From PAF to permanent? My worst Afib yet. - AF Association

AF Association

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From PAF to permanent? My worst Afib yet.


My worst Afib yet. Yesterday at about 6pm I had a bout of PAF. Heartbeat was iregular and just under 100bpm. Took an extra Sotalol as advised and went back to normal rhythm after a couple of hours or so. Went to bed at around midnight, and, after dozing off, woke with Afib, *again*. After another Sotalol nothing changed so I rang for advice. They said that they would do an ECG in an ambulance and take things from there. The ambulanceman was very helpful; he confirmed that I had Afib but said as it was only at about 75bpm it was ok to go to sleep and no need to go to A and E. He also said that *he* had Afib a couple of times a week and took Sotalol too! Said the heart would likely go back to rhythm in the morning. Went to bed and slept for a couple of hours, but, unfortunately, as I write this I still have the afib with a heartbeat of about 75bpm. So I may have gone from PAF to permanent -this is the longest episode I have had ( currently about 7+ hours). Heart skipping and jumping all over the place. Ironically, I have my first appointment with the consulatant today. Not sure what he will say or do. V miserable and worried indeed and not sure how long this will last or if it is permanent how I will cope.

17 Replies

I've had episodes that lasted up to 5days and reverted to sinus rhythm without intervention.


This is surely an opportunity to make a lot of progress, although your AF, just to be annoying, may just disappear by the time of your appointment. If not, it's an ideal chance for your consultant to get to grips with it and not only give you a forward plan and but also tell you how best to deal with it.

It seems too early to worry that you have moved on to persistent.

Sorry to hear your AF appears to be progressing. Your consultant may advise you to go for an ablation, as which mine did 14 months ago. I didn’t want this at the time. I had my pre-op last Friday & I am now waiting for procedure date. It is something to be considered if offered, as the waiting list on the NHS is approx 12 months & I was told it’s best done before it gets worse, as the success rate is better then.

Good luck with your appointment, I hope you get the best outcome needed.

Please let us know how you get on.


That’s exactly what I was told by the consultant: I am to be sent for an assessment for an ablation. The reasoning was similar too - the left ventricle is not greatly enlarged at the moment but could get worse over time, which would result in breathlessness etc. I cannot say that I am looking forward to the ablation. I don’t know what the waiting time will be as the letter has not yet been sent. To be honest I’d be happy if thee was a very long waiting time... like 10 years or so.

If you have time before your consultation write out a diary of this episode for your Cardiologist to see. That way you won't forget the details.

Let us know how you get on.

Samazeuilh in reply to jennydog

Referred for an ablation! Not what I was expecting; I had hoped that it might just be a change in medication.


It may be termed persistent if it lasts more that seven days. At HRC this year we heard the comment from a doctor that it is only permanent when you and your doctor agree that further attempts to produce NSR are futile.

Samazeuilh in reply to BobD

Well, it stopped after 9 hours - the longest I have had. One thing: in the morning I noticed two tablets missing from a new thyroxine prescription. I could have taken these by mistake which might have affected the heart.

I understand! I've had PAF for about 15 years. My heart beats to its own drum...all the time! It is NEVER regular - and it's ok.

I had a cardioversion about 10 years ago and had normal rhythm for two strange and oddly peaceful!...and then it slipped back to PAF again.

Most of the time I'm not even aware of it now. It's just the way it is.

I take Bisopralol to prevent that horrible racing, as well as Warfarin obviously, and I lead a pretty normal and quiet-ish life.

I'd love to not have to take these meds but at least I know my heart, in itself, is ok. It's just this bizarre electrical thing! I think of it as being like a creative, progressive jazz drummer :)

Try not to worry...easy to say I know!...and good luck with your consultant appointment.

readandwrite in reply to xdbx

What a great reply! It certainly rang a bell with me, and how reassuring! I have had this condition for some years now but since late spring it decided to be very silly,at several points during the summer it lasted for 2 weeks. I have now had to resort to seeing a consultant privately, too ill to wait several months to see an Nhs consultant. . It has been well worth the expense, I have had some investigations and a nuclear scan, yes, my heart and its adjacent plumbing are fine, it's just the electrics! I am now on a change of medication which seems to be fine so far in that my erratic pulse is behaving better than previously, I know I will always have this problem in varying degrees of nuisance value and it's a day to day stray thought that crosses my mind asking the question of the dicky ticker, "are you going to be good today"?. This forum , which I joined some months ago has been so useful and informative to me, plus very friendly!. Thank you to all those people who post on it and the help they give. Onward and upward!

smn100 in reply to xdbx

Exactly what I would have written. Mine is 8 years and life is very doable 😀

Samazeuilh in reply to xdbx

Did you ever have an ablation?

xdbx in reply to Samazeuilh

No I haven't. My cardiologist and team advised that it was unlikely to be successful and wasn't worth the risks, given the kind of a/fib I have, especially since it is managed well with medication in my case. I'd still have to take Warfarin anyway because there would still be high risk of stroke, and the chances of success and continued success were very low.

I too have been in AF since Monday and wondered if I had moved to permanent. Seeing the doc today.

Samazeuilh in reply to Johnno333

Let us know how you got on. I suspect it’s a bit of a lottery - some GPS might just change your medication or dosage or others might refer to a consultant with a view to an ablation.

When I originally posted on this site my symptoms in desperation a member suggested I might have sleep apnea, I went to the doctor got a referral as was diagnosed with severe sleep apnea put on a Cpap and have felt like a new man since. It was causing my PAF according to my cardiologist. I am 78kg and 5’7” so not a usual suspect for SA. It might not apply but thought it was worth mentioning as it has changed my world and is the most undiagnosed illness in America. Hope all gets sorted soon. Best wishes.

What symptoms did you notice? Sleep apnea is strongly linked to Afib.

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