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Woke up in afib again, converted by exercising. Need some advices.

I woke up in afib again two days ago, this was my 8th episode. I tried running fast to convert and found my heart rate shot up to 228. Kind of scary to see that number but I didn't feel anything but my heart bouncing around. No tiredness, no short of breath, no dizzy feeling. I then stopped for a few minutes and tried it again with less intensive running, this time I converted after about one minute.

This was the second time I converted by exercising. I didn't take any medicine daily nor at the onset of afib. Total time spent in afib was about 30 minutes. The last three episodes were about a month apart, in end of March, April and May.

I've been taking magnesium, taurine, L-carnitine, fish oil, and sometimes VB for a few months but I'm not sure if these actually help.

For so many years, I've been considering myself 'fit' with a BMI of 25. Never got over 26. As an Asian American, I recently noticed the BMI for Asian is different, which 25 is considered overweight for Asian, probably equivalent to 28 in a Caucasian man. So I started working on losing weight and target for 22.5 (23 is considered the top limit of 'fit' for Asian) by running or brisk walking for 3 miles a day. I've been doing this for a month. Other than 'overweight', I also have mild sleep apnea, which is not treated as EP says it doesn't matter.

There must be something going on when I was sleeping. I can do whatever physical activities without any problem. The afib only happened strictly when I was sleeping. Never when I was awake. But for few times, when I felt really relax before bedtime, I woke up in afib.

So at this point, should I consider taking daily medicine? Or should I consider ablation? Or do more experiment to see if I can keep afib away?

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You should see a chiropractor and Dr. Bergman is near you so try him. Your symptoms seem the same as mine and a chiropractor helped me.

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I've been seeing a chiropractor for quite a while, three times a week for six weeks, then twice a week for another six weeks, now I'm at a once a week regime. Didn't notice much difference though. I have an appointment with Dr Bergman in late November. Hope he could help me to some degree.

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I would encourage you to consult with your heart specialist. Nothing may change but I think informed decision-making is the best way to go.

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Thanks! Yes, I've seen two EP and 5 cardiologists. But they don't seem to be interested in helping me to control afib but rather just advising me to do ablation.

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They always want one to take that path ... never would l.

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Sleep apnoea should be dealt with as it's known to contribute to AF. It sounds like vagal AF if it only comes at night. Make sure you sleep raised up a bit and probably not on your back if you have sleep apnea.

I have vagal AF and have improved since walking more- my pulse was lower previously. Also found that my potassium level was below range and so increased food containing potassium- that stopped AF for 3 years and have had just two episodes over last 18 months. Cardiologist advised me to have Magnesium if I was increasing potassium in diet.

Be careful about exercise when in AF. It's different in permanent AF but with PAF there is a risk when you suddenly revert and ideally you should be resting quietly at that point. I agree with other posters that you need detailed medical advice re options for you.

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Maybe I have vagal afib + apnea. Noticed couple times when I woke up in afib I was sleeping on my back.

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They also say sleeping on your right side is better than the left if it is vagal- mediated not adrenergic

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I’m ok to sleep on the left. But right side sometimes makes my heart to skip or race.

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Hi and welcome

First - Sleep apnea even mild, is a known antagonist for AF. I have mild to moderate SA and am treated and I now have no AF at night, whilst I used to get it almost every night.

2nd - May I suggest that if you are waking with AF and convert with exercise that you may have vagal AF - suggest you do some research on this and look at how to improve your vagal tone. Cardiologists very rarely tell you about Vagal AF - but there is a lot you can do to help yourself before considering any invasive procedures or drugs.

3rd - is the cardiologist you see a specialist EP (

Electrophysiologist)

There is a small book on Kindle called - How to improve your vagal tone. I use a breath exerciser - breath in and breath out against resistance. Cold showers are also good along with 3-4-5 breath exercises.

Exercise is helpful for general fitness BUT endurance or intense exercise is also an antagonist for AF so do be careful - HR over 200 is not good.

I find that COQ10 is very helpful and also take Omega3 fish oil along with other more specific supplements for other conditions.

I also have regular chiropractic adjustment (every 6-8 weeks) as I have a history spinal misalignments after several RTAs and have been put into AF with chiropractic adjustments as well as converted back into NSR. The adjustments do generally help but what helps most to keep spinal alignment is Pilates - core strengthening and posture realignment and regular very specific stretching exercises.

Also research Egoscue exercises and methodology.

Hope some above helps.

