New to AF

Hi all,

Was diagnosed with AF five months ago following a mini stroke. So taking Pradaxa and Bisoprolol 1.25mg (mini dose). First off I find the latter turns me into a zombie. Spaced out is an understatement. So I take them only when the AF gets really bad. AF is not persistent so I get away with it a lot of the time,but when it comes what a pain, especially down the left side. Have always been a sportsman and until the stroke played tennis. Now even a walk will set off the AF. So feeling very restricted. The doctors seem unwilling to refer me to a cardiologist even though I have medical insurance. On top of that we do not seem to be getting on with it and making decisions of what to do, although I am aware that they are heading for cardio conversion. Obviously am concerned that any vigorous exercise will undo the cardio conversion and make it all a waste of time. Tempting to go for the pacemaker straight off.

So here are the questions

Has anyone found a good way to deal with AF during the waiting period before conversion?

Do GPs have the legal right to refuse referral to a specialist?

Has anyone had experience of exercise after cardio conversion. Did it hold or is it fairly fragile and reverts back to AF quickly. Serving at tennis can be quite explosive as can axing logs in winter for our fire. Will swimming be OK?

Are there any tips on what avoid? Coffee? (I do like one now and again)

Red wine? ( A couple of glasses finishes off the day nicely, but only at weekends)

I do not fancy 15 conversions. What patience!

Any useful comments would be welcome.

11 Replies

  • Hi RSB

    You didn't say how old you were, but a few things

    1) You need to be referred to an Electrophysiologist (EP), NOT a cardiologist, and your GP has no right to refuse you this, he/she is not competent to manage AF on your behalf no matter who she/he is if they are a GP. If you are private you should be seeing one within a week or two.

    2) Cardiovserions(CVs) are only ever temporary, unless you are very young and usually even then only if you can pinpoint the cause such as ultra marathon running etc. But this is not a call a GP should be making, usually not until other tests have been run.

    3) Straight to pacemaker? No...... Lot's of things before that and maybe ablation depends on lots of other things of course.

    4) In terms of what to avoid it differs for all of us, sorry but you need to experiment, wine is certainly a possibility as is exercise (sorry) Coffee less so, but can be a trigger for some people.

    5) Lastly Bisoprolol is difficult for some of us, but it's only one of at least 5 other beta blockers or calcium channel blockers which can be prescribed, and not all of them will affect you as badly as Bisoprolol, (for some we are all different, remember) your EP which you need, will talk you through the options, but for many Bisoprolol can make you feel like a zombie.

    You need to educate yourself on AF, read the AFA website from cover to cover loads of information on there and ask as many questions as you like on here.

    Be well


  • Hi Ian, many thanks for your comments. Most helpful. As you can imagine it is all very new to me. In answer to your question I am 74 and until a few months ago had no trouble in running a mile in under 11 mins. Am off to the doctor today to sort out a recovery plan and the drugs that may be required, but most of all the EP as you suggest. Had a bad bout of the AF yesterday which has go to be sorted.


  • I am waiting to have a cardio version too, unlike you I am in Persistent AF which makes it easier to control. I work a very physical job with thankfully only fatigue and shortness of breath to deal with, both controlled by being sensible and applying good breathing techniques. Diet changes and proper hydration have helped a lot too. Listen to your body, it's the best indicator of what you can and can't do. No point aggrevating things unnecessarily in the short term. If your GP won't refer you then see another GP. It sounds like you aren't in Persitant AF which could make it difficult to do a CV as the heart needs to be in AFib at the time. I'm sure you will get lots of good advice on here. Good luck.

  • Thanks Gazza. Persistent no, which now makes me think what are they going to offer, except drugs. Trying to find one that suits me is going to be fun.

    Cheers Richard

  • Hello and welcome to the forum - sorry you are here, if you know what I mean.

    I think it is outrageous that you haven't been referred to a cardiologist or better still an electrophysiologist who is a cardiologist specialising in heart rhythms. On the main AFA website you can check for specialists in your area or ring round hospitals and find the best. Then either insist on referral as it is your right, or see a different GP.

    Bisoprolol for me was a zombie-drug - I took 2.5mg for 4 months and like you, I couldn't walk about properly. I now take 1.25mg and blame it for every feeling of tiredness and breathlessness but my EP says it's essential to keep the heart rate down.

    Diet can be very important in the management of AF - some of us cannot drink alcohol, some can and the list of no-no's is endless. Each of us finds a way through mostly by trial and error - again the AFA website is extremely useful. A rule of thumb is to reduce or cut out alcohol and caffeine, ban totally artificial sweeteners, colourings and flavourings. Increase vegetables and fish intake, take moderate exercise and get good sleep. Once you get a proper treatment plan for managing your AF, then you can move forward with a healthly eating and a return to some of your normal activities.

    Whilst I was waiting to see an EP I had episodes which I managed by lying down on my right side and breathing in rhythm until they stopped - never had a cardioversion and my PAF is controlled by Flecainide. BTW I enjoy a cup of strong coffee every morning but sadly, had to give up the wine 2 years ago.

    The best you can do for yourself is to get informed - about AF, treatment options and what course you might wish to take. See a good EP who will advise and consult with you - the more you know, the better you can input your ideas to your treatment.

    Best wishes

  • Thanks Finvola, you put a lot of effort into that. Tried the lying down and breathing. It worked. The Bisoprolol is more of a problem. So trial and error in finding one to suit me. Thanks for you tip about Flecainide as opposed to CV. Have a lot to discuss with the doctor today.


  • Welcome to our mad world of AGF - one we all would rather not be in!!!

    A must to get an EP referral. I cannot fathom why not when you have private medical insurance. Did you remind GP? However you are entitled to get an NHS referral though that will take longer. You have private use it (if you have a significant excess or a no claims bonus a first time consultation would cost you £150 to £250 dependant on where you live and the particular EP.

    Look up EPs on main AFA website (all ones shown as doing catheter ablations are EPs and that is an easy sort (it comes sorted up by city / town). There are some other EPs but harder to retrieve.

    Good luck and let us know how you get on.

  • Dont worry you will most likely be offered an ablation if applicable,

    I have had two and I am older than you. I was told age is not a


  • Hallo Rsb417

    You are getting very good advice on this forum.

    Just to add, make notes of all the questions you have for your doctor/cardiologist or EP.

    It will also be helpfull to journal your AFIB journey. It is a way of data collection so that you can identify any triggers(you say your AFIB is not persistent).

    Like Beancounter said we are all different e.g I'm 45, do sport, can still drink coffee, never use energy drinks(most have caffeine in), drink beer and wine from time to time, but not to much(It has put me out of rhythm once), have used bisoprolo for many years now and doing fine with it.

    I wrote a blog about journaling and how it can help your afib:

    Unfortunately there is a degree of trail and error in this afib journey, but when you find your grove/things it gets better.

  • I am either very lucky or have a strange constitution I take 10mg bisoprolol and never have a problem I have had 5 CVs last one a month ago I have had the flu for a week now. And keep waiting for it to set the AF off so far so good fingers crossed

  • Bisoprolol at 1.25 made me feel faint two hours after I took it. Now I take 2.5 at bedtime and feel ok. It was the nurse's suggestion. Worth a try as it does slow the heart rate down and makes the AF a bit more bearable for me.

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