PLEASE HELP: I am 31 year old male, I went... - AF Association

AF Association

21,171 members25,931 posts



I am 31 year old male, I went into AF (atrial Fibrillation ) 4 days ago.

The night I had the episode I had been drinking and smoking heavily, I am a fulltime smoker for the past 15 years and due to my personal/prof life I have also been under intense stress.

I was able to go back into normal sinus after around 10 hours and was discharged from the hospital, I also suffer from severe anxiety and panic attacks.

My father has HOCM (hypertrophic cardiomyopathy) so the cardiologist seemed slightly concerned.

Now that I know what AF feels like, I would say I have been having episodes for over 3 years untreated, currently I am booked in to see a cardiologist in a couple of days and taking metoprolol twice a day.

The metoprolol is making me feel horrible and I am wondering if anyone can recommend an alternative, as I said I have panic disorder, depression and ocd.

Any advise on my next moves would be great as I am crippled with fear currently.

13 Replies

Hello Ell :-) welcome. Firstly recognise you are still in the 'shock of diagnosis' phase, most of us have been there.

Secondly, try to stay calm, there really is life after diagnosis :-) .

There is lots of information on the AF website to help you here...

Maybe look upon this as a wake up call from your body to make changes before the damage you are doing increases.

Things to help you to help your body.... give up smoking, give up or cut down on alcohol, learn breathing and relaxation techniques that can be used to suppress your anxiety during episodes of P-AF, eat a healthy diet. take regular exercise. Some of those are tough I know but doing them can make a big difference

Remember you are not alone and once you get over the shock of being told you heart has a problem and find the right medication to suit you things won't be so bad :-)

ell2122 in reply to doodle68

Thankyou mate, I am currently day 4 cold turkey, no smoking at all and no alcohol.

It is more so I don't understand if episodes can be once off or that I am now diagnosed with AF and episodes are imminent.

doodle68 in reply to ell2122

Ell :-) it sounds as though you have the type of AF called Paroxysmal AF which as the name suggests comes and goes. It is all explained in the link I gave you.

I have that P-AF too and also had episodes for some years which I ignored.

I have learnt not to get anxious when I have an episode, to stay calm and do deep breathing . At first I thought I was having a heart attack and might drop down dead during episodes but now I feel in control after making lifestyle changes and starting medication :-) .

doodle68 in reply to ell2122

....well done on the 'cold turkey' keep it up the first steps are the worst.

You might want to ask your GP/ cardiogist whether going cold turkey with the alcohol is likely to precipitate AF.

I don’t think adding extra pressure to yourself by also stopping smoking immediately, when you have severe anxiety, panic attacks and a stressful life, is necessarily going to be helpful either. It probably won’t reduce your AF right now, and may make it worse because of the extra stress.

Of course you need to get off the alcohol as soon as you can, and permanently, but perhaps not overnight. Stopping smoking completely in the long term is also essential because it is also known to cause AF, as well as all the better known consequences.

Are you taking anything for the anxiety? I have AF and anxiety and take Sertraline, an SSRI, but it is not suitable for everybody with heart rhythm problems.

In my opinion, you need a realistic plan from your GP in managing this dual withdrawal and the added stress this will cause. Support from a community psychiatric nurse may also be helpful.

This is likely to be the time you need this forum most. You will find plenty of support and good advice here. Good luck.

A friend of mine had an AF episode on holiday; after he recovered he never had another. It was put down to alcohol and dehydration. My AF was caused by a lifetime of endurance exercise with probable contributions from work related stress and regular excess alcohol.

After my diagnosis, I cut down alcohol severely and then gave up just before my first ablation. I am now in NSR after two ablations and am currently drinking again, but less than 14 units per week.

AF itself has anxiety as a symptom, and coupled with your stressful work life, this is likely to be a problem. I was on Bisoprolol, which caused terrible breathlessness as a side effect, but also has an anti-depressant function, which was useful. While I was at my most unwell, I reordered my work life and reduced stress; this was surprisingly easy, but I do have a good employer.

After you have seen the cardiologist, you will also have a treatment plan, which will probably include an anticoagulant, which will reduce your stroke risk. The main thing is to remember that AF will not kill you; keep coming on here and find out all you can about the condition.

