Got my 7th episode this last Friday. Woke up 3am in afib. Unlike what I did before, I didn't take any beta blocker or flecainide at the onset of afib, but I did a fast running for couple minutes to the point that felt like just finished a competition with my heart pounding really fast. Then in about one minute, my heart converted back to NSR.
This is the first I converted by exercising. I tried it in the last few episodes but didn't work. Guess maybe the propranolol that I took at the onset of afib prevented my heart rate to go fast enough or it just isolated the heart.
Now I have a question. Provided this is my 7th episode in eight months since diagnosed, I'm losing hope of it will just go away. Should I consider an ablation at this point? Would ablation work the same on vagal mediated afib? If I can always terminate afib by exercising, would getting an ablation at this stage considered too early? Should I control it and wait for a few years until there're more advanced technology comes out or maybe there could be a true cure in the new future.
Thanks!
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li17
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It’s a catch 22 situation. Get ablation now wouldn’t guarantee a cure and takes some risks. But wait and see would leave the chance for the heart to remodel. Really lost.
How long do your episodes last? It seems they are not too bad if you can run during one - I can barely walk at times. So maybe not affecting your QOL or remodeling your heart too much at present? In that case with a healthy lifestyle it might be a sensible option to wait a while. Hope that helps.
Episodes usually lasted about 4-6 hours before the last one. The last episode that was converted by exercising lasted 40 mins. But in those 40 mins I spent probably 25 mins laying in bed to pat my baby boy to sleep as he woke up crying after I jumped up in afib.
Strange though it may seem, your question is a personal one first and a medical one second, therefore although you will get some excellent advice here, its still all down to you and your preferences.
I have vagally mediated PAF and was offered an ablation but chose to be stabilised by Flecainide while I worked on alternatives in the shape of different lifestyle, exercise regime, supplements & diet. So 4 years down the line with no AF and no side effects from Flec my QOL is much better than expected and I am sticking with my decision, whilst accepting I may end up with and ablation. No decision is clear cut there is a lot of balancing one off against the other and accepting a less than perfect position...hence back to it being a personal decision.
Stopping AF without drugs/hospital intervention is one way where I think there could be some real advances in the next 5+ years; particularly interesting for those of us with vagally mediated AF. In the past, I have stopped it by going for a mile brisk walk, lying on the sofa and focussing hard on a steady heart beat on YouTube on my iPad for 20 mins and am interested in trying the cold fizzy drink remedy mentioned here, as my last AF came on by gulping a cold ginger beer. I have also started AF by just visiting a place where I had it bad before.
Apparently, the Vagus Nerve for some can put you into AF and take you out with the same action but not the same together if that makes sense i.e. if a cold drink has put you in AF a cold drink will not bring you out but may do so if AF just occurred or something else started it e.g. over exercise.
Sorry rambled on for too long, hope something there helps anyway. Keep posting your plans.
Thanks for the insights. My afib only happened when I was sleeping. No matter what I ate or drank or did would not start afib, it only happened when I sleep. I thought it could be sleep apnea triggered afib, but I was wearing an O2 sensor when the last two episodes happened and I didn’t see O2 level dropped before the onset of afib. Also the fact that I was able to terminate afib by exercising is a solid proof of vagal afib.
I’d love to control it without going through ablation. But I’m not a fan of taking any heart med. So for me it would be controlling without med or head for ablation.
While I’m still debating, I’m taking supplements, eating more healthy diet and doing routine exercise in the hope of afib wouldn’t happen again. As I always hope the last episode will be the last.
I had an in home study and found mild apnea. I will try to get an in lab study soon. And I also purchased a O2 sensor which can continuously monitor the O2 level and heart rate while I’m sleeping. This monitor would vibrate to wake me up if my O2 drops below 90%. Some days when I felt really tired I would found the O2 level had occasionally dropped to as low as 82% but I didn’t get afib in those nights. When I had the last two episodes, O2 level didn’t dropped below 90% too often and the time I spent below 90% was less then 1 minute compare to the night I had over 20 mins below 90% but didn’t get afib.
