I'm 37 yo. Had four episodes for the first three months, all happened when I was sleeping, after that I'm now three months free of afib and not on any med. Should I head for ablation now? I'm getting too tired worrying about this crap 24/7.
Is it too early to do ablation after ... - Atrial Fibrillati...
Is it too early to do ablation after just four episodes?
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li17
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It may be that you have vagal AF - tends to be when sleeping or after heavy meal. You need to take the advice of your doctors of course but if the episodes were short and you don't have them at present you could try life-style changes to see if that stops any more episodes.
It means no alcohol, losing weight if you need to, eating real, rather than processed foods, having plenty of fruit and vegetables. ( for example diet coke has lots of salt in which my cardiologist said would have helped mine to start) Also, if you are an athlete you may need to de-train as AF can result from that . I had no AF (vagal) for three years after making sure I have enough potassium in my diet ( not supplements as they can be dangerous.)
If you do have lots of episodes then ablation is usually advised for young people as the side effects from meds can be bad if you have to take them all your life- it's ok for us oldies!!
Let us know more about you as it's a very individual condition
Thanks. I think I have vagal afib. Before the first episode, I stopped all alcohol two months ago, and sleep no later than 11pm, and also changed to vegan diet 10 days before first afib. My BMI was 25.x, and I only did mild exercise. I don't have any other health issue other than afib. Then one day I woke up at 2am with afib. The only thing I notice was I was under extreme stress in those two months before afib. But EP said stress doesn't cause afib. So I have no clue.
I think you'll find people disagree about stress- however it doesn't cause vagal AF but can start other AF off. It's interesting that you had changed to a vegan diet- I had been dieting when mine started and I have heard others say this. When I had three very bad episodes, I went to A and E and they did blood tests and I noticed my Potassium levels were below range ( they are not normally as I have regularly tests for other condition so can compare.) If your vegan diet did upset your electrolytes it could have been a trigger,
Keep doing all these jhealthu things and see whether you have more AF How long did the episodes last?
An AF episode can begin with a clear cut cause, mine did. My AF episode(just one) began after a big swig of a slushy iced drink(not alcohol) on a hot day. I felt the slushy ice going down and when it reached my chest area my heart immediately went haywire. A very violent 90 minute episode followed, which stopped without medical intervention except the valsalva manoeuvre of a deep breath in followed by a slow breath out(which may have helped).
I also used to be troubled with night waking, not with AF but SVT. At least I’m sure it was SVT as it was never caught on an ecg, it didn’t feel like AF and it was before I had a Kardia to catch it myself.
I’ve since been able to stop these completely by taking Magnesium (plus other supplements).
It’s possible, as you were on a restricted diet at the time, that you had inadvertently deprived yourself of essential minerals.
I certainly wouldn’t be having an ablation if I were you.
Research all you can on the subject and make a few changes. Those episodes don’t necessarily mean you’ll be troubled for life or even have any more.
Pat
Thanks Pat. How long ago was your only episode? I thought the diet might set me up, because after I changed the diet, I felt so tired for days and had diarrhea, I also had heavy sweating while I was sleeping few days before the first episode. Maybe all these drove me electrolyte imbalanced.
28th June 2012. Around 3.30 pm.
Almost 6 years ago.
I think you’re on to something there.
What didn’t help me that day was feeling thirsty, which is why I bought that drink. Once you feel thirsty you’re already dehydrated therefore electrolyte impaired.
- your sweating and diarrhoea would also have made you dehydrated.
If you’re switched on and have a logical mind, you can help yourself by researching as much as you can especially regarding supplements.
After that dreaded day when I thought I was having a heart attack or certainly something majorly life threatening, I wanted to find out all I could to stop myself from dying. I wasn’t going to wait 8 weeks for an echo, 24 hour ecg or a cardiologist appointment. To be honest, at the time I didn’t think I had 8 weeks left!
The thought of imminent death spurred me on and I booked a private EP consultation within 2 days. I had all the relevant tests too which were all normal.
Researching online led me to the American website ‘Afibbers’. That site gave me a positive direction in self help.
Then I bought myself a Kardia (previously an Alivecor).
In general the medical profession here will not or cannot get involved in recommending supplements, I don’t know which. My EP listened and seemed interested but does not comment either way.