Stopping smoking, reducing (or stopping) drinking and finding a way to reduce stress at work will all improve your situation. You didn't mention your weight, but losing a few pounds, if appropriate, would also be very beneficial.

Hi Ell, welcome to the forum. I see you have already received some good advice.

You say your Metoprolol is making you feel horrible, what dose are you on, as they are quite strong tablets? They are beta blockers and should help with your anxiety too. It may be an idea to ask if you can just take these pills when you have an attack. They were the first ones I was prescribed and I was shocked that they wanted me to take them every day. After I queried this I was told I could take them just when I had AF. I found them very effective, but only at a low dose.

After an attack it can leave you feeling tired for a few days. Your heart rate going so fast has probably left you feeling like you've been running at your top speed for 10 hours straight, so it's no wonder you feel as you do.

It's a shock when we have our first attack, mine was 13 years ago and like you it made me aware that I'd had it a lot longer than I realised. Please do not get anxious about it as you will realise in time that there is no need. It took me years to get that into my head and I can honestly say that I've never heard of anyone dying from it.

We're all here to give support, so please ask as many questions as you like.



Wow! Sorry you have involuntarily become a member of the A Fib family. You have already found that the people here are beyond friendly, helpful and knowledgeable. I want to congratulate you on kissing smoking and alcohol goodbye. I never cared much about alcohol but I was in love with my smokes. Quitting smoking was the hardest and best thing I’ve ever done for myself. Keep up the good work. Adjusting to new meds and going thru withdrawals is not child’s play. My thoughts and prayers are for your success. Just don’t quit trying and have hope your life will settle down, just not today💜

Appreciate all of this great advice!

Congratulations on the cutting out smoking and drinking.

I exercised a lot and drank 3 units a night (a beer and large glass of wine). I cut back to 3 units a week and my cardiologist has told me multiple times alcohol opens path ways for A Fib. Cutting back to 3 is good none is better.

It takes a few weeks to adjust to the BP meds. I couldn't handle metoprolol so I am on the lowest dose of Bisoprolo 1.5 mg. I take a rythem control drug Flecainide which works great and need a Bis to prevent potential side effects from the Flec. The plus side is the BP meds like metoprolol helps calm you down a little. They are prescribed for stage fright and pro golfers took them for nerves under pressure but now need a therapudic Rx to use them while on tour.

you’ve already had good advice here, its a very supportive forum. I stopped smoking in 1985, and went cold turkey. Its the best thing I’ve ever done. I had a few false starts, but got there in the end.List all the positives re. stopping smoking.

Better health

Financial gain, (I put the money saved aside for a special treat at the end of the first year)

Clothes won’t smell

Home won’t smell.

Decor in the home won’t yellow

There are many more reasons you will be able to list when you think about it.

One of the things I did was to put some old cigarette stubs and ash from an ashtray in a plastic bag and seal it up. When I was desperate I undid the bag and sniffed ugh! It smelt vile, I really didn’t want to smell like that!!

Also don’t have them in the house. If you feel like you are caving in walk and breathe deeply.

Also mindfullness meditation can help. It might help with your stress as well.

I understand these days the GP can offer help as well.

I wish you well.


I sympathize with your troubles. I recommend that you read these links about NAC N-Acetyl-Cysteine an overlooked amino acid. Even helps with anxiety and other panic disorders. I had metropolo and I caouls baely walk across the office, I got switched to Cardeziem/ditiezem which taken twice a day for me works, The NAC however has changed my life. I was always too tired or didn't have the energy to do too much after work. Now I am doing projects again! Took about 2 weeks b4 I felt really more like my old self. I'm even moving parts from an older motorcycle to a new (to me) same model bike and riding again. I'm 62.

read it

6 months on and I have not had another episode of AF, I quit smoking and dramatically cut down alcohol.

One of the big factors that made me feel better overall was stopping caffeine and controlling stress.

I have managed to also start at the gym 3-4 times a week doing mostly weights and light cardio.

I am not sure of I will have another AF episode however I am trying my best to do my part.

My trigger was caffeine and binge drinking in hindsight..

You may also like...