Methods to convert AF to NSR: I am curious as... - AF Association

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Methods to convert AF to NSR

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I am curious as to ways people have devised to put themselves into NSR. Not what you heard, but works for you. I am 64 and I had vagal AF since my early 30's. BTW I am 13 days post ablation. Have been having the blips and skips as well as 3 rounds of AF lasting 12-18 hours each since. Much better than pre-ablation where they always lasted minimum of 36 hours before I could self convert back to NSR. Any attempt prior to that only worsened the symptoms and guaranteed nearly another 24 hours before next attempt. 3 years ago I went from paroxysmal to persistent AF for 6 months duration. So I tried the pharmaceutical route first, Tikosyn. After 2 weeks I was still in persistent AF. I'm an active sort and had avoided all heavy activity since going persistent AF. So after a couple of weeks of no change I decided I was going to shovel snow as I was sick of doing nothing. So I took it easy and shoveled. After about 45 minutes I got a chest sensation that was not pain but definitely something and it turned out it was the shift from AF to NSR. A week later I was back in AF and shoveled some more, being careful. After an hour bang, I converted back. Then there was no more snow to shovel. Nothing else seemed to work so I was convinced it had to do with my back and and elevated heart rate from exertion. So I bought a rowing machine. I was able to convert back to NSR the same way. At first after 7 minutes but over the next 4 episodes I noticed it took longer and longer to convert as I became in better condition. It was taking 20 minutes or so to convert. Being a walker I learned that walking up a steep hill (which only took about 5 minutes) I could convert from AF to NSR. Then I went on vacation to FL and there were no exercise equipment or hills to convert to NSR when in AF. But I was staying on the 10th floor. So after 3 days of AF and desperate I walked up the stairs instead of the elevator and after 7 floors bang, back in NSR. So the next two years (before undergoing ablation) I could always get myself back in NSR from AF episode by climbing stairs at home. Run up and walk down. Thus I was able to get myself back into NSR at will (usually 12 flights of stairs). I got in great shape and was able to convert after about 3 minutes of effort. Either during the effort or in the minutes after when my heartrate would begin to drop. It's such a relief to go from 140bpm to 70bpm in about 2 seconds when converting back to NSR.

26 Replies
TommoHFC profile image

Well done pearlbob.

I will have to give it a go I could do with losing the weight ??

in reply to TommoHFC

I would make sure it's OK with your doctor before doing engaging in things that will raise your heart rate. I use a O-2 sensor so I can see my rate and beat. AF is pretty jagged and uneven. NSR is nice and smooth equally spaced. I had a stress test prior to the ablation. I was in AF when I arrived for the stress test. I told the 4 people in the room when the stress test was over I would go back into NSR. I think they thought I was nuts. However about 3-4 minutes after finishing while still wired up I went into NSR. Two of the technicians said they had never seen a patient convert while watching the monitor. I'd say I was able to do this probably 100 times over the past 2 years so I know it worked. I also learned that I had to wait a minimum of 36 hours (day and a half). All the years prior of having AF I did not know it could be done. I had always believed that when in AF you were not supposed to do any exercise outside of walking. So I am hoping this thread will get others to share their home remedies to get back into NSR. Cold water never worked. I was able to get in NSR going to a Chiropractor who would crack T-4 & T-5 joint and that would put me back in NSR too, but it took half an hour to an hour to work.

So.... I need snow or a boat.

in reply to jedimasterlincoln

HA, you should have your Dr. write a script for that! Maybe you could deduct it from your taxes for medical purposes.

Sean_C profile image

Fascinating. I loved reading that, thanks for sharing!

GordonS profile image

Well done for taking control.

DK81 profile image

Pressing really hard on my stomach while lying down and stretching up while standing to the point of discomfort seemed to help to ease AFib, but not consistently, and not necessarily converting AFib all the way to NSR. I rarely bother now that I am taking anti-coagulant medication.

KMRobbo profile image

For the first 20 months and approx 10 occurrences of a fib I went running. 7 to 10 mins , mile to a mile and a quarter and the high erratic hr went away.