Was treatment such as CPAP suggested? Mild SA is considered borderline for NHS treatment. What I notice is my sats now never really drop below 92 - and are normally 95+ and that difference makes a huge difference to QOL. They shouldn’t really go below 90 is my understanding.
No CPAP was suggested. I didn’t go to the follow up appointment with the doctor because of insurance changes. Will try to get an in lab study with the new doctor. Not sure why, it happens occasionally even when I am awake and with shallow breath, my O2 level could drop to 88%. But I can’t reproduce it intentionally like holding my breath for one minute and it didn’t drop.
I’m in US as well. I will check Amazon. However what is the importance of monitoring? How does oxygen levels tie in with afib? Is this monitor considered a preventive measure?
Because sleep apnea is considered a strong cause of afib and I was diagnosed with mild apnea that EP said would not cause afib. But I wanted to know how bad the apnea is and wanted to see if I get afib when the O2 drops too low. However, per my observation, I had few nights with O2 dropped below 90% to as low as 82%, and the total time I spent lower than 90% was 20 mins, that that didn’t trigger afib. But in the two night I had afib, the total time I spent under 90% were less than a minute. So that now I suspect my afib is not caused or triggered by apnea but truly vagal mediated.
On the other hand, I think if I have apnea, as the sensor would vibrate when the O2 level drops below 90%, then I would wake up and that could resume conscious breathing to raise the O2 level.
It’s a Good question - and a very difficult one to answer for someone else. It does sound like vagak AF - so my first inclination would be to see if you can improve your vagal tone and see if that helps. Do your research. Learn all you can about the Autonomic Nervous System and connection between ANS, gut and mind.
Consider your factors - age, health and general fitness, lifestyle, nutrition and mental and emotional health and any factors which could suggest underlying conditions linked to AF.
I was 57 When I was first diagnosed in 2007 I did quite a lot of research and discovered there are 3 types of AF - vagal AF, non-vagal AF & mixed ie episodes of both vagal induced and not vagal induced AF. I had both type of episodes. All can be progressive and not always are. Very difficult to pin AF down - everytime I think I got it taped - it appears in another form.
I waited until 2014 for ablation - mainly because it wasn’t as easily available so I persevered until episodes were very frequent and very symptomatic. - by which time I just wanted rid! In retrospect - I waited too long. After 2 ablations I had 3 years completely free of AF, episodes then returned but not as often and not as symptomatic so still an improvement. But my episodes lasted up to 72 hours, my BP went through the floor and I couldn’t even stand up, never mind try run!
Ablation is effective for many people and the success rate is quite high and we are told risks, although when they happen are serious, relatively low in percentage terms. We are also told that the younger you are and the earlier in the process we go for ablation - the higher the possibility of success. I don’t use the word cure - which in medical terminology is when you are disease free for more than 5 years.
Any treatment for AF is based on improving QOL but all treatment carries a risk so it depends upon your inclination toward risk:benefit.
Only you can decide whether or not it would be a useful treatment for you - but do your own research and weigh up your personal circumstances and options and pick the one that is most appropriate for you at this time. Things are constantly in flux and you can change your mind as time passes.
Thanks! So if you could go back to 2007, would you do an ablation in that time rather than waiting until 2014? Would you think you could get a better outcome from the ablation?
I don’t know. All I do know is that it wasn’t offered so I didn’t know about it and by the time I did know about it I was feeling that AF had so limited my everyday life and work - if anything could help I wanted to try it.
The trouble with having infrequent episodes was that there was such a long time between episodes you forget how disabling it can be so you just get on with life. Then it gradually gets more frequent and more symptomatic.
But it is an invasive procedure with risks so there has to be a big benefit for me to go ahead and live with the small risk. And if I had known then what I know now I would have looked at nutrition, exercise, sleep and Autonomic Nervous System with chiropractors in a lot more detail before taking that decision.
I tend to agree with you. I did have to use Flecainide to stabilise as had 9 AF episodes in a month and it was either that or ablation. The snag is now after 4 years my QOL is such that I have for now chickened out of stopping the Flec, after having promised myself I would start weaning myself off after 6 months! Enjoy the day!
