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AF Association
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Stopping an AF episode

I know AF is a law unto itself, and there have been many discussions on here about what might trigger an attack. I just wondered what others have experienced when the heart returns spontaneously to NSR. I had a 3 hour AF episode this morning, decided to just stay quiet and sit it out. After 3 hours my daughter rang to see how I was doing and within about 5 mins it reverted. Other times it has reverted often in the ambulance, or on arrival at the hospital. Once, when the nurse slapped a freezing cold cuff on my arm for bp, or another time the nurse gave me a cup of tea. What circumstances have other Afibbers found might revert them to NSR?

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I had been having an episode that had lasted nearly 5 hours in A&E. I was lying quite flat throughout then when they took me for a chest xray the nurse abruptly raised the bed & hey presto back into NSR. Did not have any intervention the whole time either.

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So random isn't it?

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I work on the basis of (stating the obvious), we have an internal problem. My thoughts are to alter my inner temperature, in order to cool the blood, (probably a madcap idea).

Having said that; whilst very cold drinks have started my Afib, they have also stopped them. I have also plunged my arms into iced water and let them soak - that has also stopped Afib.

I guess whatever works, is worth a try. If you have/find a better one - please share.

Good luck.....John

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Hi John, I have tried the arms in cold water trick. It did work on one occasion,.

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Thanks John, I will add that to a long list ready to try, one must work!!

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Since I never in my history of AF ever bothered with A and E I can't vouch for this but there is ample anecdotal evidence to suggest that the car park adjacent to such places has a somewhat magical affect on returning AF to NSR especially if you have driven there in the middle of the night.

In my time with AF not a lot ever did work for me other than time. I did in the early days think that by working my heart very hard and then resting then when it returned to more normal rates it would return to NSR. I was persuaded by my EP that this was a stupid idea.

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I've had many night journeys and I know what relief I feel when I reach that car park!

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We really need to invest more effort on stopping techniques using the mind, particularly effective I think if you have vagally mediated Lone PAF. I have stopped and started an episode with the mind - stopped when doctor said this IV Flecainide is not working we are going to have to shock you (it went back while he was literally still talking) and on another occasion started when I revisited a place where I had a bad episode pre-diagnosis.

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Completely agree with you that more should be done to investigate the part the mind can play here.

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We have a long street near to my house which is all speed humps. Paramedics told me that they picked up a patient with very fast SVT but by the time they had reached the end of the road she had reverted to normal rhythm.

I've tried everything over the years and am just left with attempting very slow deep breathing. My last episode a few days ago at just 170bpm had made my skin very clammy and limbs extremely weak. Never felt quite like this before so a call to 111 produced paramedics quite quickly. Taken to A&E ( who said I had every right to be there...) and had DCCV there a few hours later. Funny this because I felt worse than when my rate exceeded 240.

Always ready to try any remedy to help abate this tiresome condition!

Sandra

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I've had a pulse of 250 plus a couple of times and it is awful, but only for a few minutes. I think prolonged fast pulse like 170, is very dibilitating. I have also found that I feel much worse, hot, sick and clammy if I have an episode after eating a meal.

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That's interesting because I always feel worse with an episode on a comparitively empty stomach. Further goes to show how we are all affected differently.

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Episodes of AF always scared me but I started to notice that if I could divert my full attention elsewhere (imagining a stroll along a deserted Beach in Hawai’i), the episodes stopped.

I once had to attend outpatients for a heart monitor fitting and was in fast AF in the waiting room. As my elusive PAF had dodged all efforts to catch it, I was quite happy that finally it would get caught. My name was called - bang, back into NSR.

I suspect that even the mental concentration needed to try to convert could be enough to divert attention successfully and restore NSR?

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That sounds such a familiar scenario, and so frustrating for you, but also a relief too. So many mixed up feelings with AF.

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Twice I have reverted in hospital when they have been wheeling the cardioversion trolley to my bedside !