Pat
I had my first panic attack two months before my afib. Then I was sent to ER. The doc there told me my blood was think and heart rate high (but regular), and asked me to follow up with primary doctor and cardiologist. I then tried to make appointment, got in to see primary doctor in two weeks, but here in the US everything is so damn slow. The earliest appointment with cardiologist I can get was about two months. There’s no such private consultant here. So I had to wait. In those two months, I was in constant worry mode, I kept thinking there might be something wrong with my heart and I kept going to ER whenever I felt something in my chest. ER tests came out all good, but I still worried. And started to do lots of things including switching to vegan diet in the hope of getting bette health. I was thinking once I got a thorough examination by the cardiologist, my worries can be eased and I will b fine. Then finally the cardiologist appointment came. I went to see him and he said I would be fine, and scheduled stress test and calcium scan on th next two three weeks. I thought ok, that’s what I wanted and I would be all calm in two three weeks. Then the day after I saw the cardiologist, I woke up at 2am with afib. When I told him about this, h didn’t even believe this can happen. I always think if I can get fully checked out much earlier, I could have avoided all these things. Yet I can’t prove. I just feel my whole life was screwed up in those two months, now I can’t get out from the anxiety anymore.
This is why some people go undiagnosed for years. AF and other rhythm disorders tend to keep a low profile when you’re being monitored.
This is why a Kardia is very handy.
If you have one of these you can catch abnormal rhythms when they’re happening. A Kardia is around £100 if you can afford one. You can record irregular rhythm proof to show your doctor, or be very reassured to see that all is fine.
Pat
So you had only one episode six years ago. Would you worry about it could happen again? After my first episode, I followed up with my cardiologist a month later, he told me if it happened again, then it will be time for me to concern. Then two days later I had the 2nd episode. Maybe I was scared by the cardiologist lol. But I can’t prove.
Yes of course I’m worried it will happen again. I’m in no way complacent. Whenever I feel an ectopic I think, ‘ooo is this it?’ Then relieved when it’s just one missed beat.
All I and anyone else can do is take any precautions we can.
Pat
Especially taking into consideration your age and no meds ... wait ... but get dr opinion ...
That's interesting because it's believed by some docs that taking a cold drink will actually STOP an Afib occurrence and I had that experience not long ago. It wasn't ICE cold - like the kind that hurts after it's swallowed - but evidently it needs to be colder than tap cold. Mine was refrigerator cold - about 33ºF or so... just a little fyi.
Yep it works both ways. Dipping the face in cold water can be a way of stopping it too. It’s the shock.
Pat
Sorry to but in on this conversation as I don’t mean to be rude , but stress can definitely cause it !! I had my attack due to withdrawal from diazepam and the stress sent my blood pressure up and then sent me into a SVT then a fast PAF . As you probably no high blood pressure can trigger AF!! High blood pressure and stress go hand in hand .
Sorry for chipping in 😬
I'm curious about your comment re potassium. Maybe I've missed some info here or there but I haven't heard about any dangers about supplemental potassium over food-origin potassium. Please expand or give me some references, if you have time and desire. Thanks!
Your biggest risk is a stroke . You should be on anrtioagulant. . A NOACsuch as apixaban would seem most reasonable.
Saw two EP, both of them said my score is 0, so no anticoagulant needed. But I got Xarelto and Pradaxa prescription from my PCP (i'm not taking them at the same time). I'm not taking any of them daily, because I haven't got an episode for three months. I'm planning to take a pill of xarelto in case an episode rises.
I don't think so. Anti-coagulants are not advised for people with low CHADSVASC score and infrequent paroxysmal AF.
Exactly. If aFib episodes are of short duration the risk of creating a blood clot is near zero while the risks associated with anti-coagulants are very real.
Paroxysmal AF is not life threatening, and if it's rare and only at night probably has negligible impact on your QOL. Any Op (ablation is no exception) comes with risk. If you're going to take the risk it has to be because you feel that it's worthwhile, i.e. that you're mitigating some other bigger risk or gaining a material improvement in QOL.
Only you can make that judgement. But as someone who had paroxysmal AF and went for ablation for QOL reasons, in your situation I tried modifying my lifestyle/diet before opting for ablation, but in my case the AF became more frequent after about 6 months, started preventing me from running, and I wasn't able to control it.
Steve
Hey, I’m 29 and recently had an ablation for AF following only one recorded episode. Can’t say for certain I hadn’t had episodes over the years and not really realised.
They didn’t want to leave me on all my medications for life, my chad2vasc score was also 0 but xarelto was recommend until ablation. I’m almost two months post op and they will review in March and hopefully take me off all medications for good.
A recent post by Jonathan PittCrick, a cardiologist, said recent research does not recommend anticoagulants with a chad score of zero because the risk of taking anticoagulants is higher than the risk of what they are meant to stop. This may be why the EP said no.
You are seeing a chiropractor. Give that a chance. Taking risky medications and opting for a risky ablation may get you into a far worse situation than you now have. You worry too much. You need to tell your brain to get lost. People don't realize they do not have to listen to their brain. Listen to your body. It is telling you that, at present, you are fine. Some people actually do not have further AF episodes but they are seldom on sites such as this. The left brain, the final decision maker, is being over ruled by the right brain which can have a totally different point of view. So use the left brain to tell the right brain that it is making the decisions which the body indicates needs to be made.
