Hi all, suffered acute AF this Wednesday this week for the first time, treated in Emergency Department with Flecanide and Amiodarone infusions to no avail. AF corrected with one delivery of cardio version. Came home Friday on Apixaban, feeling anxious that it will happen again! Had a short (few seconds) palpitation yesterday but nothing since. Everyone telling me to relax and take it easy, which is easier said than done. Wondering when I should return to work, I know that routine cardio versions are told to return to normal activities after 24-48 hours. Just wondering about acute onset AF like mine. When do you think I should return to normal activities and work? I'm normally fit and healthy, non smoker, not overweight, active cyclist and hiker. Normal resting Heart Rate 50.
Thanks in Advance
Jon
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Foilboot
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Hi Jon, I've had numerous cardioversions and have learnt the hard way what not to do after having one. Allow your heart muscles to gain strength beating correctly, before attempting anything strenuous. I once walked up a hill the next day and my heart immediately went back into AF. So wait at least a week, or as long as you can before doing anything strenuous. The longer you can leave it the more likely your heart will be to stay in normal sinus rhythm.
Thank you Jean I will try my best to take it easy. I feel like I’ve lost faith in my heart a bit, whenever I climb the stairs and my heart rate increases I feel anxious that it’s all about to start up again. I suppose it will take a while for me to get over that worry. Thank you again for your response. Jon
I've had 20 cardioversions following acute episodes of AF as have been unresponsive to meds the same as yourself. I would have thought that you would be able to return to work after 48 hours as long as you avoid heavy work for s few days.
PS
I understand your feeling that AF will start up again....i invariably had that feeling for a few days following cardio version. Spoil yourself for a bit and you will soon begin to feel your normal self.
I had my first AF episode out of the blue and ended up in A& E , I was just about to have a cardioversion and equally out of the blue, my heart went from 168 bpm to 65 within a few minutes and was home within hours. Three weeks later it happened again but this time I did need a cardioversion which worked perfectly. I can't remember being told to take it easy and went back to light work the next day.I felt this inner feeling of security knowing I had been rectified so simply! That was the beginning of my journey and after a few more episodes and cardioversions I had my first ablation and all seems well so far. I guess the moral of the story is that there are no real rules, my only real advice to anyone who asked me, is that I believe fear and anxiety are bigger contributions than we realise and learning a few basic breathing techniques will pay dividends. Good luck.
Chances are it will return at some point - you should probably be discussing treatment options with your GP which may result in a referral to a Cardiologist to do some tests to see the best way forward.
All your stats seem good. Assuming your blood pressure is normal, did your AFIB strike after giving your bike a good blast around the countryside at the weekend?
Hi, blood pressure usually around 115/80 which has remained the same. I was actually asleep, my alarm went off at 06:20 which made me jump! Then it all started! So no I wasn’t giving the bike a good blast. In fact my sleeping heart rate is 35-40.
In my case a low heart rate of 35 to 40 when asleep often brought on AF usually around 2.00am. Bisopropol lowered my heart rate and made it worse. I dumped it two years ago. Nasty drug for side effects. You may experience further episodes of AF . Cardiologist appointment and tests is the best route.
I wonder if that’s what caused mine? My HR is around that when I’m asleep 😴
Sounds like you are just like me (when I was younger). Here is what I found to trigger Afib. Give it a try - it should work for you. And if it works, that means your diet is causing/triggering your Afib episodes - you should then go see a Nutrition Response Doctor to find out what you need or are lacking. Here is the cut-and-paste of the data I have accumulated over the years:
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After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt??
Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer
I had exactly the same as you in 2015, I was told I could run or cycle "straight away" so imagine my surprise when it took me a month before I felt able to do much more than very gentle cycling or rowing or walking.
This time I had to wait 5 weeks for the cardioversion during which they tried five different cocktails ofdrugs to control it (this is because they thought I had had it longer than the 48 hour window for immediate cv). Eventually they had to do a t.o.e. (camera down throat to check for blood clots) and cardioversion the next day. Just what they had threatened to do five weeks earlier.
I dont know why they didn't just get it over with then. Instead I was sent home feeling too Ill to do anything for 2.5 weeks. A change of drugs saw me collapse with a HR of 35 and BP of 80/55 and get rushed to hospital and still have to mess about with drugs to try and control it for another 12 days before they finally did the toe/cv as mentioned.
