy through their link I think there is a donation to the charity.

    Hope you have a great holiday, I haven't been to Majorca for over 35 years, used to love it!

  • Thanks CDreamer - I'll see what I can find, it sounds a good gadget to have!

    At the moment I'm feeling ok and planning to fly tuesday. I'll say hello to Majorca for you! We try and have a few days there every year, it's such a short hop and so lovely! We've just moved house so I won't be straying too far from a sun lounger for the week lol😊

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