Why did I go back into AF : I am a 56 year... - AF Association

AF Association

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Why did I go back into AF


I am a 56 year old firefighter who was diagnosed with AF in June of this year. I went back into sinus within the week, but two days ago I felt myself go back in to AF.

What are the causes? I have done nothing different in the last 4.months and how do I get it to go back ?



30 Replies

The choices are just wait, take a drug as "pill in the pocket' usually flecainide, but otherwise bisoprolol, thirdly get a cardioversion.

Whatever you need to see your doctor soon as the longer you remain in af the less likely it is to settle

Hello Dave, just a quick reply to let you know that there are a lot of experienced folk on the forum who will, I'm sure, respond in detail to your post......basic stuff, but AF comes in all shapes and sizes and no two people affected in exactly the same way. It sounds like you have paroxysmal AF which is the type that comes and goes....often for no obvious reason, although many sufferers are aware of "triggers" that cause AF.....chocolate, booze, overeating the wrong stuff.....the list goes on. If you have been diagnosed, then one assumes you have at least seen your GP......

There are no easy answers, but the good news is that there are a number of treatment options available, the less good news, it may take a while to get the proper medical help you need unless can see a cardiologist or an EP (specialist in arrhymias) privately to get the ball rolling. The AFA webpage provides masses of helpful information, but bear in mind, the condition is very variable so you should seek specialist help.....one important issue is anticoagulation. As you are around 56, you might not need it, but you must understand that AF can significantly increase the risk of stroke as you get older. You really must get professional advice on whether or not you need to to be anticoagulated.

More good news, it's generally believed that AF in itself, is not life threatening even though symptoms can be unpleasant. Once the stroke risk is dealt with and a treatment plan is established, many sufferers manage to lead a reasonably normal life.....over 1m people in the UK have AF and there are thousands more who may have it and don't know it.....

I've tried to paint a very general outline in the hope that it might make you feel that there is hope out there......if you have not had AF for long, then you are in a good position to have it treated, but you may have to push the medics.....maybe there is some medical support at work that might help.....best of luck......John

Dave1471 in reply to FlapJack

Thanks John

Very informative



FlapJack has made some very good points.

A few other ones are adrenaline, too much sugar / salt / processed foods.

You should not be on active duty if you are in AF unless you have been given the ok by both your own physiologist or cardiologist (not your GP) and the bridades specialist (not a general doctor).

There is another firefighter on the forum (Trevor but not sure of full username). He has been on office duty or sick for a few months and has had one ablation.

Dave1471 in reply to PeterWh


Yes wait on occupation health to give me the go ahead to go back on duty but not sure what will happen now


Adrenaline for sure, and if there is no apparently reason, it could be triggered by a digestive issue that you aren't aware of. I used to think my AF episodes were random - 9 years later I'm convinced they are *always* triggered by either adrenaline (via stress or exercise) or digestive problems.

Could not agree more Thomps95. I am 99% certain that my digestive problems( IBS and GERD caused by my Hiatus hernia) or stress set off my A FIB. The doctor I saw at the hospital said that there was evidence now that there was a link between having a Hiatus hernia and having A Fib. My GP doesn't believe it though!!

Funny you you say that but on both occasions was after eating a large diner


I will keep that in mind


After getting AF regularly in 2014, I have changed my lifestyle, diet & started taking supplements and am very pleased AF 'twisted my arm' to do so. I also underwent all the checks to confirm I had Lone PAF; a relief too as there was nothing wrong with my heart or arteries.

I agree with the points already made here and I suggest it is time well spent to determine what your individual triggers are; many common ones are mentioned on this Forum. Like Thomps95 I believe most of mine are stress & digestive issues i.e. probably Vagus Nerve sensitivity.

As AF is such a mongrel condition my pet analogy is: given we all have a bottle, we must make sure it doesn't overflow. The bottle can get overfilled by all different things e.g. you can be perfect in everything but stress & because so much stress goes into the bottle it overflows i.e. an AF episode. Equally you may have a number of small things which together make it overflow.

Your firefighting duties may be the cause as I understand as men get older we produce a lot more cortisol in the evenings than we used to - maybe have a break to see if that is the trigger. Good luck.

rothwell in reply to Hidden

Hi Orchardworker...I also have lone PAF ...do you take anticoagulants?