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I'm trying to get an in-lab sleep study. But since I'm in the middle of changing insurance, the whole procedure is being delayed. I guess improving vagal tone might help. But I can't find the book you suggested in Kindle bookstore. Maybe it's not available in the US Kindle store? I'll look somewhere else.

And yes, I've been seeing EP. But he doesn't want to talk about anything else but just offering ablation. I'm considering seeing another EP soon.

When my heart rate shot up to 228, I was scared it would become v-fib. Is it possible? Now I know if I ever need to do it again, I shouldn't do it intensely but speed up gradually.

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Yes, I think going into VF is a possibility with sustained very high rates.

The book - could be that it’s not available on US site.

HEAL YOUR VAGUS NERVE, HEAL YOURSELF: A Guide to Enhancing Vagus Nerve Function Kindle Edition

by Hoyd Lucy (Author)

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Thanks!

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Hi Li, my recent 'run' of AF episodes has coincided with having to sleep on my back because of hip/back pain. Also my cardiologist thinks my heart may be slowing down too much when I am relaxed. I think tiredness is a factor too but as I am an unfit 73 year old I obviously get tired more easily than you do!

I think you are doing well looking at your lifestyle. Perhaps it would help if you concentrated on living a balanced life, good diet, rest and exercise but nothing extreme and accept that you will have AF now and again. An EP will always want to ablate, that is what they get paid loadsamoney for!!

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Hi Li, i have had PAF for about 15 yrs now,on medication,and have been not to bad but last attack,I lay quietly breathing slow,and listening to a you tube video of normal heart beat,this stopped it within 30 mins,I have done this 4 times in all,and it worked every time.

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I did the same and it stopped the AF in 20 mins.

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That’s good,whoever suggested it in first place,thankyou,hope it continues to work.

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I used to be able to convert AF to NSR by running up flights of stairs but it gradually took more and more exertion to convert until it wouldn't do so at all. Then the AF really started getting me down but since my ablation I've been fine so do consider that as an option.

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Hi Mike, how many years have you been AFib free following ablation? Any risk that they sever the heart's electrical system? I see a specialist at Allegheny General Hospital in June.

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Four years, apart from a couple of weeks when it came back when I was laid very low by a virus and my heart expanded. Once I got rid of the virus the AF disappeared again. There are risks with ablations, as there are with the main AF drug amiodarone, which simply didn't work for me so it wasn't really a choice once the AF stopped me working.

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I took amiodarone for nine months continuous. On it, I was going in and out of arrhythmia. Since switching to Flecainide, I have been in sinus. How did amiodarone not work for you?

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It bombed by blood pressure so had to come off it immediately

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I have had similar issues, and found the evidence-based cardiologist and EP route extremely helpful, rather than the witch doctor approach.

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If your EP is really an EP and not a cardiologist, you must get a second opinion regarding your sleep apnea. As noted by CD Dreamer, sleep apnea is a known trigger of AF and the fact that you are getting AFIB events at night is likely no coincidence if you have been diagnosed with sleep apnea. Surprisingly, when I was diagnosed with AFIB almost three years ago, none of my medical team even considered having me tested for sleep apnea even though I had complained of poor sleeping. So I took things into my own hands by getting a sleep test which confirmed mild sleep apnea. I now use a specialized dental devise which has opened up my airways at night (couldn’t get used to CPAP). You need to take care of this!!

PS- be careful about over exercising as a means to get back into normal sinus rhythm. Might seem to work for now, but could pose problems down the road

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Me too, the cardiologist and EP and primary doctor had never shown interest to test for sleep apnea. It was me to pay money out of pocket to get a test.

Would you please explain what could be the problem down the road by exercising to convert?

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From personal experience, I tried exercising when I first went into an AFIB event and it got worse. There is some thought that exercise for some make things worse. Some folks on this site limit what they do due to AFIB while others don’t have an issue. While I exercise daily, I wouldn’t consider doing it whilst in the midst of an attack again. Deep breathing I’m told can be helpful too when having an AFIB event. All of that being said, consult with your EP. if he or she indicates that exercising your way out of an AFIB event is beneficial without causing long term consequences, then you should follow their advise To me, the key is prevention and I’m doing that now by faithfully taking my Flec and beta blocker which is working well for me

Best of luck

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I think that you should definitely be on medication. Very mild. Ask your cardio. Magnesium taurant definitely helped. Plus l am on lots of other vitamins, minerals. I have had only two episodes in a little over one year. I don’t feel as though it will ever happen again. But who knows. Only God, our dear one, knows what is in store for us all!