Sadly the trick stopped working, for two occasions it took multiple runs to convert and the next time it would not convert however far i ran. Was in high rate afib for 8 days until chemically cardioverted.

in reply to KMRobbo

I have vagal AF but not tachycardia fortunately. So my resting heart rate was in the lower 40's and even would drop into upper 30's prior to AF. AF usually almost always set in after 10pm and particularly in the first 15-30 minutes of falling asleep. I was able to get into rhythm consistently after 36 hours. However any attempt within 24 hours always resulted in higher heart rate (low 100's) that were 2-1/2 times the normal rate and then would generally take an additional 24 hours before another attempt was tried so I stayed pretty close to the not attempting for at least 1-1/2 days.

Valsalva has always worked for me, but I consider myself to be a "mild case"...

So with vagal AF my triggers were generally working with hands over head, even trimming the Christmas tree. Also meat with nitrates such as pepperoni, salami, bacon, chorizo and pancetta. Sometimes I could get back in NSR after a good chiropractor cracking of T4 & T5 in mid back. Usually took about half an hour to work. Interestingly if I was in NSR the same cracking would put me into AF within half an hour. I'm not sure it was actually the cracking of that joint or the tremendous pressure on the chest/abdomen cavity that was created. Maybe similar to valsalva does and what DK81 mentioned pressing hard on the stomach or reaching really high (the opposite of working overhead in which case your spine is collapsing under the weight of your shoulders and arms in that position). I spent a lot of time documenting foods and activities trying to figure AF out over the past couple of years as the episodes increased and was trying to avoid ablation. However I finally succumbed to ablation 2 weeks ago because I was tired of the yoyo of in and out every week.

Fascinating story, pearlbob!

If I have an episode that started in the middle of the night, like the one I’m in right now, often it’ll stop after I eat breakfast and take a shower. I take 100 mg Flec+Arnica when it starts.

I still haven’t figured out exercise. I never go into AF when exercising, but it will hit later in the day if all the day’s activities seem to be too much, best I can figure. I can feel fabulous during my hike in the woods, only to have an awful episode later on. I always want to get more exercise than I’m getting these days, but I’ve paid the price enough times now that I stop sooner.

But then at other times I’ve had the experience of sort of rising to the occasion for an event that may be taxing somehow, but my heart feels stronger, in NSR, and content.

The mystery continues and I lose weight by not exercising.😂 For real.

I never tried Flecainide. My EP put me on Tikosyn which is a 2x a day maintenance drug. I had to go to hospital for 4 days/3 nights for this. They do an TEE first (you're asleep for that) where they look at the backside of your heart through your esophagus. Then you are put on pills for 4 days to see if you convert. They're monitoring your heart 24/7 because it is possible to go into a dangerous rhythm on them. Supposedly you should go into rhythm while on them. I didn't, so they did a cardio-version before I left the hospital. Again asleep for that. First jolt NSR for 6 seconds before back into AF. Second jolt NSR for 2 minutes then back to AF, so they sent me home in AF. Didn't convert until shoveling 2 weeks later (mentioned in first post at top). I think a pill in the pocket PIP would be a much more effective method for us vagal AF. Do you have any side affects after taking the pill? If so how long do they last. I also was on a beta-blocker (25mg) for 30 years which is supposed to be something not good for vagal AF sufferers

in reply to

I had tried Propafenone, but it was too strong for me. My system is super sensitive, so the drugs tend to hit me harder than most folks.

My doc prescribed Flecainide PIP last year and then later every day to prevent episodes.

What I learned through trial and error is that if I have either too much Flec at once (150 mg) or too much from even 2 days in a row of 25 mg 2x/day, or if I take it in NSR (if I was in AF but flipped back right after taking Flec), I get a much more intense episode and more side effects.

I've had a few really scary hallucinations and can feel very depressed from it.

So I now take 100 mg PIP, wait 15 minutes, then take 30c Arnica, which generally seems to shorten the amount of time it takes for the episode to stop. Often it'll take 1-2 hrs.

Today, it was longer, maybe cause I couldn't resist reading stuff on my phone during my sleepless night. Who knows. So I took 50 mg at hour 5 or 6, another Arnica, my manic stretching and Tarzan maneuver and there we go.

From what you say about Tikosyn, I'm sure it would be too much for me. My EP mentioned it, but I'm going to stick with Flec for now and take it only when I really have to.