Maybe its the fear

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That says a lot doesn't it? Once, they told me they would cardiovert me at 4 pm and I reverted at 3.59!

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It was suggested to me once in A&E that they cardiovert me there and then without any sedation or general anaesthetic. Within minutes of being told that, and feeling shocked by the suggestion, I was back in sinus rhythm!

Another time after being in AF for weeks I went to have what would have been cardioversion number 5, a cannula was inserted ready for the anaesthetic and right away I went back to normal rhythm again.

A few times I've converted just by having a shower.

I believe sitting still and concentrating on what's happening when AF strikes will keep it out of sync. Try and take your mind off of it and there's a chance it will revert to normal rhythm naturally. If you're feeling faint of nauseous as well then that's different, it then has to be a telephone call for help .

Jean

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It just shows that there is so much we don't know about the connection between the mind and body. The very first time I had AF, I was kept in hospital overnight. The next morning, I was surprised I had not died in the night, and was visited by the cardiologist and his team. He explained to me what was going on, and then sat on my bed and reassuringly put his hand on my arm and said 'Don't worry, we will sort this out', and to the amazement of all his students, my heart reverted immediately to a lovely 70bpm. He went off being hailed as having healing hands!

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Love that story of yours. Do doctors have the power to heal by touch? Hmm!!

Every time I have an appointment to see my EP I feel extremely well and if I wear an NHS heart monitor that will be the week I can climb mountains!

Jean

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So very true!!!

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I'm not surprised to read that about healing hands. I honestly feel that if all cardiologists had some training in the importance of warmly reassuring patients with all kinds of heart problems the hospitals would have more empty beds! I do feel my AFibb is driven partly by stress and anxiety. I've never had a doctor sit on the bed and touch my arm and say 'don't worry we'll fix this'! We are mammals after all and connection with other mammals is hugely important to our nervous systems and by connection I mean warm caring connection. Thanks for sharing your lovely story Melleray.

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Good Morning, Melleray, I have had similar experiences, once I was really poorly had been in hospital for 4 days had all the normal done, whenever I go into hospital with AF I get terrible diarrhoea and they decided to put me in a room on my own in case I was infectious. Anyway they put me on a drip but couldn’t get the catheter in. So along came someone higher with a thicker one both my kids were with me and I was hanging onto them for dear life she was pushing it in then all of a sudden my pulse went straight back to normal and I went home within the hour. Then. Another time I was rushed in and they decided to give me an emergency cardio version and as soon as they got the pads out same thing happened again. It it doesn’t happen all the time. Have a good day.

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For the first 22 months and 10 or 11 attacks of my AF life going running stopped AF after 7 to 10 minutes.

Unfortunately this the stopped working after that time.

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After ablation for permanent aflutter with no other underlying condition. l started to suffer from proxysmal afib that lasted 6 to 24hrs they decided to try flecanide as a pip this had to be under hospital conditions and found a high dosage reverted me after 1to 2hrs . I did this on a number of occasions but felt groggy for up to 24hrs after .Read on a web sight similar to this it was back in 2008 the quirky ways they have reverted and I found going for a walk reverted me in 15min to 1hr also found (on holiday) a couple of pints of lager did the trick (l normally had a third one just incase!). I cleared this with my EP as my HR was very high but kept the beer one to myself. I have used this every time since 100% successful. This is probably getting boring for avid readers as I have mentioned this a few times on this site as this question keeps popping up in one form or another.Just hope it may help someone else but I must reiterate I had no other underlying condition.

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Everybody seems to have find different ways to revert to NSR. I had an hour-long episode of SVT in a restaurant before an ambulance arrived. I had tried everything I could think of but what actually made my heart revert was when the paramedic struggled to get a cannula in my arm. I was distracted by the struggle/pain and I just went into NSR whilst in the back of the ambulance. No rhyme or reason!

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It seems to come and go as it pleases for me! I have parox.Afib and flutter.Sometimes i know what has triggered it(dehydrated,stress etc)but at times just pounces on me.