Hidden in reply to rothwell

No, I am 63 and my cardiologist is happy. When I reach 65 and a CHADS score of 1, I will revisit this decision. Right now I am in the minority of not favouring anti-coags. My view (caution: I am an optimist) is that I hope if you are otherwise healthy, eat/drink and exercise according to the best advice, which I do, you are x5 less likely to have a stroke than the stats produced on the 'average person'. Of course, I could have a stroke tomorrow but there are also risks with anti-coags, some published and no doubt some yet to become widely known.

Hcoe in reply to Hidden

I am happy to finally finding other optimists who believe more study needs to be done on PAF. The quality of life is affected when you take anti-coags . Side affects and worry of bleeding. Listening to my body and stopping triggers is the path I am on. I can do this because I do not have a medical condition causing afib. I am 67, eat healthy, exercise daily, take supplements and educating myself about AFIB.

Dave1471 in reply to rothwell


Rivaroxiban just start back and know not sure if I should have!!!!

Dave1471 in reply to Hidden

Thank you

You're comparatively new to this Dave - we've all been there. One thing is almost 100% certain. Now you have the condition, it won't go away and the frequency and duration of episodes are likely to increase. Except......only one thing is anything like a cure for this condition and that is an ablation. Keep that thought paramount in your mind as you are recommended to try the various cocktails of drugs available for us by physicians and a host of natural remedies by well-meaning folk who believe the evil empire of GlaxoSmithKline et al never actually went to the moon.

Just don't leave it too long.

Dave1471 in reply to RobertELee


And thanks

Hidden in reply to RobertELee

Hi Robert, like your humorous reply. I am very grateful to Big Pharma for the only drug I take Flecainide which stabilised me in my hour of need. However, my policy with drugs is as with surgery, only go there if you are backed into a corner with no where else to go.

I feel so sorry for the folk who take statins as that myth starts to unravel in the States with thousands of law suits. With a cholesterol level of 7 the medics tried to put me on them years ago, fortunately I was able to say no on that occasion as my life was in no way disrupted.


Just to add to what others have said Dave. You have done nothing wrong. You have AF therefore you will have AF. It is also a progressive condition so the more you have it the more you will get it. My EP told me when I first met him in 2005 to forget looking for triggers. That way madness lies. Obviously avoid alcohol and stress, try to stay well hydrated and loose some weight if you have a BMI over 30 but as soon as you find a trigger suddenly it will switch to something else.

You have am electrical malfunction in the wiring of your heart that is all., It's like when you occasionally get a warning light come up on the dash of your car for no apparent reason. Eventually the short circuit becomes permanent and it won't go out. The same with your heart. As the rogue impulses shoot across they establish permanent short circuits over time. This is why it is important to see a specialist at an early date to try and prevent these from happening by possibly considering ablation as Robert above has suggested. .These guys are known as electrophysiologists or EP for short.

That said some people have success in reducing events by life style changes. No alchohol, no ibuprofen ( a known cause) reduce reliance on meat and processed foods, less stress and plenty of exercise ( which no doubt you get in your job along with all the lovely stress).

Go to AF Association main website and read all you can as knowledge is power.


Dave1471 in reply to BobD

Great thanks Bob

Some good points made regarding life-style, stress etc but sometimes there are absolutely no known reason of triggers or causes, however - the latest thinking is that there are underlying causes such as thyroid imbalance, diebetes, hypertension, autonomic dysfunctions such as POTS but there are plenty of others., These need to be ruled out or treated before considering any treatments as latest thinking shows that treating any underlying conditions which trigger AF often eliminates AF.

After that I would suggest, if you haven't already, to go the AFA site and read all the information leaflets which can be downloaded.


have you been assessed for stroke risk? Most people on this site will be taking anti-coagulants as the danger of AF is that it increases your stroke risk by 5 times - and that is life threatening. Not everyone needs anticoagulant but it is often advised but you would need to decide for yourself after assessment from a specialist therefore keep yourself informed.

