PAF and tiredness. What's the connection? - AF Association

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PAF and tiredness. What's the connection?


Hi everyone. I'm wondering what the connection is between being tired and episodes of PAF. For the moment I've decided not to have an ablation because I thought my PAF was pretty infrequent and only lasts for usually a few minutes at a time. But over the last 6 months I've been exhausted. Some days I spend all day in bed. Other days I'm pretty good. Currently I've put this down to a chronic fatigue like syndrome due to years of stress/anxiety. If I run around one day and get tired or too hot / dehydrated I'll probably go into AF and feel a wave of tiredness afterwards. This could fit a chronic fatigue picture as chronic fatigue relapses with exercise. But could it be the PAF that's causing the tiredness. Causing or contributing ?

Does anyone have experience of having PAF and feeling much less tired after an ablation. I have heard some people get this effect ?

Thanks for thinking about this one for me. Your experience and thoughts are very much appreciated. Jeremy.

24 Replies

There is no doubt that ablation stand the best chance of improving quality of life over a life time of unpleasant drugs which often cause side effects sometimes worse than the AF.

You sound very normal PAF to me and you may well be having far more events than you are aware of.

I do think that after due consideration for recovery (six months say) most of us ablatees have felt so much better and wished we had done it far earlier.

souljacs4 in reply to BobD

Bob can I ask a question if you check your pulse and use an alive core and your in sinus rhythm does that mean your not in AF?

BobDVolunteer in reply to souljacs4

Of course if you have a regular pulse with or without ectopics. You can have AF but may not be having an event.

souljacs4 in reply to BobD

Thank you Bob .

jeremygray in reply to BobD

Thanks Bob. I just can't decide !

jeremygray in reply to BobD

Liked reading about your interest in motor sport Bob. I have a couple of E30 bmws but I haven't had the energy or time to go to any of the Bmw meetings this summer. You have been around this site for a long time now I note you retired in 1997. That's 20 years ago. ! And you are an advocate of ablations having had 3. I decided to get on and have mine, started the apixaban but after three weeks got nasty headaches that resolved when I stopped it. I'll have to sort out another NOAC or warfarin now before deciding on the ablation. I read the cardiologist EP blog from near Atlanta and was impressed by his hands off approach.

jeremygray in reply to BobD

Hi bob so does that mean you think the tiredness is part of the general picture of PAF. ?

BobDVolunteer in reply to jeremygray

Frankly yes I do Jeremy. It is the underlying commonality for everybody with AF I think even though other symptoms/problems may be different.

By the way and off topic, after 35 odd years of Alfa ownership including ten years as race engineer with Alfa here in UK I bought an F22 BMW 220i coupe last year so joined the dark side. ha ha. 0 to 60mph in 7 seconds with 8 speed auto-box and huge grin factor . We also run an E36 with a 2,5 turbocharged engine alongside our two Skylines GTR drift cars. When I cut myself I bleed oil.

Hello jeremy :-) it's hardly surprising we AFers feel tired when you consider the pump that keeps our bodies working is not functioning correctly some of the time .

I have found I have more energy since I changed my diet (something which will be permanent now) and eat even more vegetables, fruit , nuts, olive oil and fish than I did previously hopefully boosing my magnesium levels natural and helping my body to cope better with the drugs and condition.

I wouldn't consider an ablation not that it would be an option where I live with the local hospital in 'extreme measures 'and getting to see a cardiologist of any kind an impossibility, the best that can be achieved is an arrhythmia nurse once a year .

jeremygray in reply to doodle68

Thanks. Yes some ep s seem to be quite conservative about the ablation procedure. I have changed my diet and am a lot more vegetarian than I was. I hope your chosen path works out well

Hi Jeremy - my PAF wiped me out, even though the episodes were fairly short at around 2 to 3 hours, but I was tired for most of the day afterwards. Some of this effect I blamed on Bisoprolol.

For the last 3 years I've been taking Flecainide and have had no AF but get very tired when bouts of ectopics start. If the heart is not beating efficiently then tiredness is likely and when my heart is OK, I feel fine.

Could you be having more AF than you can feel, as silent episodes might explain the fatigue? I can't help with ablation, as I hope not to have to go down that path - heart might think differently though.☹️

jeremygray in reply to Finvola

Thanks so much for your reply. It's such a difficult one to work out. I suspect I might be getting more tiredness with each minor run of AF that I know I am getting and maybe some ones that I don't know I'm getting. I wonder why you are not going down the ablation route. Currently I have been put off after reading the cardiology blog from the states and just not wanting to risk any of the side effects.

Finvola in reply to jeremygray

When I was diagnosed four years ago I wanted to have an ablation immediately to 'get back to normal'. Understanding and knowledge have tempered my attitude, as has the current success of Flecainide in controlling my symptoms of AF.

I have decided to stay with drug therapy for as long as it continues to give me an acceptable life. My EP is willing to ablate but feels that my quality of life, drug toleration and minimal side effects lean him towards advising against ablation at the moment.

The risks of the procedure, the possibility of making things worse and/or needing further intervention seem to be a step too far for me at the moment. Against all this is the likelihood of progression of the condition and my ageing body (I'm 73).

The decision not to ask for ablation was not arrived at easily, but after almost 3 years of research and soul-searching, discussions and Q and A sessions with my poor EP! Were I 20 years younger, I suspect things would be different . . . medically and personally.

