Help with understanding strange feeling after my first afib episode

Hi, this is my first post here and I was told I have paroxysmal atrial fibrillation after having an episode about 4 weeks ago. I ended up staying in Hospital over night and my heart rate finally went back to normal after around 18 hours. Since then Ive had a sleep study done and found out I have moderate sleep apnea which may have caused it. My first question is, is it normal for people who have afib to find out they also have sleep apnea? I'm only 33 years old, slim and consider myself to be in good shape from working out and swimming a lot, so I wasn't expecting this at all.

My second question is how do people usually feel after having an episode of afib? Since 4 weeks ago I've been having on and off days where I'm getting strange 'tight' feelings in my chest on the left side, plus slight fluttering. My left arm sometimes feels weak also. This can last a few minutes or seem to go on all day. When I told my doctor this he didn't seem concerned as they did an ECG, EKG and I also wore a holter for 24 hours which showed no damage.

This feeling I'm getting every 2 or so days is making me quite worried though. Is this anything to be concerned about or is this a 'normal' feeling for someone with afib?

Thanks in advance for any replies!

28 Replies

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  • Sleep apnoea is often a trigger for AF so yes to that question.

    AF is a really mongrel condition and we all experience it in different ways. In fact many people are totally unaware that they have it as they are asymptomatic and it is usually discovered either because the person had a stroke or by accident during routine health examination. The big problem is that it makes us far to aware of our hearts and every little blip sends panic signals to our anxiety centres. You may be experiencing ectopic beats but I do think it important to look deeper.

    A holter monitor will not tell anything about the condition of your heart so don't understand why you say "no damage". All it does is record you heart rate as a series of ECGs. To check the condition of the mechanics of your heart you would need an echo-cardiogram which uses echo sounding to measure the size and shape of the chambers plus the condition of your valves etc. .

  • Hi Bob, thanks for the reply. Sorry for the confusion, when I said 'no damage' I was referring to the total check of a Echo-cardiogram plus the ECG's and holter. I still feel really strange though and I'm basically wondering if this is just the afib or if there's still a possibility it is something even more serious. I know its impossible for anyone to say on here but I'm so anxious of whether I should just try and ignore it or keep going back to the hospital for more check ups.

  • Hi Bill, following on from BobD's comments, AF effects everyone in so many different ways, so it's impossible to generalise. Most have a rapid, irregular beats during an episode, but some have slow irregular beats too. You sound reasonably fit, but excessive endurance type exercise can cause AF which may not apply to you. Similarly, so can excessive drinking and other lifestyle issues, like being overweight, all of which can cause high blood pressure which also plays a big part in AF. The list of variables goes on, so the best thing you can do at this stage is to read up on all the information thats available on the AFA webpage so that you can get a better understanding of the condition and the various treatments which are available. You will then be better informed and any discussions you have with your medics are likely to be more helpful. A couple of points which may help, it is generally accepted that no one has ever died from AF (but it is important to understand about the possible risk of a stroke) and in the UK alone, there are well over 1m folk with AF, and many live relatively normal lives. Hope this helps, just shout as the questions occur, but many points will be covered as described.......

  • Hi Jack, thanks for the reply also. That's comforting to know and will hopefully help me relax a bit.

    I'm just not sure if these feelings in my chest are just the afib returning or maybe something more serious. If it's just the afib will it likely return to normal eventually?

    I'm not overweight and I don't smoke or drink. It seemed like it happened while I was asleep which would point to it being sleep apnea causing it. I'm hopefully fixing the sleep apnea problem, so maybe it won't return?

    Thanks again

  • Best of luck Bill that would great, it's neither here nor there, but I'm John and my motorhome (RV if you are from the States) is FlapJack.....you ask Bob, I rarely flap, but I sure did when I was diagnosed!!!!

  • He is very laid back these days!

  • Just adding here that I too suffer some anxiety that my condition is "beyond" AFIB alone. It's tough for the doctors information to outweigh my own paranoid concerns.

    I keep telling myself that if there was something larger than just AFIB at stake here, they'd have kept me in the hospital when I went.

    I recently posted about my experiences here:

    healthunlocked.com/afassoci...

  • Searching for triggers for my AF proved a thankless job as there are so many variables, but I proved alcohol was definitely one and reading of the link between AF and SA, plus my wife informing me that I snored and stopped breathing during sleep and that 80% of my AF events were with me when I woke up, I asked for a sleep study which told me I had mild SA. Not severe enough to treat apparently, only averaging 8 events an hour, against 30 plus for those that need treatment. Being a skinny thing, fairly fit and active I was amazed to get this diagnosis, like you. My EP is inclined to see how I go as my second ablation 12 months ago has so far held off further AF. Wife says I still snore so I will ask GP for a further referral to sleep clinic as I would like to take this further to see if I can eliminate this risk of AF again. The tight feelings and 'fluttering' I can relate to, heavy tired feelings also. Out of interest have you any results from the sleep study, number of events and how long you stopped breathing etc? My longest SA was 57 seconds which I felt was terrible and needing addressing, but because of my build, BMI of 20 and general health (not inc AF) they were not concerned.

