Back In AF.: Hi everyone. After 9 days in NSR... - AF Association

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Back In AF.

TommoHFC profile image

Hi everyone. After 9 days in NSR I woke up this morning back in AF. It certainly seems that food is one of my triggers, I didn't get home from work till 20.30 last night had my evening meal and went to bed at about 22.30.

I'm thinking of having my main meal at dinner time and just having a snack for tea. Do you think this would help ?

Only diagnosed about 7 weeks ago and not seen a cardiologist yet. When I was at a+e the Dr gave me apixaban and bisoprolol,but the bisoprolol forced my blood pressure down and after 4 days went to see my gp. who said because I was back in nsr I didn't have to take the beta blocker. She told me to keep them and take it again if I had another episode. Dose this sound OK to you ?

Can't wait to go and see the cardiologist.....

10 Replies

Hi Tommo - great you are are back in NSR.

Eating - yes smaller meals in the evening I think help and also eating absolutely nothing for at least 3 hours before bed. If your AF is vagal then also watch your stress levels and when you eat a larger meal ensure you have time to stay in Rest & Digest mode - that essentially means focus on your eating and digesting and don’t jump up as soon as you finish eating - learned from experience. Avoid eating as you go, there is a reason the Autonomic has 2 balancing sides - one to allow us to get proper, restorative rest and sleep and digest our food and the other to help us survive when we had to fight and flee.

These days we rarely need to fight or flee from attacking tribes or from dangerous animals however we live in a chronic mode of stress, on high alert, always ‘doing’ and rarely resting result = Autonomic dysfunction = AF.

Reducing stress and adapting lifestyle - healthy diet, ensuring you apmaintain optimal weight, moderate exercising are the 3 things we can self manage and to take control of our own future health and to reduce the AF burden.

The other main trigger for me and many others is inflammation in the body - any cold or virus will also trigger everything else - Autonomic controls the immune system which activates the immune response - whole body goes into high alert = AF. If you don’t allow yourself adequate rest and time to recover = more problems down the line.

Again learned the hard way so please avoid what I did -

‘working through’ and pushing myself, working late into the evening, eating large meals late at night, eating on the go because I didn’t make time, feeling pressured by others to perform better.

Again the answer, in hindsight, is not in taking a pill - that will only supress the symptom and is like using a sticking plaster to stop a major artery bleed.

These are all things that I wish I had known 15 years ago, but no-one told me.

You don’t say what dose of Bisoprolol was prescribed? 2.5mg seems to be usual and when I was prescribed it I was told to titrate up and down - so I started on 2.5 and went up to 10mg but it didn’t work for me and I had a lot of side effects with it. I would go with your GP’s advice but if you continue to have episodes then see a specialist as soon as you can.

TommoHFC profile image
TommoHFC in reply to CDreamer

Thank you CDreamer for your quick reply. This forum is the place to get info some of the things AF sufferers go through seem very frightening. I'm not particularly looking forward to it....

CaroleF profile image
CaroleF in reply to TommoHFC

Take heart, TommoHFC …… AF is such a mongrel condition that people's experiences of the condition can be very different. It's true that some people have a very difficult time, but not all of us do. I remember when I was first diagnosed and found this great Forum that I was very scared at the thought of what seemed to lie ahead of me - from reading some people's experiences. Has 'the worst' actually happened? No - not yet anyway!

TommoHFC profile image
TommoHFC in reply to CaroleF

Glad to hear it CaroleF hope it stay's that way for you.

I don't really suffer when I'm in AF I can feel it when I'm in it ie heart rate but that's all. If I'm in for a couple of daysy the Bisoprolol pushes my blood pressure down,and that makes me feel a little weak. Then I come back into nsr stop taking the Bisoprolol and it returns to normal.

I think I need to eat healthier and get my weight down.

Hello Tommie....CDreamer has I think covered it all in her usual excellent comprehensive replies.

I would certainly recommend eating your main meal at lunchtime if at all possible and avoid eating late at night. I take Bisoprolol as and when which is when go onto fast AF. It usually helps to slow down my rate a bit but very rarely to get me back into NSR.

Good luck with your appt


TommoHFC profile image
TommoHFC in reply to

Thank you for your input Yatsura. All you long term sufferers seem to know more than my GP. Or is it that there not that interested because you have a cardiologist to see ?

CaroleF profile image
CaroleF in reply to TommoHFC

I think that, by definition, GPs are generalists so unless they have a particular reason to become very well informed about AF (eg a family member with it?) there's a tendency to stick to their basic knowledge and to pass things 'up the line' to cardiologists. I doubt they're 'not interested', but they are under such pressure these days and have so many patients with chronic conditions to deal with that there are not enough hours in the day for them to become up-to-speed on everything.

By way of contrast, those of us here have every motivation to become well-informed about AF so it's no surprise to me that some of the contributors here know more than your average GP.

in reply to TommoHFC

I think we know a lot more than some cardiologists too. EP's are the ones that we need to be talking to, and cardiac rhythm nurses

Just a thought - have you thought about looking at Dr Michael Mosely’s Books on intermittent fasting? This doesn’t mean you have to fast for long periods - essentially you need to have at least 12-15 hours in any 24 period without eating - so if your meal was at 7pm, you don’t eat again before 8-10am.

You can then go a stage further and eat normally 5 days a week but reduce your calorie intake to 500 2 days a week. I find that means for 2 days a week I have a homemade vegetable smoothie for breakfast, soup or small green salad for lunch and then a small evening meal - Tapas are great for evening meal - that’s what the Spanish and the Italians do because they work until 10pm - but they also start later in the morning and have a rest midday - when they eat their main meal.

G'day Tommo,

Just a couple of points ............. how do you know that it was Bisoprolol that forced your BP down.

Bisoprolol is a medication used to control heart rate but it may have some BP properties - haven't had time to look in detail.

I have read this several times on here but I've never seen anything to support the statement. I would think that the lowering of BP is as a result of the heart behaving in a dysfunctional way, i.e. actually in AF or as a prelude to tipping into AF. I would have thought a more first line approach to BP control would be Ramipril or some other similar drug.

I can't understand your GP's approach in the use of Bisoprolol as a pill in the pocket. Don't wait for a cardiologist - go and consult your local pharmacist. To the best of my knowledge Bisoprolol is not the sort of drug that you should be switching on and off just like that to suit the moment.

I have been in NSR for the last 3.5 years (with the exception of one 5 hour burst in Feb 2018) and I take 5mg Bisoprolol daily at night.

I have my main meal at around 6 pm, followed by puddings ( if I choose to, not always), then nothing till breakfast apart from my evening medication around 8 pm. Always have small meals. Not much you can do if you get home from work late of course. When I worked shifts, sometimes not getting home till 11 pm, I'd eat a main meal at lunch time which depending on the shift I was on would be between 3 and 5 pm.

Apart from that take note of CDreamers wisdom.


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