I feel you are not struggling too much at present and have not had it too long. I took meds at age 40 and I was told then, you may find you need an abation in about ten years and I thought, no way but thanks for telling me. And happily continued with meds. I didn’t like taking them as they can make you tired but it was the only way for me to get a controlled heart rate and to stop feeling dreadful as I had prolonged and regular a.f episodes. Maybe if you are under control and not too bothered, hang fire for now and carry on with what you are doing.
As regarda your a.f. and stroke query. My mum had a heart attack in her late 40’s and she too had a.f., this went on to cause a devastating massive stroke, which was extremely debilitating for her, paralysed down one side and very little speech. The A.F. cause clots and it is those clots that can sometimes drop into an appendage in the heart, it is the a.f. clots that can lodge there and cause these disabling strokes. I was told all this by my consultant and he showed me where the a.f. clots can form and cause the a.f stroke, which are the worst. I don’t want to spread doom and gloom I wanted to explain my experience and the consultants knowledge of a.f. strokes as I have seen it first hand. I want you to give yourself the best chance with your health and to take the right precaution and guidance. My mum survived that stroke for 17 years, she was an amazing trooper. I went on to need two ablations 12 years after diagnosis as the meds no longer worked and the symptoms increased. Obviously, my a.f. is a family thing and everyone’s journeys/experiences are different and can be more or less troublesome than others.
AFIB itself doesn’t cause too much physical problem to me per se, but emotionally I suffer every second since diagnosed. It is life changing and literally altered my career, family and kids life. I just want to get rid of this thing but gradually losing hope.
Please don’t lose hope. I find the mental situation of dealing with an out-of-control heart unsettling but as much as I detest the medication, it comforts me to know I have some protection against strokes.
It is life changing for me. I don’t have much energy and am exercise intolerant -so I do stretching slowly and always wondering if it will go away completely or ready to rear up. Read as much as you can I think-from people going through it. It makes me think a little less about it as I read about people who continue on.
Did you get the Alivecor Portable EKG? I just ordered it today and it’s already shipped out. I think having that will help you to see what your numbers are and connect any triggers . I don’t know. I debated getting it because I can feel when I am in flutters and in A Fib. Oh well...
I didn’t mean to write so much but just didn’t want you to feel hopeless.
Thanks for encouraging. I do have the AliveCor and the strap for Apple Watch. I’m not too afraid when I was in an episode but the long term and no cure make me feel hopeless.
I think changing mindset may help more than any procedure - if you aren’t that symptomatic. I have found that Mindfulness, Yoga, breathing techniques and working on Vagal tone has helped in many ways.
Engmac posts quite a lot about Dr John Bergman YouTube videos talking about spinal alignment and arrythmias which may be worth exploring - but I really don’t think there is a magic bullet for everyone and so we need to learn to live with uncertainty and adapt and still enjoy life.
Can I ask also whilst on here and someone mentioned vagal a.f., what is that? I can be a fainter and after my last ablation my vagal nerve was damaged, very rare btw, this caused gastric dysmotility. I wondered if a connection with vagal and a.f. Thanks
There most definately is a connection because it is the ANS (Autonomic Nervous System) which sends the electrical signals to the heart. The vagal nerve is part of the ANS which regulates heart and digestion,
Regarding treatment for AF, CDreamer has said all I would say but I have to comment re anticoagulation.
Of course anybody can chose to ignore advice should they so wish but it has been estimated that here in Britain we could save up to 8000 serious strokes a year if all at risk patients were anticoagulated. Make sure that your Chasd2Vasc2 score has been properly done and please don't take risks if it says you should take anticoagulants.