  • Have you tried a mandibukar advancement device for your snoring. It often works can be bought from boots

  • No haven't tried that, tried nasal spray, chin straps, various pillows designed to keep one lying on their side without success. Seems I have tongue related snoring so will look at that, thanks

  • Hi checkmypulse, thanks for the reply

    I have the full results from my sleep study here and I had 22.5 events per hour over 6 hours of sleep. The longest SA was 72 seconds. I'm quite surprised they didn't want to treat 8 sleep apneas per hour for you. Is it normal for everyone to have at least a few of these events per hour?

    I've been using a CPAP machine for 1 week now and I do seem to be sleeping better and feel more refreshed. I'm hoping this might stop my AF returning, but I still have the tight chest, fluttering and other random feelings in my chest both days

  • Bill, I don't think it's normal (to be fair I didn't ask that) but with me the sleep man weighed up what he called a small amount of SA events, with my general health, size, BMI, blood pressure etc and decreed that I didn't need further treatment. My neighbour has just been given a CPAP machine and loves it. He has severe SA with 80 events per hour average. You may be feeling anxious over the AF returning which could contribute to the chest feelings. Are you going to see an EP who is the best medic for AF? Any medication in the meantime from the cardiac people? I found a beta blocker helped with fluttery feelings, didn't prevent AF but helped also with ectopic beats. This may not help with you of course, just my experience.

  • Hi Bill

    I am 42 and diagnosed 2 months ago with Afib. I asked my family physician to refer me for SA study and still waiting results. I am also waiting some other tests and cardiologist appointment. I think SA is one of the important causes of Afib and is very important test if you are diagnosed with Afib.

    I had a very similar feeling like what you have mentioned before and after Afib and almost went in to depression and was very upset at the beginning of my Afib but now I am feeling better every day and today I did 15 minutes treadmill self paced walking and light weights 1 set of 15 reps after 2 months of gap. Feeling great!!! my max HR during walking on treadmill went up to 96 bpm not bad!!!

    Hoping just one episode and Afib will never come back and if back and affecting my quality of life will go for ablation procedure.

    Wishing you feel better soon!!

  • Hi Kastir, thanks for the reply. It looks like we have had a very similar experience so far. I've only had one episode and I'm really hoping that fixing my sleep apnea will stop it from returning.

    I'm still feeling quite low at the moment because all these feelings in my chest are very unnerving. I'm hoping they will gradually go away like you. I've not started working out again yet and it's been nearly 4 weeks. I'm planning to start swimming again next week and go from there.

    Wishing you the best also and that you feel better!

  • After the last couple of times I had AF, I also had a weird tight feeling on the left side of my chest for a couple of days afterwards. On one of the occasions it was so painful I took myself to A&E; I was in far more discomfort than the AF itself caused. They did several tests and said I was ok, so I still don't know what it was.

    When I mentioned it to my EP she didn't seem bothered by it.

    It didn't happen during the AF, but started about 24-48 hours afterwards, lasting for a couple of days. My heart rate was fine, and I didn't feel out of breath, but it was quite an unpleasant tight sensation that varied in severity throughout the day. I was thinking angina or something at the time, but neither the Dr at the A&E nor my EP thought it was.

  • Hi Uscore, thanks for the info and it's encouraging to know I'm not alone with these 'after' feelings. Quite a few times I've been wanting to go straight back to the hospital. But during one of my appointments with my Dr he told me they are nothing to worry about.

    It's been nearly 4 weeks now but I'm still having these feelings, but I am starting to feel a bit better

  • Also, if that fluttery feeling you have, it might be ectopics. Have you tried taking your pulse when it happens? When I get it I get a weird wave feeling in the centre of my chest, and if I'm checking my pulse at that moment I clearly detect a missed beat. Sometimes there will be 2 or 3 of them in quick succession, sometimes it will just be 1 a minute, usually lasting for a couple of hours.

    I think I've discovered that caffeine is a major trigger for them. I've avoided it for about 3 weeks now, and haven't had any sustained ectopics at all in that time.

    Fortunately, so far, exercise doesn't cause ectopics (or AF) and I'm back up to 30 minutes on the X-trainer at the gym, and I'm going to restart running again soon to see how that goes.

    Also, touch wood, alcohol doesn't seem to be a trigger for either, although I've cut back a lot on that too because it seems like a good idea.