I find the slow deep breathing helps,as well as pressing on my diaphragm. Changing positin..i.e if Im lying down,sit up...glugging a large glass of cold water has often helped too.

All depends on how fast and how long its appeared,if its low level,it helps me to potter about watering plants etc.if Im in for a longer session,I need to sit and keep still as i get breathless and dizzy.

Such a wide ranging condition!

Best wishes

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Without wishing to be seen to be stating the obvious; it would seem that many stoppages have responded to a change in body temperature through cold drinks, shower, arms in iced water, running, walking etc. On a winters night I have also stopped mine by leaving my arms/shoulders uncovered in the cold night air. Then we have the jolt/shock of reality from the medics when one is going to be wired up.

I would guess that we need to find a way of tricking the body into saying " What is that, that I should be reacting to"? I have not done it yet but I am guessing that a VERY COLD shower might just stop it - or make one (unintended pun) more down hearted.

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After several hours of AF, did the early morning trip to A&E yesterday at 5.30 and after ecg, bloods, etc was finally seen by A&E consultant who doubled my sotalol dose to 80 as a one off. Apparently cardioversion not a reliable fix after ablation, which I had 3 months ago. Just sat out the hours waiting for drug to reduce heart rate to below 100 bpm and, although arrhythmia still there, I was discharged as being back within safe limits. After an early night to catch up on lost sleep, this morning I am back to NSR. Not sure what I learnt about how to manage an episode and feeling weary, but otherwise ok. Thanks for all the tips for self- help everyone!

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Hi Liz - I could feel the weariness coming through your words, and I know that feeling. I take 80mg Sotalol twice a day, not sure if it does anything, as I still have frequent AF episodes and have also had 5 ablations. Cardiologist offered to do another, but really I don't see the point. Am listed for pace and ablate, but not at all keen. Hope you have some AF free time now. Best wishes

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Thanks for your good wishes. In comparison to your experience (and those of other contributors) I am a novice to this AF life! It seems this is a community of survivors and mostly with stoicism and a sense of humour to be much admired. Glad to have met you all. To quote Tiny Tim - God bless us, every one!

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Hello Melleray,

I experienced all that you mentioned as triggers or stoppers during my time with AF. Basically a sharp movement that you are unable to suppress can either trigger or stop the AF (The Ambulance driver jamming the brakes on for instance). I used to go for a short rapid walk during AF and this on occasion stopped it. Yes it is normal to return to normal at the click of a finger unfortunately, it is easier to trigger AF than it is to stop.

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It is interesting though, to hear that AF is often stopped by an albeit, unintentional concentration on something else.

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If only we knew the answer, but it is a great comfort to talk to all you people on here, knowing that you all understand.

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Hi Melleray

I’ve had multiple afib events - multiple cardio versions (23), and 4 ablations ; after the fourth ablation there are now transient events of the type I would typically have gone be to the ER for. Now the events go away if I lie down / calm down somehow. I’m advised by my cardiologist to regularly exercise but not to exhaustion or extreme-type exercise; I do light cardio and fairly intense weight training 4 times a week (1 hour) and a 10 km run once or every other month.

Triggers include caffeine , alcohol, OTC flu medication, and the BIG trigger - anxiety or stress.

I believe the ablations have successfully (mostly) removed the errant nerve pathways that do cause the arrhythmias and had I not had those procedures or not been on meds I would be at severe increased risk of stroke etc.

BUT, before the ablations I was on medication, had the many cardio versions and during that period, nothing worked at all. Events started declining in frequency after the 3rd and 4th ablations.

I’m 50 male, not carrying extra weight and before diagnosed (2 years ago) I was boxing at least 5 times a week (extreme) and sparring (fighting) two days a week.

Now with xarelto (blood thinners) I can’t fight any more but am allowed to exercise.

Interestingly , I had a freak bike accident 11 months ago which resulted in the amputation of my left middle finger (15 orthopedic operations leading up to that). Frequency of events were consistent during this period and in no way seemed to lessen or spike during the period...