Whoa! You don’t take ANY anticoagulant? What about turmeric, ginger, taurine, aspirin, Japanese nato, fish oil and other things known to thin the blood? Do you take prescription strength versions of those things instead (which are still too weak) ? I would not dream of putting myself in the way of a completely devastating stroke by not adhering to medication on anticoagulants. I mean I would love to, but the fear of being in a severely deformed vegetative state from an AF stroke and being a burden on others encourages my compliance on this. I was so reluctant to take this medication, but after reading authentic research and double blind studies with peer reviews on the need for anticoagulants if you have A-Fib, I came to a more reasonable decision for me. Doctors aren’t just guessing about the stroke danger. It’s very real. And A-Fib strokes are the more devastating ones.
Be careful with your thoughts on medication. Nothing is perfect. What would be perfect is not having A-Fib. We can not just pretend the research is not there: A-Fib clots are dangerous, and must face the harsh reality we are living through; the consequences of not taking anticoagulants if you have a-Fib are much too grave, in my opinion.
Best of luck and good clean health to you. I want to say you are brave and that I admire your bravery on this because I want to think the same way as you do about this and not take this challenging medication, but it just seems more foolish instead. Be careful dear.
“....8,000 serious strokes in Britain alone, could be avoided (by the ones at risk) taking anticoagulants”......
That’s compelling and direct evidence.
Why risk your QOL, being a major burden to others or death if you can make more of an attempt to avoid it? I am not getting the logic. Do you not believe the data? No one likes this medication for sure. Yes, pharmaceutical companies make money from our illnesses, but so do funeral homes.
I agree. None of us want this condition or to have to take medication but I also think myself very very lucky that I live in a country where such treatments are freely available to me. Of course It's right to try to reduce unpleasant side effects from medication of but not at the risk of serious harm
I have been speaking to my Dad about my AF (I've only had a handful of full on episodes over two years) as I know he has an irregular heartbeat and other issues. Sounds like he has been having undiagnosed regular AF episodes for 50+ years. He is very anti medication and doctors so has figured out self help ways including carotid massage, cold water immersion and fast walking! He is an 82 year old vegan, very fit and on no medication for anything. Does make you wonder. I'm 56 also vegan but on blood pressure medication and Bisoprolol for the AF - he walks for two hours+ each day, I sit on my backside at work 8 hours a day ...
Oh my! I peed like crazy in A-Fib. I did not know it was a thing. What causes that?
I can see why you feel comfortable. I am constantly dehydrated even though working on more water. I do have stroke risk in my family and I am not in good shape-so clearly my risk is much more complicated than yours!! I understand better now.
Did not know about the peeing being a thing when in A/Fib, I even had to pull the car over to pee on way to ER!!!
I know. I remember you had six episodes in 15 months before ablation. By the time I contacted you I had only 4 episodes and was in a period of 105 days without any. Then I had two in March and one in April. My life is seriously affected. Sometimes I just wanted to call the doc and lay down for an ablation, but still, being told it’s not a cure, I’m so frustrated and concerned to get one. That’s why I have constant debates.
I was diagnosed afib sept 2015. I only realised I had it owing to one odd high HR when running causing a temporary fluttery feeling in chest. then 6 weeks or so later i had a similar fluttery feeling a 21:30 and just out of interest I put on my garmin hr belt for my running sat nave and found out i was doing 165 bpm sat dow!. It stopped there all night so i rang 111 in the morning and asked for advice and they sent an ambulance! I was totally asymptomatic . Less than 24 hours laterIn hospital I returned to nsr. I ended up just taking 60mg of verapamil pet day as rate control. I then found if I had the rising HR then going running cured it . My HR went high, 7 to mins of running and it dropped to my normal 150bpm running rate for 6 miles. Then normal nsrcafterci stopped runnning.I usually took 120mg of verapamil rate control before starting the run for after wards, (verapamil took 4 hours plus to get into the system so no use as a pip)
I pulled this trick off approximately 12 times in 22 months. The highest HR I recorded was 243bpm. I was asymptomatic at that.
Then June 17 I had two attacks in a 10 days that took multiple runs to get fixed and a lot longer than 10 minutes .
2 weeks after that (mid July 17) I had another attack. I ran and ran over a couple of days . It would not go away. The magic trick no longer worked.