Consequently, 11 days later, and another change of drugs later, I still feel dreadful - faint, sick, weak and whoozy and tired all the time. I can't imagine I will feel like running after a month this time...
Any light at the end of the tunnel encouragement would be gratefully received.
All I can say is take it easy, foilboot, and that I managed four years without recurrence on flecainide.
I got so anxious after experiencing AF that I had panic attacks which mimiced AF. As everyone says, try to relax and not think about your heart every minute. It’s a lot to get your head around. Also if you are prescribed any medication give it time, but don’t put up with side effects indefinitely, there may be an alternative. If found I could not take beta blockers, they made my heart rate too low. I also practiced relaxation exercises for the anxiety, which is always worse at night. Good luck.
Betablockers have lowered my HR to 44, feel terrible but cannot have amiodarone (side effects) or verapamil (collapsed as mentioned above) so I am on what I think is the tiniest dose of 1.25. I think there are no other alternatives for me except ablation
Sorry to hear that. I was given verapamil as a pill in the pocket to take if AF occurred, so not on any AF medication regularly. Thankfully I have not had it for nearly 3 years. But I know what to expect if it recurs. Been lucky so far.
Thanks, I’m only on Apixaban, my normal resting heart rate is too low for beta blockers. I’m slowly getting over the anxiety and worry of it all. It’ll take time and I’m going to take it and try to chill out a bit 👍🏻
Try to keep calm- I know it is not easy as it is a scary thing having a heart that occasionally goes crazy but I've found that rushing or getting anxious or stressed are my only remaining triggers so in possibly stressful situations I endeavour to keep calm and it does seem to be helpful for me and hope it is for you. I know it is difficult in these troubled times but good luck with it- try meditation or mindfullness or breathing techniques etc. I just have flecainide to use as a PIP (pill in the pocket) if/when necessary - it isn't often and episodes stop within a few hours so I don't need to trouble A and E!
I have a long history and my cardioversions were along time ago but it always took me longer than 48 hours to feel completely OK. I would say listen to your body and if you can afford to take a few extra days off
My ablation failed, the day after I had a heart attack and my kidneys failed. I now have a pacemaker and on a lot of meds that make me tired and unable to think straight. However, the doc thinks I really had sick sinus syndrome and that the afib was likely keeping me alive (compensation for the SSS).
However, I think I am in the minority where ablation did not work.
As to afterwards, the docs may say you'll feel fine right away but a lot of people post that it takes anywhere from two weeks to three months. It takes time for your heart to heal! Just be easy with yourself and don't overdo it!
Hey Foilboot. My first a-fib episode (in which I was highly symptomatic) also occurred/began when my alarm sounded (i.e. I woke up startled and immediately found myself in a-fib). I had no idea what my heart was doing, but convinced myself my heart was in BIG trouble, and that I might die! Part of the problem of symptomatic a-fib is the "panic" factor that sets in which causes the body to release adrenaline, which in turn makes things way worse (it causes the heart to beat even faster). In the hospital I think my heart rate peaked at around 200 bpm. That was all back in in 2001.
Now, many years later (I'm 63 now) and after experiencing a great many a-fib episodes, I am still here . I took several different anti-arrhythmic medications over the years, with many/most of them doing the job, especially in the early days. Gradually the meds became less and less effective at keeping a-fib away, to the point where I was having 12-18 hour a-fib episodes about every 2 weeks. Something had to be done about the situation, as my quality of life was badly impacted. So I ended up having a PVI cryo-ablation in August 2018. Since having the ablation I have been completely a-fib free. Amazing! - I've got my life back.
For me the definition of a-fib (specifically PAF) is that the heart has an intermittent electrical problem - nothing more, nothing less. Like me, the vast majority of PAF sufferers have structurally sound hearts, and the issue is an electrical one. The electrical problem is addressed with either meds (anti-arrhythmics) or via an ablation(s). I suspect you will try meds first and if/when they no longer work for you, there is Plan B (ablation) waiting for you. In my situation I wish I had gone with Plan B much sooner, as I might have avoided the ischemic stroke I suffered 3 years ago. Thankfully I emerged from that terrible experience with no physical deficits.
I didn't intend to write so much here, so my apologies!
Many thanks Richard, luckily after a cardio version I’m still in sinus rhythm and only on a precautionary blood thinner while further tests are carried out. Hopefully this was just a one off. My anxiety has got lots better though as I’ve understood the condition and treatment better.
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