  • When I wore the holter for 24 hours the Dr said I had 5 events of something called an atrial run where my heart beat went fast for 2-7 beats. This only happened while I was asleep and he said this is almost certainly linked to my sleep apnea. During the day I've not really felt my heart beat fast or skip beats. It's mainly a tight feeling in a larger area and an anxious feeling

  • I think that a day or so of rest and recreation is a good idea after an AF attack. Certainly, I recognise your feelings both in your chest and a general malaise. The big problem is that while resting you can muse on your condition and increase the inevitable anxiety. I think the main problem is learning to cope with and suppress that anxiety, your heart will manage the remainder.

  • Thanks! I think this is what is happening, I definitely have these feelings more when I am laying down or sat still. I'll make sure to rest up if it returns

  • May I ask, what symptoms were you getting that prompted you to get the sleep study?

  • My first AF episode started early during the night and the doctor inquired about how my sleep has been. For the last 5 years or so I've been sleeping quite bad, waking up 2-4 times per night and usually waking up once where my heart is racing and I'm unable to get back to sleep. I thought this was anxiety or stress. I've also been getting increasingly tired in the afternoon and early evening even though I was getting 8 hours of 'sleep' per night

  • hmm, prior to my ablations, I started getting what I am still convinced was sleep apnea which I know was prompted by taking Amiodarone. They sent me to a throat specialist who, could find nothing wrong. Just as I was dropping off to sleep I would suddenly find I was unable to swallow or breath in through my mouth, very scary. This would only last for a few seconds but it was getting worse with the increase of Amiodarone intake. I was still getting them every now and then 6 months after stopping the Amiodarone. I now find that although I go out like a light bulb, after 3 hours, I spend the rest of the night waking up every hour. I have not experienced the collapsed throat feeling but like you, wonder whether I have a mild sleep apnea that caused the PAF in the first place. The doctors refused to entertain the thought of sleep apnea whilst I was getting the constant problem during the Amiodarone course. I always got that feeling that they knew something but decided not to tell me (the Amiodarone is TOXIC).

  • I used to get a lot of pain on my left side but I think it was mostly tension. It took me a long time to reduce my stress about AF. Eventually I tried a Physio and she found all the muscles in my upper body were very tight and tense. A very small movement could set off a chain reaction of pain which would come And go for days. Finding out that AF is not a death sentence helped a lot, as did having an incident of Very fast AF while in A&E. I'd gone in with AF at about 150 and suddly it shot up to 220. I was getting pain in my chest and It wasn't the same sort of pain or in the same place as the pain I had on my left side which I had thought was heart related.

    I'm not saying you should dismiss any pain or strange feelings you get, but maybe explore alternative causes.

  • Hi Linda! Thanks for reply and this is something I've not thought about. I feel like I'm having something similar though, where a small movement can set off a chain reaction or tight feelings across my left side. I'll look into a physio also and see what they say

  • Hi

    I have had paf for 2 years now

    First you need to get all the test to rule out any underlying problems

    There are many theories out there as to what causes PAF in otherwise healthy people

    You need to research yourself to be come aware and clued up

    Some poeple will say it will get worse others even cardiologist say no it does not always get worse , this makes sense since if PAF is not still understood by the health professionals this means that that dont know Whats causes it 🙈

    Therefore you can not be given a prognosis😳

    Many triggers ::;over exercising, foods , alcohol, gut link to afib, nutrient deficiency

    But in PAF with no other cardiac issues

    You just need to find whats causing it

    It is a long journey but well worth for you

    Its important as such a young as to find out whats going on with uour body

    I wish uou well in your postive journey of a healthier lifestyle 🌺

  • Thanks for the reply! Hopefully I can find what caused it and I'm hopeful it was sleep apnea which I am now treating. I've also cut out caffeine and alcohol for now as I really don't want it to return

  • I'm really interested about the SA possibly being a cause for your AF....my sleep has been terrible for years but no one has discussed it in relation to my AF. I will mention to my EP when I see him.

    In relation to your symtoms, when mine first started, or when I first became aware I only ever felt it when I was quiet and relaxed. It started with a feeling like my heart and flipped over and it made me feel sick.....I wore a holter and was diagnosed with ectopics.....this progressed quite quickly from having a Heart flip every few weeks to daily and then to AF episodes which was picked up when I wore a 5 day holter. My symptoms were similar to yours and I did start to experience some pain....I am of the view that some of this was anxiety related as I was worrying about what was happening to my heart.

    If we were working out at the gym it's tiring when your heart beat goes up, that's what gives us the work out so therefor it stands to reason that if when in an episode of AF when the heart is usually beating faster than when we are working out that we are going to feel exhausted.

    I guess we all experience this slightly differently by nature of what our triggers are and what other issues we have. I for one would want a further discussion regarding the feeling in your arm and chest if it is worrying you so much otherwise you will keep focussing on this and worry will make it worse.

    Good luck with everything.

    T

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