I ended up in hospital 3 times over 8 or 9 days and only got cardioverted by flecainide infusion , and after that I had to be on flecainide and diltiazem daily.
In hospital I started off a asyptomatic but after 8 days at 140 to 190bpm i was totally knackered. Not sure I have been the same since. I cannot really tell as I have been on the drugs since and I do not like the drugs . They limit my exercise tolerance, give me brain fog and keep me tired.
Only at that point did I start looking for an ablation. I was lucky in it only took 4 months to get an appointment with an EP and an ablation 10 weeks after that. 9 days after the ablation l developed atrial flutter Which was very aymptomatic: very tited and breathless just walking around the house.
Again lucky got a second ablation in 3 weeks after the flutter started.
I have now stopped the flecainide and hoping to drop the diltiuazem after the 8th May after my EP appointment.
Point of the note:
Unfortunately the afib can develop so the excercise option stops working ( I was gutted!).
Afib begets afib. The more you have it the more you are likely to have it. (Atrial remodelling?) Something caused my flutter. ( afib or the drugs or both?) When he afib stopped the flutter started.
What would I do different with hindsight?
By managing the afib by exercise effectively I hid the occurrences from the medics. Perhaps had I flagged it to them we could have altered something to slow its progress. Also I would have had discussions about a potential ablation earlier so when it did develop I could have had the ablation set up earlier.
Of course with this disease nothing is consistent so your exercise magic may not go away but I think generally the condition worsens.
I was 55 when diagnosed almost 58 now. I was pretty fit .
Thanks for your first hand experience. It is very helpful and informative. I'm worrying if mine is getting more frequent. As I posted here earlier, I had four episodes in the first three months since diagnosed, then went three months without any (not sure why), then got three in the last couple months. The last three episodes were 27 and 29 days apart. My current 'plan' is to get all my body abnormalities corrected, and if it doesn't make any difference, then I'll get an ablation. The problem is, even I get an ablation, it's not a guarantee of long term relief not to mention cure. This thing is driving me crazy. I felt my life is suddenly turned upside down and it had seriously affected the time and quality that I spent with the kids.
You and your family will work through this and you all will be ok. I love the way you said “get my body abnormalities corrected”! For me, that is weight loss. Did you read on here that the sooner you have an ablation that it appears to be more successful? I saw it somewhere.
First, wow! I truly admire your determination and strength. You are one strong person with the ability to achieve your goals!! Wow! I am impressed that you kept it at bay for so long with exercise. Now, you are almost medication free. I loved the way you wrote about your experiences. I am not a candidate for ablation but I am thrilled that you just never gave up and look at you now!! Almost free!! I hope the flutters go away completely and you heal completely. 58 still young and you seem to be in great shape. Any idea on your triggers? Will you continue your exercise or does exercise bring on problems now?
Well thanks, but I don't feel like that - I am the same as everyone trying to get over something that does want to be got over!
I never know any triggers - maybe stress but "stress" is a bit woolly it can mean lots of things. Originally I had a high proportion of issues on a Thursday usually late-ish I was working very hard at the time Second most popular day was Sunday, often late on.
I do not feel young any more - probably about 10 years older that I was last July!
I will continue exercise - I am not an endurance athlete I was doing 4 - 10 miles per week running , 20 -75 miles per week cycling ( in summer) , would like to get back into some circuit training at some point if possible, but that has not been possible so far.
I won't know if I am AF Free until I come off all the drugs, so it still can all go pear shaped at that point. We will see
Just one general warning of all who exercise - there is a saying that AF won’t kill you BUT the only person I know personally who died as a direct result from AF was an ex-marine who exercised hard - and I do mean hard ie reckless - despite being warned he continued to ‘run through the pain’.
It’s the extremes that seem problematic none - too much, too hard.
Please check your heart rate when exercising and keep it under control. I think the advice is you should be able to speak a sentence whilst exercising - for us non elite atheletes!
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Posting for the first time,
First time I have started a post
New Member, Acute Atrial Fibrillation first time!
paroxysmal atrial fibrillation converted back to sinus rhythm 
First time post !