So helpful to be able to compare notes with everyone here!

in reply to

Good to hear you had success with exercise. I can tell you I rested in AF for years until I had been in AF for 7 months straight (including 2 weeks after starting Tikosyn) and I said to myself "I am not going to let AF control my life day after day" and was amazed when I went back in NSR. I could feel it the second it switched in my chest. So I have been doing this for the past 2 years successfully. Basically your getting your heart rate up and then it converts on the way down. This would not be wise for people who have tachycardia which is totally different AF response. Yes it is good to compare notes! I am disappointed that EP's do not take notes, they just want to dispense Rx & surgeries. Many people think the symptoms are in our heads because we tend to be very descriptive of our experiences and devote too much time thinking about our next episode which is inevitably coming for those of us who have AF. I hope I never need an Rx after my next appointment in the next couple of weeks. That was the plan for having an ablation. I'd like to hear more from the people who had successful ablations. We tend only to hear about the ones that weren't. So far since my ablation I have had 2 AF episodes but they converted back spontaneously in 12-18 hours HURRAY! I've also had lots of odd beats but I'm understand that this is all normal. Something weird about the 2 AF incidents I had is that I could barely tell I was in AF without looking at O2 (finger monitor) in which you can see your heartbeat on a moving graph on the bottom.

in reply to

Yes, this is so helpful! I can feel it switching into AF and when it switches back to NSR. I have a Kardia Mobile that I check and sometimes I feel a bit like AF, but it's NSR. There is a sense of not wanting to overtax the heart when it's in an episode, which is why I rested, but I can see now how this sort of jump-starting can help. Will give it a try.

My new cardio really wants me to exercise, so I'm going to try to do more. I really miss exercising as much as I used to, which wasn't crazy intense or anything, but just a bit more than what I do now. I like the mental clarity and good mood that comes with a decent workout.

When I'm not feeling like crap from an episode, it's actually fun to make these discoveries and to learn from others. Keeping an open mind is key, I've learned.

My first real bout of AF came from overdoing on a Nordic Track about 30 years ago. I was early 30's and I was really pushing myself hard. Went into AF that afternoon and it lasted for 2-3 days. I thought I was going to die. Subsequent attacks brought on anxiety attacks which really made each event feel like I might need to go to ER. However after a year of this I realized that I was not going to die and the anxiety went away after time and only experienced uncomfortable feeling and of course the jumping out of chest flopping that always is how an episode starts out. Fortunately most of them occurred in my sleep so it was not so bad when I woke up in the morning, just the disappointment of being in AF again and knowing that I would have to wait to get myself back in NSR.

Well, pearlbob, you sure inspired me with this post. Here's what happened this morning.

In my earlier reply, I was in AF. Started at 3:30 am, kept me awake all night. Not super uncomfortable, but annoying, like suspended animation, HR OK.

I was scheduled to teach a lesson on video at 10 am and was so tired and draggy I debated cancelling but opted for just going for it, thinking maybe it would help pull me back to NSR.

Around 9:50, still in AF, I think of your post and decide, what the heck, and do a series of quick, intense stretches and a qi gong type of self-massage I learned (gentle slapping of legs, arms, kidneys, shoulders, head). I end with pounding on my chest like Tarzan, without the Tarzan yell.

10 am I sit down at the computer, check & see my HR up to 107, but then it settles down, and click, I'm back in NSR and good to go! Ha! 😄 🎉 🎈

Lately it's like a light switch for me. Once back in NSR, even on no sleep, I feel good.

I am so grateful for your post to inspire me! I've often focused on resting when in AF, but now I'm going to try this type of thing.

planetiowa profile image

Before having an ablation done, I had probably 40 episodes of AFIB (vagal-related) over a period of about 10 years (the majority of those being the year before I had the ablation done). For me, other than the first episode which I went to the hospital for as I didn't know what AFIB was, I've had a 100% success at conversion from AFIB back to NSR by running. It doesn't matter how many hours I've been in AFIB before that, as soon as I start running, I will convert back within 1-10 minutes after beginning to run. I think this is probably very similar to what you experience. I don't know for sure but I guess my theory is that once the rate of the ventrical part of the heart gets up close to the rate of the atrial part, the atrial part resyncs??

