High temperature

[SingingT]

Hi all. I was diagnosed with PAF last July. Since then I have been on Sotalol which was replaced by Bisopralol and Flecainide. I have been experiencing periods of ectopic beats since the change. I don’t tolerate beta blockers very well. Two days ago I started a head cold and my temperature has been raised 38.8 c. I went into AF last night at 1.15 am. It resolved in 45 mins. after I took 1.25mg Bisopralol. After lunch today I went into AF again. What is concerning me is that I am feeling as if I am passing out from time to time while in AF. This didn’t used to happen. Questions coming up at last.....1. Is it likely that a raised temperature has triggered my recent AF.

2. Should I be concerned about feeling faint while in AF.

I am seeing an EP on 27th Feb.

3. Also not sure what I should expect of medication. Should it stop AF or reduce its impact or frequency.

I haven’t posted much but it really helps me to know you are all out there.

Best wishes T

[Hidden]

Yes to 1.The infection underlying the feveri is contributory.

Possibly to 2 What was your heart rate when you felt faint? Fast or slow?

3. Flecainide is rhythm control like Sotalol and Bisoprolol is rate control. The combination is intended to reduce frequency and length of episodes.

[SingingT in reply to Hidden]

Thanks for your reply. HR was about 128bpm. in the night. However this pm it was only 87bpm.

Yes, I understand about the rhythm, rate issue but still don’t know if, when controlling these, I should expect to be AF free.

[Hidden in reply to SingingT]

On feeling faint, the fall in cardiac output with AF and fall in BP with Bisoprolol could explain that.

On the other, I would say it would be unusual to be AF free on drugs alone, but generally your AF burden should reduce significantly when you find the right combination. If not, ablation might be considered.

[SingingT in reply to Hidden]

Thanks so much Oyster. You have confirmed what I had worked out. I am looking forward to my appointment with the EP although I’m not expecting all the answers on one day.

[BobD Volunteer in reply to SingingT]

Not necessarily. ANY and ALL treatment for AF is only ever about improving quality of life. (QOL) There is no100% cure and it may take some time to get the balance of treatment to your satisfaction.

[SingingT in reply to BobD]

Thanks Bob, I am hoping to improve that balance. I seem to be having symptoms of some description every other day currently and when I go into AF I feel unwell and faint. I have booked to go to New York in May but am not sure I could cope if I stay this symptomatic. Hay ho.

[Auriculaire in reply to BobD]

If AF has been provoked by drug treatment ie overmedication with thyroid hormone or treatment with an antibiotic known to provoke arrhythmia then why would cessation of these treatments not constitute a "cure"? Especially if echo shows no changes in the left atrium.

[BobD Volunteer in reply to Auriculaire]

You have AF therefore you will have AF. How often and how seriously may change according to treatment is all. Diseases can usually be cured but conditions less likely.

[Kaz747 in reply to SingingT]

I’ve been on a variety of drugs over the past 3 years- Verapamil, Flecainide, Sotolol, Atenolol, Digoxin and even the dreaded Amiodarone. None of these have been able to keep my heart under control very well. I have multiple daily AF episodes and am now booked it for another ablation. You might, like me, have a stubborn heart that doesn’t like being told what to do (a bit like a rebellious teenager).

[SingingT in reply to Kaz747]

Thanks so much for replying. Does the ablation give you some respite? I have been told I am not a good candidate because I have a mild congenital heart malformation ( ventricular septal defect) and I had bacterial endocarditis when I was 19 yrs old. Neither of these stopped me leading a normal life and I was fit and healthy until this AF kicked in which something else! I have asked for a second opinion which is why I am seeing an EP in Glasgow on the 27th. 🤞

[Kaz747 in reply to SingingT]

My atrial flutter was fixed with my last ablation but not the AF. I had a strong anti inflammatory response to the ablation and went back quite quickly into fast AF. I’ve had AF episodes every day since my ablation 5 months ago. I’m going for a touch up ablation next month so hopefully that will do the trick. If not I’m not sure what the next move will be. I’m leading a super healthy lifestyle- no alcohol, no caffeine, exercise, meditation, excellent diet, good sleep, reduced stress (I’ve been off work for 8 months).

[SingingT in reply to Kaz747]

Yes, I too lead a healthy lifestyle and always have. Although I did used to enjoy the odd glass of red. I have given up Pilates (in the short term), Scottish Country Dancing, 5 mile round trip walk into town, heavy gardening and one of the choirs I was singing in. Beta blockers make me breathless if I try to exercise.

Sorry to hear your progress hasn’t been straightforward. Fingers crossed for your next procedure. I am retired, thank goodness.

[Kaz747 in reply to SingingT]

I used to enjoy a glass of wine too but not any more. I’m only 54 and had planned to work for another 6 or 7 years but if I can’t get my heart under control I may not be able too. If I can’t get back to work we’ll have to rethink our finances and retirement plans. I have a long way to go to pension age (currently 67) and I was the main breadwinner in the family with my husband working part time as he has his own health issues. He’s working a bit more now but I’m not sure how sustainable that is. It is very true - good health is the most important asset you can have.

[cuore]

As I am in persistent AF, my international EP has stated that we know that anti-arrhythmic drugs will hardly fix the problem. I am in the process of scheduling third ablation.

[SingingT in reply to cuore]

Thanks so much for replying. It seems ablation might give me some respite. I guess what I am experiencing is the progression from paroxysmal AF to persistent AF. I had a temperature resulting from a cold virus yesterday. The first cold I have had since diagnosis and boy did it upset the apple cart. No temperature this am but coughing. Singing sometimes sets the AF off so hoping the increased thoracic pressure from coughing doesn’t do the same. Learning all the time!

[Jennyquilt0]

I find that every time I have an infection either a cold or a gastric one I have bouts of PAF so this would seem to be one of my triggers. See if you can work out what or if you have triggers.

Good luck with your appointment.

[SingingT in reply to Jennyquilt0]

Thank you Jenny. Yes I am learning all the time. IBS sets me off too. So good to know there are people who understand and can share their experiences. Makes me feel less alone. Thanks again.