AF or not?: I had more or less my first... - AF Association

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AF or not?

I had more or less my first episode of AF *during the day* yesterday- it only lasted for about 15 minutes and it seems that the heart went at about 80bpm according to Kardia. About half an hour ago , when I got up and went to the kitchen I felt the heart beat irregularly for about 1 minute or so, then revert to normal, then beat irregularly for about 2 -3 minutes. This was more or less completely unexpected.I checked on Kardia and it is now beating regularly at about 48bpm. Earlier during the day I felt a bit dizzy when I stood up from a seating position. Now all this might sound fairly minor, but it marks a new pattern for me. I have been under a lot of stress for the last two weeks and I am wondering if this could have provoked it. I’m a bit concerned as neither episode began with a lot of ectopics beforehand, which is what I usually get. Does this suggest a move to going to persistent/permanent AF? I’m feeling very sleepy af the moment and want to go to bed, but am uneasy in case the AF kicks off when I am asleep.

I finally had my appointment with the ophthalmologist at Royal Hospital London And he seems to think that it would be ok to take an anticoagulant.

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I don't see you have a problem there, 80 bpm is quite normal !

Start to be concerned when HR goes over 150-200 bpm for any

length of time. Good luck ! Chris.

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Thanks for your reply. I agree that 80bpm isn’t a problem, but I have gone up to 150bpm. My concern is that this new episode, although undramatic, was unexpected (I don’t usually get much AF during the day) and has been an increase in frequency of AF and a change in pattern.

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I meant to say that I have gone up to 150bpm on some occasions.

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Maybe your question is largely academic, now you are scheduled for ablation during the summer. You must presumably be due to start your anticoagulant now as planned 3 months ahead of the procedure.

Not sure why you would worry about having AF while asleep. As I have suggested before, address the anxiety and stress in your life, and perhaps try to ignore what has sounded over the last 9 months as fairly minor episodes of AF from a symptomatic point of view. I speak from experience as someone whose slow vagal AF caused no physical symptoms, but huge anxiety in the early years.

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I haven’t been given a date for an ablation yet. I had an appointment with the EP at Barts a few weeks ago but because the local hospital had not organised an appointment with the ophthalmologist in time as he requested (Barts eventually arranged it themselves at RHL) it has been delayed (I don’t have an appointment yet). I’m also unsure whether an an ablation would be the best path this stage- I would want to discuss that with the EP. At the moment my concerns about the PAF are that it will progress.

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3 months ago you said you had seen the EP at Bart’s and ablation was planned in around 6 months. Quite confused here, because on the one hand you say you are concerned that your PAF will progress and on the other you now seem to be uncertain about the advice you had to have the ablation from one of the top teams in the country.

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I was told that the waiting time was about 6 months and that I would need to be on an anticoagulant for several months before. I was also to see an ophthalmologist before starting the anticoagulant; this was to be arranged by my local hospital. Another Barts appointment was booked but because the local hospital had not actioned the request from Barts, the follow up appointment had to be cancelled; Barts referred me themselves to an ophthalmologist at RHL. They will now rebook another appointment with the EP but I don’t know how long that will be.

I am worried about PAF progressing but also about the prospect of an ablation since a) the Barts EP said that this only addresses symptoms and b) the procedure could make things worse at least in the short term. I don’t like anything about PAF at all and have not really been reconciled to it after 10 months.

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I’m just curious. What does an ophthalmologist have to do with getting an ablation.

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As a rule nothing; however, when I took an anticoagulant I suffered from a subconjunctival haemorrhage soon after. A GP felt this might indicate proneness to bleeding (possibly in the vicinity of the brain- it was never made explicit). As an ablation requires months of anticoagulant before the procedure a check by an ophthalmologist was needed.

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Thanks. I was confused as I am seeing an EP about an ablation but I have already been on an anticoagulant, Pradaxa for 4 years now so guess if I was going to have a reaction I would have had one by now.

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