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I’m taking all kinds of supplements but not prescription medicine. I did try, but can’t toler any.

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I know ... the side effects can be bothersome ... they were pretty bad in the beginning, but now the side effects are disappearing. Good luck!

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Are you on prescription?

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Yes … 80mg solotol … split day and night … but I am in the USA … I don't think that they prescribe it any longer in the UK.

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The first EP I saw seemed to be ready to do the ablation as soon as I would get horizontal. He had a good reputation as a doc, but I wasn’t ready at that point. Subsequently, I saw a more conservative EP who worked with me, explained all my options and performed my ablation a few weeks ago. I’m positive about the experience. While I have had two episodes, he had indicated that this was not to be unexpected for a month or three after the procedure. It is all about quality of life.

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What does the chiropractor do? Does he adjust C1,C2, T1,T2 and T5 as well as check to see if all the other vertebrae in between are ok? Has this person ever treated for AF? C5 could be the vertebrae that affects sleep apnea. I can't remember which one does for sure. You should ask the chiropractor. If this chiropractor does not answer your questions with confidence, you may wish to find another one. For me I have been at this for almost two years and the vertebrae still won't stay where they should be. In the last week though, there has been significant change which seems to be for the better. Time will tell. I am 70 so fixing me and me changing how I sit, stand and sleep takes time. I know there is a definite impact since just by me manipulating my back I can pretty much always put my heart into regular sinus from irregular beats, and sometimes even when it is in AF. So there is something to the spinal impact on the sympathetic and parasympathetic nerves but unfortunately this is not being researched to any great degree and certainly not by heart doctors.

There is a British emergency program on TV where one show depicted a lady whose heart stopped while walking. She was saved by doctors and a defibrillator was put into her heart to restart it if it stopped again, which it did. Even though the doctors said the brain controlled the heart, they did not have a chiropractor check if the sympathetic and parasympathetic nerves were functioning correctly. To me this seems like something that should be checked.

I am an electrical engineer and I know the solution to a device that is not receiving the correct electrical signal is not to install a brand new source of signal. First an attempt would be made to find out why the signal from the original source is not getting through. Why should the body's electrical system be any different and why is this not done?

How many people have ever had a heart doctor check to see if the electrical signal from the brain is being received by the heart appropriately? Asking people this question might be a survey worth doing.

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Please let us know what Dr. Bergman says when you get to see him in November.

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Pershaps it takes a long time to heal the nerves in the spine since it is possible that they are continually being compromised. It takes 6 months or a year for nerves to heal once they are free to heal. When this point is in the spine is difficult to determine. Perhaps gradual healing occurs as chiropractic adjustments reduce the impact on the nerves. Some chiropractors are doing 5 to 10 adjustments a day and having success. So if the vertebrae that affect the nerves that impact the heart are not kept in the appropriate place, it may take a while for the nerves to function as they should. Unfortunately, there may not be a magic procedure since each person's situation is different. So if your chiropractor has to continually adjust the vertebrae, I suggest that you continue for maybe a few months yet; and if you gradually see differences, you will know that you are making progress. If less adjustments don't seem to be helping, you may need to go back to more frequent adjustments for a bit again. Also the chiropractor can adjust the vertebrae in different ways so this may need to be tried. You need to give feedback on the impact, if any. Quite often after I have had an adjustment, my heart behaves for a few days then acts up again. And I have had instances when it is fine for a few weeks; but then my back acts up again and so does my heart. After 7 months of twice weekly, and sometimes more if my heart misbehaved, I had once weekly adjustments for 6 months. Now, I go once every two weeks; and occasionally in between, if my heart misbehaves. This is a frustrating process but because change occurs, I will keep plodding along. I wish I knew someone who has had success following this approach as apparently there are people who have had success.

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The chiropractor I’m seeing had treated afib patients but they’re all much older than me. From the x-ray at the first visit, she showed me my spine was a bit twisted. I can see my left nipple is much higher than my right one. And my neck is lack of natural curve. But I don’t see any difference she did on me for the adjustment as she did on other patients. And each time I went to see her, the adjustment was always less than 5 minutes. She said there are notts deep inside my back which built up for years. However, I didn’t see much difference after 13 weeks of adjustment.

Before the most recent episode, my daughter fell asleep in the car so I lifted her up from the car to the 2nd floor. She’s 55 pounds. After that I took a shower and went straight to sleep then woke up in afib. Not sure if this was related.