That's an interesting theory. I had not heard that one. What makes that more interesting is my AF heart rate was triple my resting heart rate generally for the first 24 hours and then would gradually settle down after the first day to double. That's about the time I could get it to convert. When I tried the normal ways (stairs, shoveling, hills, jogging up a hill) too early it would lead to a second day of triple digit heart rate. Maybe you're on to something. I usually stress to people with Tach not to try this as they would probably end up in ER for a cardio-version. BTW, how long ago did you have your ablation? Were the AF episodes terminated immediately or did you have them on and off after? If so how long to settle down? Any since? I was having probably 40 a year for the past 3-4 years and on and off for the 30 years before that. Gradually increasing in frequency and duration over the years. Used to self convert but the past 2-3 years had to exercise for results.

planetiowa profile image
planetiowa in reply to

I had the ablation done a year ago. I had one AF episode about a week after and they then put me on a rhythm control medication for 2 months. I did have what I would describe as a very mild case of AFIB about 6 or 7 months after that which I actually had to take my pulse to confirm (I can usually tell the second I go into AFIB and the second I go out of it). I just took a quick walk around the block and got out of it. So while my ablation may end up not being totally successful, it definitely reduced the frequency of them (I was having episodes 3 or 4 times a week right before) and the strength of the AFIB.

That's good to hear. I am 2-1/2 weeks after ablation. Have had three episodes, last one lasting 2 days but always self converting so that is a change. I can immediately feel when I'm going into AFIB like before but within an hour I can no longer tell without sticking my finger in an O2 sensor and watching the jagged uneven beats. So like you mention, so far it's not as strong and self converting is new as well. I do understand that prior to formation of scar tissue later down the road, this is not out of the norm for AFIB during this period. I was interested in hearing from folks like us that had higher frequency and ability to exercise out prior to ablation. Dr. probably won't let me do the activities to run up my heart rate for a couple more months. Hopefully coming off the Tikosyn & Eloquis in a couple of weeks. Tikosyn regimen had been for the past 2 years. Was on Atenenol for 25 years up until 2 weeks before the surgery. The EP did not want me on beta-blockers for the surgery and so far has said I don't need to go back on them as I do not have high BP. The Eloquis was just for the surgery so I have been on them for about 6 weeks and should be getting off them in a couple more.

planetiowa profile image
planetiowa in reply to

I think my initial AFIB episode right after my ablation was probably because I started trying to do too much too soon. I'm not a hard-core runner but I run about 3 miles (5K for our UK readers) every other day. The day after my ablation I walked a mile and then 2 miles the next day and within a few days I was trying to do a walk/run. After that AFIB episode though, I decide to stick to walking for a couple of months before trying to get back to normal. The only medication I am on right now and have been on for years is for very slight high BP (12.5 mg Atenolol - a whiff as my EP says). Also I think similar to you, my resting heart rate was pretty slow - prior to ablation at least it was 52 which dropped to 42 when they had me try 25 mg of Atenolol to see if it would help with my AFIB). I also tried all of the other self-methods to convert from AFIB to NSR and none of them worked for me other than running.

HA! I was on 25mg Atenolol for many many years. My resting heart rate was in the lower 40's and at night sometimes dipped into the 38-39 range. AFIB was never to long after it got very low. I never felt any symptoms from low heart rate, no shortness of breath or tiredness as my heart rate would naturally increase upon exertion. I'm sure if you tried to run up 10 flights of stairs you might've found yourself converted during or shortly after you finished as your heart rate started back down. I did run up the stairs and not walk up them. That was the fastest way without having to put on jogging shoes to NSR for me.

planetiowa profile image
planetiowa in reply to

Actually, I had to go for a CT scan about a week before my ablation surgery and I went into AFIB right before leaving for my appointment. I was in AFIB the whole time during the scan then went back to my car afterwards. I ran up ONE flight of stairs in the parking garage to my car and was back to NSR by the time I reached the top.

Yes, sometimes i would go in during running stairs. It started with 4, then 7, then 10 and I seemed to plateau at 12 flights. Was getting in great shape putting myself back in rhythm a couple of times a week. My office is downstairs in basement as well so it was not unusual to get in 30-50 flights a week. Since my ablation I just started bounding up the stairs in the past few days. Not wanting to overdo yet. Being patient.

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