In AF again

My last episode of PAF was on the 9th of July and I foolishly thought that, as I had had my longest period without PAF since diagnosis, the thing might be in retreat. But good old PAF had other ideas: after about 2 hours sleep I woke up with the familiar irregularity. As always, I initially noticed it at the wrist rather than the heart. At the moment it’s slowish (only 77) but with quite heavy beats. I don’t have chest pain. For the moment, I haven’t called the ambulance and am trying to stay calm. Although it was only two months ago, the last episode seems years away.

[wilsond]

Why are you thinking of calling an ambulance? AF isn't classed as an emergency really. Do you have flecanide on your drug list? Can you take an extra one? I assume you have tried the slow deep breathing technique as well?

I get PAF on average 3-4 times

a week and if it's not gone off after few minutes,take flecanide as response medication.

Try not to be too worried and anxious..easier said than done I know..

Hope you settle soon xxx

[Hidden in reply to wilsond]

Thanks for your reply. I take Sotalol. I rang 111 for advice on whether I could take any extra (above the extra half tablet which I already took- different doctors have given me different advice on this). They put me through to a GP (unusual for 111) who said if it was him he would go to A and E , but “if I was not worried” I could go to sleep. Although I was worried I opted not to go to A and E. The episode terminated at about 0930 (7 hours). It never went above 77bpm but the doctor said there was still a stroke risk. I haven’t been out yet, but felt a few ectopics when I was walking upstairs. I’m very disappointed as I thought there was a chance that my episodes were declining in frequency and I could avoid an ablation. But that’s no longer the case. I will probably have to have one on about 6 weeks. I was also a bit worried because I did things like give my old address (where I lived 20 years ago) when asked for it by 111- I recognised the mistake immediately however. I also have the date as October and (later) made a mistake on an elementary calculation involving subtraction. Of course this could be because I was anxious and/or drowsy. Slow breathing doesn’t seem to work for me. Usually, if I walk briskly up a hill it seems to help sometimes. For good measure, I have toothache which the dentist says is tooth sensitivity, but doesn’t feel like it.

If you can terminate PAF in minutes using flecainide then that is good, as the PAF, presumably, doesn’t have much time to do any damage. But 3-4 times a week is quite frequent. Have you had an ablation?

[JaneFinn in reply to Hidden]

Hi Samazeuilh, I’m sorry I’m so late to see your post, but thought I’d respond now anyway

I feel for you that the PAF came back after a good spell without it 😕 Very disappointing, I know from my own experience. I had had 10 months without any significant PAF (just short bursts of under 30 seconds) when I went into fast PAF that wouldn’t stop without cardioversion, after hospital admission. Now I too am heading towards ablation after hoping it wasn’t necessary.

The reality is that unless we’ve been able to stop it occurring (or dramatically hold things back) by lifestyle changes or a new meds regime, I think PAF does progress. In some ways it’s good you’ve got your ablation booked and can get it over with. But I understand your reluctance, of course! A good chat with your EP about all your options and concerns would sound to be a good idea to ask for, if you don’t feel you’ve had that opportunity yet?

Like Wilsond, I was surprised that going to A&E would be suggested at such a good AF rate. Unless you’re feeling chest/arm pains or fainting etc, the advice as I understand it, is that normal rate PAF is not an emergency, so no need for urgent medical attention. Many people live with permanent AF and this is thought to be fine so long as the average heart rate is kept below 100 bpm.

I’m guessing from your stroke concerns you’re not anticoagulated? I understand your concerns - I assume your CHADVASC score has been assessed? Regarding your brain-lapses while in AF the other day, I really wouldn’t worry at all. Our heart is not beating efficiently, which has a temporary affect on many parts of our body, including clear thinking. (And add anxiety and drowsiness, as you say, and it could make anyone give forgetful answers!)

Anyway, It’s great you managed to sit out the AF, and it self converted. Really hope you’ve been AF free since then, and that you get some peace about your treatment plan xx .

[Hidden in reply to JaneFinn]

Thanks. I slept well last night without any PAF (so far as I can tell). Yeaterday, I had a couple of runs of strong ectopics lasting no more than 5 secs, but sometimes these can be a prelude to PAF. I find the prospect of the ablation very alarming indeed, but given that I’m still getting the episodes there seems to be no way to avoid it.