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After being diagnosed with afib in Sept 15 I found out I could cardiovert by exercise. 7 to 10 minutes and my HR went up to generally 180-5 then dropped to my normal 150 running pace. When I stopped It reduced to my normal resting HR.

The reason I tried this in the first place was because my normal hr trace shows a rise to 165 and then after the 7 to 10 mins down to 150 . So i tried it to see if the exercise took over the afib and it did! ( I did it as one saturday or sunday i could just not be bothered to go to hospital!

I only found out I had afib as s I put my garmin on one night when I felt the fluttery feeling and found i was doing 165 sat down. That lasted all night and all the next day until midnight -

By which time I was in Hospital.

My max recored HR on one of these "restore NSR" runs was 243. I was totally asymptomatic even at this HR. I only get a fluttery feeling in my top chest/ throat area for a few minutes which disappears but when it disappears I was in afib which gradually increased HR until about 160 resting (but jumping all over the place)

Warning - I was not worried about a short term high heart rate as I could often see peak of 175 on push bike or 185 running normally. ( not sustained). If my HR had only normally peaked at 150 I would have been more concerned at 185 - people are different.

Second warning. Because I could cardiovert this way I never went to hospital or GP after my first episode. I was using only 60mg of flecainide or day as rate control so not intrusive.so I was happy. But no medics knew I was getting so much AF so no advice either!

Unfortunately after 11 or 12 AF episodes in 22 months an episode did not convert on a run . A second run and 120g verapamil 5 hours later sorted it. 10 days later same again. The second run was up a long hill got a very high hr which dropped going up the hill. 2 weeks ish later I had another AF episode at 8:20 PM in the car on the way back from A walking /climbing holiday in Scotland. This would not cardivert to nsr on a run. Nor the second nor the third at 220 bpm. Went to a&Eand they put me on more verapamil . Hr reduced so they sent me home. It came back the day after ended up inA&E after a full day of AF with HR jumping from 95 to 195 and back. So i was accepted to medical assessment unit and given some injectionsand I went to NSR overnight. Two days later back in a&e where I stayed until being taken to the coronary care unit and given a flecainide infusion which cardioverted me. I was then put on daily flecainide 2 x 50 mg and 200mg diltiazem which I found very intrusive: brain fog, tiredness all the time and no exercise tolerance 137 max HR which is a fast shuffle running , but the effort needed is like the last 100metre of a race for all the run. Frustrating.

So third warning AF can evolve for the worse. Also having a high hr was asymptomatic or me, but after 8 days at 130 to 195 I was exhausted. Totally knackered.

In the intervening 10 months I have been assessed for an ablation, had an ablation , 9 days later developed atrial flutter, spent 3 weeks in bed as I could not do much else, had a SECOND ablation for flutter(possibly caused by the flecainide which promotes flutter). I was then 3 weeks at 130 to 145 hr, again exhausted I.recovered over 3 weeks following the ablation as i was totally unfit and since returng to work have only worked 3 day weeks for 2 months. I have been off all drugs now for 3 weeks (off flecainide for 6 weeks) i am back cycling (6 outings) and running ( 5 runs) and I am now begging to feel better.

If i did all this again (and I so hope I do not) , I think I would have had more discussions with my medics about the AF attacks I could solve with exercise so they were aware of the frequency. Probably as a result I would have also looked at the ablation earlier, maybe I would have missed out on the intrusive drugs and probably missed out on the delights of atrial flutter and the two months grief it caused.

Hindsight is wonderful!

However everyone is different and what happened with me may not happen to you anyway

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Hi Li17. Adjustments do only take 5 minutes or so. It almost sounds like you may have scoliosis in your back. If you do, it is difficult, and perhaps impossible, to fully straighten your spine. My daughter has this. Chiropractic adjustments help her keep her back limber and she has less pain. You may not have had enough adjustments to make much difference yet. You could ask what you should expect and how long it will take to help.

Did the chiropractor help the people with AF that she treated?

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Hello, you have lots of good replies from quality respondents, so I will be brief. My recommendations are CoQ10 200mgs/day, Krill oil 1 cap per day, regular daily walk minimum x2 per day for 2 miles, Nasal strip at night and a few Qigong exercises daily - I use one only which strengthens the neck, back and stomach muscles. Good luck, persevere!

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Thanks everyone that give suggestion. I’ll try all these and will report back if I notice any improvement.

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