The best advice I have had from anyone is from a friend who has AF and is a retired cardiologist and that was 'You will know when it is time to seek intervention'.

jeremygray in reply to Finvola

Thanks finvola. Yes. I have had it for three years now. Starting with just a few missed beats and then progressing to PAF that's possibly getting more frequent. I tried all the tablets and I couldnt tolerate any of them. Totally agree about not rushing into an ablation. I'm just not sure about the tiredness. It's debilitating but I'm wary of putting all my eggs in the ablation basket as I know I was frequently tired before any problems with my heart emerged. It would be lovely to think that an ablation would help but I'm wary of the cerebral fallout as well as the other complications though it's inspiring the people like Bob have had three and are strong advocates


WendyWu20 in reply to jeremygray

Hi, what side effects are reported from ablation?


A wiser man than I once said " When the pupil is ready the teacher will come."

When I was first diagnosed in 2004 and offered an ablation I was horrified at the risks but the cardiologist who was NOT an EP merely told me that AF was progressive and when I changed my mind he would refer me to his preferred EP . OK so that would be six months then! Sitting in the pits as Monza in 34degrees C with a HR of 200+ is mighty good at changing one's mind.


A good question and good answers. Oh I wish I knew the answer to give you. I had CFS long before I had AF but it was manageable or at least I rolled with it which included giving up work. I had a first ablation in 2011 and from then on my whole life turned upside down - have been worse - quite ill with all sorts of sensitivities pain wise. Was it the worsening of the CFS and what is the link with that and the AF - basically the underlying problem is not being resolved. I resisted my 2nd ablation because of how I was after the first. I had the 2nd one in end just in case it helped I guess but willingly and hopefully. I'm now 6 months after my 2nd ablation and although at moment off 2/3 of the drugs just on the BB I am steadily getting worse all the time with internal pain and tiredness. A wave of extreme tiredness hit me this morning and its only just eased enough to try and distract myself with emails. I'm still having AF and the EP wants to catch what is happening now of course to do another procedure - yeek. I'm in a loop - procedures wipe me out - AF wipes me out. Ablation alas has not helped me personally. If you work the answer out I will after your guidance. I am certainly suspicious about the BB's and will press again to consider the consultant changing them when I see him again but so far it has been no. Go with what feels right for you at the time is the best thoughts I can give you from my experiences. In the meantime you are in good company in your ponderings.

I would highly recommend getting an ablation. I was on sotalol medicine and I was exhausted all the time and the meds did not stop my afib from happening. When I had the procedure done they kept me on meds for 1.5 months and then took me off of it. Not only did the ablation fix the problem so far... I am 2 months past it, but it saved me from the meds! Before the procedure I would go into afib every 2 weeks. I heard that if you let the afib continue too long then the ablation is not an option to solve the problem and won't work, so I jumped at the chance to save myself from a life of meds. As far as I know, the afib was less than a year new to me. I am convinced that it was due to digestion problems setting off the afib since it always happened after I ate. I had to have 3 cardioversions. Nothing other than the ablation worked. It took me a week to recover in bed afterwards but nothing but upwards from that point on. I am so grateful to my EP Doctor Heist, at Mass General. He is an amazing man that got me my life back.


I have persistent Afib with NO symptoms . I am on metropolol 25 mg and benzazapril for high blood pressure

Saw EP - mass general- he did not recommend a halter. Recommended electric cardio version

Wants me to be on anticoagulant 1 month before and one month after cardio version . Please tell me your experiences with cardioversion - is it general anesthesia ? Did u have them done at mass general? Did u see s cardiologist? Mine put me on 23 mg metropolol which I don't think I need thanks for your reply


The cardioversion was painless and they put you out under a short lasting anesthesia. They will put a tube down your throats after you are asleep. You will not know what is happening. You will immediately feel better. The actual process is about 15 minutes or less I recall. Nothing to fear. The team over at mass general is absolutely amazing. You are in good hands. I would recommend dr heist if you want an ablation. That was fine as well. Just took a week to recover from tired and dizzy feeling. I could not tolerate the metatoperal or sotalol or multaq. And none stopped my atrial fib from happening. They just hindered my life. I was listless. The ablation was a live safer for me. My cardiologist is dr scott whom is also good.

I find that I get extreme tiredness from attacks. If I get one in the night I wake up like a limp rag. I am on Bisoprolol 10mg that also adds to the weariness. Not sure if I want an ablation or not; I have not been offered one.

I completely stand by my decision to have an early ablation, it is 3 weeks to the day that I had mine; although still recovering it have only had a couple of short lived AF episode's although do have a number of ectopics. I find the beta blockers unbearable (Bisoprolol ) and cannot wait to come off it. I am fine with the Rivaroxaban although think my EP may look at me coming off those as well....interestingly my GP thinks I should be on them permanently but I am not clear why if the ablation is a success....which I strongly think it will be given the lack of AF episodes I've had. Can anyone explain why I would still need to be on anti coagulation medication?

Thank you.

Good luck Jeremy, I hope you reach a happy conclusion.


I am still undiagnosed with my very irregular heartbeat. I am going into RUH Bath next Thursday to have a loop recorder inserted. I am affected by bouts of this irregular beat almost daily. These can last for several hours. I know as soon as an episode starts as I feel very tired & woozy & the minute they stop I return to feeling ok.

I have a friend who is 78 who has AF she get tiredness but only after she has a bout of AF the rest of the time she is fine. I think we put everything down to AF when there could be other reasons for not feeling well. Not everyone with AF suffers from tiredness some are very active.

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