AF returns after 2 years

[jondeanp]

Just thought i'd update on my recent experience for those interested.

I had my first diagnosed AF episode in December 2013. It was persistent (24/7) until i had an electrical cardioversion in May 2014. I was taken off drugs shortly afterwards and have been AF & drug free since then. I have returned to swimming & running on a regular basis

However on Tuesday (April 2016) it returned during a run. I quickly realised what had happened. Resting HR was in the 120's and rhythm was erratic.

I decided (maybe wrongly) to see what it was like the following morning after a sleep. In the morning the HR had dropped into the 60's but the rhythm was still erratic, so i took myself off to A&E.

Although they confirmed slow AF they were reluctant to intervene immediately, rather they wanted to send me away with warfarin and an appointment with the cardiology dept. I didnt want this!

With the knowledge i have picked up on this site and elsewhere i made numerous comments about the chemical cardioversion. The triage GP went and sought further advice and came back saying they would take me in and go with the chemical cardioversion. Hurray!

Due to my HR being relatively low they didnt think amiodarone would be appropriate but gave me instead an increased dose of flecanide

30 mins later, during a routine BP check my ECG flatlined to zero ( i could feel my vision clouding) then immediately reverted to sinus rhythm at my usual resting HR. (Question does flecanide usually work like this ie flatline HR?)

After a couple of hours of further monitoring i was discharged, with a follow up appointment planned with the cardiology dept

Fingers crossed for another 2 years AF free

Jon

[BobD Volunteer]

I think you have been lucky so far Jon in having so few events but do be aware that AF is a;most always progressive. By the way I don't think your decision to wait it out was wrong at all. Rushing to A and E is not always welcome or productive. Like I say you have been lucky.

[Rellim296]

I don't usually notice exactly when NSR returns when I've taken flecainide.  I go from being all too aware of AF to not feeling many wobbles and then I'm just not feeling any wobbles at all any more.

Fingers crossed, yes, but it might be wise to have a little stash of flecainide and before or at your cardiology appointment I would get firm instructions about when and how much to take whenever AF strikes, plus a phone number to ring if you have any worries. 

[Thomps95]

It doesn't sound good if your ECG flattened to zero and your vision started to cloud! I'd follow up with your cardiologist. Flecenaide slows conduction of the electrical impulse of the heart, but I doubt you want that electrical impulse to cease entirely, even temporarily. How high is your heart rate while running? In my own case, a high heart rate during exercise is a trigger - so if I'm involved in high energy sports, I take a small amount of beta blocker to prevent my heart rate from going too high, and am cautious about over exertion. 

[jondeanp in reply to Thomps95]

I did think it was not the usual response for flecanide as i know from this forum that people take them as pill in pocket.

At the moment that i had the flat reading & cloudy vision i was in the middle of a BP check ie the arm cuff was squeezing. I wondered whether that also was why i had that reaction or maybe just coincidence. I was given 150mg (3 x tablets) of flecanide

I will ensure that the cardiologist is aware when i have the appointment.

As for my usual exercise, i usually try to keep in the 140's or below. I do go beyond that occasionally but am always aware of the expected HR against the effort from me. In the case the other day i was only a few minutes into my run ie hadnt had chance to get up into my usual zone

For info i did do a stress/ exercise test while monitored last year and i was given a thumbs up from the consultant to continue to exercise.