My big question is whether I am born with the tendency to go into afib (also svt and more recently have also had an ectopic ventricular arrhythmia diagnosed) , OR whether triggers alone cause these events and therefore should do in 100% of any population experiencing / allowing these trigger events (?).

I’ll end with this - my cardiologist’s advice is to avoid triggers but he hasn’t actually answered this question directly. What he has confirmed is that there is an avalanche of diagnoses world wide and stress / modern lifestyle is definitely attributed to this. At 48 when diagnosed I was considered a rarer younger candidate though.

My view - one has a predilection / or congenital condition which makes more prevalent in some than others.

KEEP CALM 😎

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I am sure that anxiety, underlying maybe, is a big factor in developing AF. Anxiety which caused the heart to beat too fast, too often, and ultimately sparks AF.

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I can remember my INR nurse (on Apixaban now) saying I should get my wife to walk behind me holding 2 dustbin lids and whacking them together when I least expect it....never tried it but almost impossible to get dustbin lids now!!!

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My remedy after 6 episodes of SVT is just coughing,keep it going for as long as it takes,have a drink of water in between the coughing, good luck,it works for me.Before I found this remedy I’ve been into Resus in many different hospitals in this country as well as abroad....so annoying

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Hi - I've heard of this working before, and I have tried it without success. but I wonder if it only works for SVT, rather than AF.

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I know everyone is different as far as what triggers AFIB and what causes it to stop. For me, I tried every trick in the book to try to stop it but the one and only thing that worked for me and worked nearly every time was to run/jog. Usually within a km or so, I would convert back to NSR. I can be in AFIB for hours prior to that but once I go out for a run, will usually convert back quickly. I've been known to go out running down my street at 2:30 in the morning to try to convert back. I had a CT scan prior to my ablation and was in AFIB that whole morning and during the procedure. I ran up a flight of stairs back to my car in the parking garage after the procedure and by the time I reached the top of the stairs, I was back in NSR.

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Trouble with this is, I cannot move whilst in my type of AF as it makes my pulse go crazy - 250+.

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Getting up. changing position.

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All of what you have described have happened to me and many more peculiar things will stop it in its tracks. Each time I think I have the answer for next time but it never works so I go through them all when I have an episode hopefully!! Good luck for next time and tell us if you have any other answers !

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When I get an episode of PAF I breathe in slowly for 4 seconds, hold for 4 seconds and then breathe out slowly for 4 seconds. I do this a few times. I saw this on a medical programme and believe me it has stopped many attacks. It's worth a try 😊

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Thanks will certainly give that a try

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Hope it helps you. I was getting paf probably once a fortnight but 'touch wood' it's been about 2 months since I had a proper one. This technique has stopped a fair few from developing.

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Cycling (sometime for 90 minutes) does it for me -- but that is already part of my daily routine.

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Yes - it seems that some exercise is useful for some people, unforturnately, my AF increased badly if I move, so I have to stay pretty still until it reverts.

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Sorry to hear that. All the best

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Initially (16 years ago) each episode resulted in me being taken to A&E, even my GP told me to go straight there from her surgery (but not to drive). The problem I have is my heart rate becomes very fast. Each episode reverted into NSR after Intravenous Amioderone, length of time varied from 16 hours to 3 days. However the most recent episode was in December, after having the flu jag, it was out for 5 days, but not fast, so no need to go to A&E but did feel awful. GPs refused to admit it was the flu jag that caused it, but Cardiologist (paid privately to see him) confirmed this , but insisted I have a flu jag next year, not looking forward to that. When I have an episode I want to have a cup of tea as that cures most things, only to be told by my other half..."when did a cup of tea become the cure for arrhythmia?" Wait till I tell him some of the cures mentioned on this forum!

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Thank you!! A cup of tea cures many things!! Have you ever been advised to have a pace and ablate procedure?

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No, my episodes are rare now, thankfully. I was told already that ablation would not help me.

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