I read a lot here about triggers of an AF attack and I am a bit puzzled, I have persistant AF, after a failed Cardiversion I take tabs to control fast heart rate, now does this mean if tabs continue to do their job I will not get an attack of AF and I can ignore all talk of triggers?
Drugs haven't stopped my attacks
I am not medically trained but I would say emphatically NOT. You don’t say what meds you are on but I suspect the intention is for them to ‘cap’ your heart rate to reduce the risk of going into AF. They are not a cure. Although you don’t say as much, it sounds as though you are lucky to have found a helpful medication regime. Many people find the side effects to be as bad as the AF.
Thanks Ianmk, the meds are not perfect they can make me breathless sometimes The meds are the usual ones, bisoprolol 10mg, Diltiazem 180, ramipril 10mg,and Apixaban 5mg twice daily. Having said that my heart rate is between 65 and 80 which stops my anxiety which I believe is one of the worst things about AF. All the best.
If you have persistent/permanent AF you are in AF all the time and the drugs are to control your heart rate, blood pressure etc. Triggers are only relevant to people who have Paroxysmal AF, that is AF that comes and goes so they want to avoid it coming! However many of the things that are known as triggers are bad for someone in permanent AF. It is still good to avoid/reduce alcohol, caffeine, stress and follow a healthy diet, slimming if necessary. Sorry 🤗
I am in permanent AF and on medication which I would say manages my AF to an extent - my HR is erratic but around 80-100 most of the time. I avoid triggers alcohol, caffine and chocolate as this sends my HR up into the 150-180's. I was craving some chocolate a few weeks ago and I had two choccies from a box hoped it would be okay - wish I had not my HR was really bad all night and did not calm down until late next morning. When this happens I am very symptomatic. There are other things I have to be careful with things like MSG, food colorants and additives in certain foods.
Cassie
Hi Cassie,
Your comments are really interesting. I have paroxysmal AF (diagnosed in Jan 2010) which I now see as evolving from around 2 and half years of palpitations. Back in the day my heart rate was constantly around 85 to 95 bpm. The day AF hit it peaked at 160. I was 65 at the time. Eventually I related the onset of AF with food I'd eaten. Long story short, I consulted a Nutritionist who put me on a course of Probiotics and a diet, which I've widen over the years.
So for me at least its like this;
* Diet deals with the triggers
* Bisoprolol controls the HR ( keeps it around 62 to 65 bpm), and
* Warfarin deals with the stroke risk
It all took a few years to take effect and now I can truly say I have only had 1 AF event in over 3 and half years now, it occurred in Feb 2018 in the early hours and woke me up - sleeping on my left side ( which I've got recorded on my portable ECG device,not Kardia, and in hard copy.
Just by way of an observation, and no slight intended, with you being on medication and all that I am surprised that your HR is still batting away at around 80 - 100.
Prior to AF hitting I was already on statins and Ramipril - which I'm still on.
John
Hi John - I was first diagnosed with AF after being taken to hospital with heart failure, I had been unwell for 4 months prior to this with water retention and breathing problems, had seen 3 GP's in that period, one even mentioned my HR was high, but I was told I might have women problems, no symptoms as far as I was concerned for this, so had scans, MRI ect to find nothing. I realise now that I must have had AF for some time. Spent 12 days in hospital, loads of tests and eventually sent home with mediction for AF and HF. At present I take Nebivolol 5mg, Diltiazem 180mg, Ramipril 5 mg, and Rivaroxaban. My doses of Bisoprlol (was on that until 3 months ago) and Ramipril have been increased during the last four years to try and get my HR down but I cannot tolerate higher doses, so keep going with the 5mg doses.
I have never been offered a cardioversion or ablation, not impressed with my cardiologist so went privately to see an EP. My options now are stay on medication but he recommended a pace and ablate. So I am still making my mind up at the moment, but will probably go with the pace and ablate. I am also on breast cancer tablets (was diagnosed day before I had heart failure) which can effect the HR, this is a five year course, another year to go. This has been discussed but told I have to take them.
No one seems overly concerned about my HR nowadays, as long as it keeps under 100 most of the time.
Cassie
Hi Cassie,
So sorry to read of your horrendous journey of health issues and can well understand how/why you are still making up your mind. I guess this is yet another example of how/why AF is all things to all people. Best wishes with the decision making process and more importantly with the pathway you choose.
John
Hi John
Is the rampiril for blood pressure and does it work for you?
Ian
Hi Ian,
Yes on both counts.
But, by way of background, my blood pressure issue was first identified way back in late 2006 early 2007 (aged 63) and roughly 3 years before paroxysmal AF was diagnosed. At this point not only did my GP put me on Ramipril (10mg dose) but he put me on statins too (Simvastatin 40 mg). Then came AF in Jan 2010 and my party bag of drugs got bigger to include Warfarin and Bisoprolol (5 mg). In those days I lived in Surrey.
Once I'd moved and retired to Cornwall my new GP added 2.5 mg of Felodopine to the party bag !
For me my blood pressure is much more of an indicator of an AF event about to hit than HR. It always has been. In fact it was the weird, chaotic behaviour of my BP that sent me to my GP in Surrey and from that point, and within 9 hours, I was in hospital A & E, diagnosed with AF and treatment started.
So, these days I do pay attention to my BP and HR. If the BP ceases its boring, regular pattern (126/70 and HR 63) then its my wake up call.
All that said - my last AF event (the first in 3 and half years) in February 2018 occurred in the early hours and arose from sleeping on my left side. I'd never ever had that experience ever before. In the early days, and it still is, food is the trigger. On that occasion I initially chose to wait it out rather than panic and within 5 hours my chaotic electrical activity had reverted to NSR but my HR took a further 21 hours to drop to normal. During this event my HR peaked at 149 bpm and my BP 175/97. Again totally different to the original onset, back in the day, where my BP went totally haywire and trended downward until it got to the lowest point of 76/50.
Hope that's of interest.
John
Not really,drugs help control the amount of AF we get,hopefully.Drugs are just one of our weapons,AF has bern described as a warning from our bodies that all is not well...high blood pressure,stress,dietary probkems,lifetstyle etc.
The triggers will still trigger!
Triggers can break through your anti-arrhythmic medication, so it's best to avoid triggers, full stop.
Triggers can be difficult to identify- my main one is cheese - not dairy otherwise, and , worst of all is Mascarpone which has when eaten unwittingly (desert Baked Alaska ) has given me worst Afib attack ever
How do we know it's an AF attack? 
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