The only other life threatening danger is to continue doing strenuous exercise whilst in AF - hence the warning about being on active duty as a firefighter, sustained strenuous activity with high cortisol levels could certainly be cause for concern, so if you haven't already, please do go see an Electrophysiologist - specialist cardiologist who only works with the electrics of the heart - for specific advice on your AF.

Treatments are for quality of life so if your AF is not particularly symptomatic, you don't feel ill, have no pain and convert to NSR within a few hours then you may think that it is ok to 'sit out' an episode - stress and worry will increase your symptoms so do distract yourself if you chose this route.

Other treatments - drugs - as PIP (only take whilst in episode) or daily but many of them are very toxic taken over long terms and/or cause side effects such as extreme breathlessness. Ablation - you may be a suitable candidate but only an EP will be able to advise.

You have a tendency to AF and therefore think in terms of management - for life.

Best wishes CD

Dave1471 in reply to CDreamer


On rivaroxiban so hopefully rule out a stroke

The stress of the job is always there. When not at work the stress of get in back To it is also great



Lozza53 in reply to Dave1471

Hello Dave... I'm 54 and was diagnosed with Afib in August 2015. I too am on Rivaroxaban along with bisoprolol. I hope you get a positive outcome when you get your appointment with your occupational health dept. I was a HCA before my diagnosis, and occupational health wouldn't let me go back to my job. I was put on a redeployment list for an office based role (no patient contact) due to the risk they thought I posed of uncontrolled bleeding should I be assaulted by a patient.(I worked in a psychiatric hospital) I didn't get redeployed, they terminated my contract on the grounds of me being unable to fulfill my duties as per my job contract. I hope your employers treat you much better than mine did with me. Good luck for the future🙂

Dave1471 in reply to Lozza53

i am sorry to hear that. Have you managed to find alternative employment.

OCH have put me back on light duties ( sat behind a desk) for now but not sure what will happen next . Been in the job for 27 years now. This is not what I had I mind as an end to my career ☹️️

Lozza53 in reply to Dave1471

Good Morning Dave.... I was finished from my job in January this year, and still haven't managed to find employment . It's stressful, but I think I'm gradually accepting my situation now. At first I was really angry, and almost felt like "why me... what have I done to be in this awful situation" almost like you're grieving for something you've lost if that makes sense? Anyway, I have a supportive partner and I'm getting on with things and you'll be fine too. Our health and wellbeing is paramount. Take care Dave, and let me know how things pan out.🙂


Its so frustrating i know

When i had an episode of PAF it was so scary and dread the day it returns again

But as an A & E nurse in london it made me realise something had to change

Like u although your job i would say is far more stressful

We are constantly having adrenline pumped into our bodies while we work

A few months before my first attack i was so stressed i was crying in my car and having these awful adrenline rushing

Then after a few months wham bang i had my first PAF in my sork place attack 🙈

I decided to change my job and stop all caffine booze and sugars and retrain my body doing yoga and eat anti-inflammatory foods

A great cardioligist is dr john day he has a fantastic web page on lifestyle changes for PAF And states that if no other pathology of the heart PAF might dissapear completely with lifestlye changes or at least reduce the episodes

Just k now your triggers and change things if can and find alternatives to the foods and drinks u like

Stay strong and positive and look forward to maybe a healtheir lifestlye where u can still make a differance in peoples lives


Dave1471 in reply to Jamila123

Very positive

Thank you just what I needed to hear



Hello Dave,

More and more physicians are finding a link between obstructive sleep apnoea and AF. It is worth finding out whether or not you suffer from OSA. Since getting a CPAP machine, I have had no further episodes of AF. But as others have pointed out, we are all different.


CDreamer in reply to Hidden

CPAP has also helped me enormously.

Just to say that when I was first diagnosed 11 years ago I became very depressed. Now, with the condition permanent I am happier than ever I have been. Hopefully you will get rid of this with an ablation. If not, please do not despair. Believe me, with the right attitude and medication you will come to terms with AF and come to appreciate that many others suffer far worse conditions. I walk miles, cycle, play badminton and table tennis and fully enjoy my retirement years. I just have the odd day when anything physical becomes tough but mostly I enjoy a fantastic quality of life with AF always in the background. Be the boss.

expences in reply to Emsysy

That is so good to hear, being a newby. I'm battling to think of anything else at the moment.

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