After only 4 events, I would leave the ablation and try lifestyle changes. I think you need to look at your diet. It's a bit of a giveaway that your first AF episode was 10 days after you switched to a vegan diet.
You could also up the exercise. Exercise is recommended for AF as long as it's not extreme endurance. It would also help with the stress as would a more balanced diet.
I had more than 1,000 episodes before I went for my ablation (8 years ago and successful).
I agree totally with the advice above to change your diet to one that is more plant based and natural. Avoid anything with artificial additives. My sister had a few attacks of AF, but has had none now for many years.
Jean
A vegan diet is totally plant based but it is difficult to obtain balanced nutrition from it unless you are very knowledgeable. Also a sudden change in diet no matter how healthy can upset your digestive system, I went vegetarian for Lent once and the results were very uncomfortable to say the least......
I had 2 short episodes of AF both waking me from sleep at 3am in June last year, one hospitalising me. The 12-months prior I had lost my Mother and Father, experiencing awful grief and juggling a very stressful job. I believe at the time of both episodes I was stressed and fatigued.
After seeing an EP I wore a ambulatory heart monitor for a weekend. The results of which identified I was in and out of AF much of the time but hadn’t recognised it. I had an Ablation in September and haven’t looked back. I feel better than I have for a long time. It was a really big decision to proceed with the Ablation but I was struggling to come to terms with the fear of it happening and lost confidence to be on my own or go very far away from home. The EP suggests my AF was caused by emotional grief/stress
Thanks. I thought stress could cause afib while you’re awake not when you’re sleeping. I was under huge stress those two months when my afib started, but afib only happened when I was sleeping, so the I thought it’s nit stress related. Now based on your experience, it’s possible.
I was stressed over Christmas, nice stress getting ready for family staying and wanting to provide 'magical' Christmas, anxious about cooking goose! Soon after I went to bed Christmas Eve - bang! My heart was going crazy 😲 Another explanation is that your AF may start when your heart goes below a certain rate. I know you are an engineer so you feel you ought to be able to 'fix' the fault but our bodies are so complex you may have to accept it is just one of those things you have to live with.
ETA I think you need to get over your anxiety a bit before you have an ablation because after you have had it you may have 'blips' from your irritated heart and you may not cope very well with that. I would say you should be kind to yourself and work through your grief (because that is what it is) a bit longer and then if you have more episodes, go for it!
Well, just my 2¢... But thinking about awakening from a stressful dream that I actually remember and having my heart banging away tells me that stress is a 24hr a day gift... In fact, when it's reported that someone "died in their sleep" I always wonder what their nightmare was... or possibly they were climbing a mountain. Or - heaven forbid... making love...?
I only have had one attack and had my ablation procedure in August last year. They like to get in and sort it out before it gets worse over time , the earlier they get it the better outcome of a successful procedure. Glad I did because they found I had an SVT and a PV tac that needed sorting out , had I not gone for the procedure I probably still would not have known about the other 2 problems . So to answer your question is no it’s not to early to have an ablation procedure. To many people are left to get on with it then it just gets worse and can in the end not be managed with a ablation procedure for some people . It’s down to the person at the end of the day if they are happy taking medication for it or want to try and get off the meds and maybe have a good outcome with the procedure. You will find a lot of posts on here about this and your definitely in the right place for good feedback 👍🏼
Hope this helps a little
Best wishes
Sam 💖
I have had two episodes in 8 months ... one early in morning ... one after din ... NO way would l have an ablation procedure. I’m on meds ... talk with your dr.
In my opinion, yes.
My afib in the beginning started after working long hours for 3 months. I had 5 days off in three months and ended up in ER at a afib rate of 230. I realize that is extreme stress, but it did start then so, YES, I believe lack of rest and pushing your body is absolutely a trigger. It was and is for me. I comply with every possible thing that could be a trigger it for me. I was guilty of not getting enough sleep, sometimes 3-4 hours. I abused my body and My heart said, NO. Take care of yourself, you are young. Mine started at 59. Listen to your body being tired.
Thanks. Yes, being an engineer in a high demand and fast pace industry, I sometimes only got 2-3 hours sleep. The day I had my first panic attack I had only slept for 2 hours then went to a customer site and drank four cups of strong black coffee. That started the snowball of anxiety and two months later I got afib. I think there’s a link.
Its never too soon to be AF free....
My ep put me on the waiting list for ablation and at that time I'd had 3 episodes.
in reply to UScore
And li17 there's a hint in the answer above: if you are undecided, the time to consider whether an ablation is your best way forward may not be when it is offered to you but when you are at the top of the list. In the UK there can be a long wait - over a year in some areas - but maybe you would have a shorter time for consideration and developments.
Being on the waiting list may add to your stress or may be a comfort in that you may feel an opportunity to make progress lies ahead.
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