Bristol Visit

[maria68]

I’d had a bad cough and cold over two weeks since Christmas.doctor said it was a virus. Then travelled to Bristol (5 hour) journey. Very tired but managed to see relations that evening. Went into AF in the night and took PIP. Flecainide(150 mg) didn’t seem to have the usual result of converting to sinus rhythm so had to visit the A and E. Not knowing the city it was very stressful but the staff at hospital were very attentive. They were going to put me on digoxin but then decided to give me fluids intravenously and a further Flecainide(50mg).

After around 2-3 hours my heart rate went down to 60. Saw a cardiologist briefly who was happy that I had recovered. Doctor convinced I was dehydrated. So, it was a shock as my first time that Flecainide didn’t work. Do you think it it was dehydration and exhaustion? I had been drinking water but not as much as usual. I would be interested to read anybody’s reply.

I did e mail my EP when I left hospital and he said I can take up to 300mg of Flecainide within 24 hours.

But my real question is - why does the AF start when I tried to sleep and not earlier when I felt tired?

[CDreamer]

Virus always stimulates AF as does dehydration for me - combination of the 2 - lethal.

150mg Flec is half of what I used to take as a PIP to stop AF, then 150mgx2bd but AF broke through eventually anyway as AF can be, but isn’t always, progressive.

Sounds like you had good attention in Bristol - I’ve never been treated in A&E, just sat in the waiting room until it stopped.

Dehydration and keeping up your electrolytes is really important so if the IV drip worked for you that was the most likely trigger.

Best wishes CD.

[CDreamer]

As to your ‘main’ question if it mostly starts when you are sleeping then it may be vagal AF which is triggered by either posture - lying down or exercise. My AF would often start at night but I have PoTS as well so that was a factor. Is it worse if you sleep on one side or the other? Try raising the head of your bed by 15 degrees, that can sometimes help. Sleeping propped up can, but doesn’t always.

Sometimes vagal AF can be triggered by various foods or drinks so don’t eat a large meal in the evening and leave at least 3 hours without eating anything before you go to bed.

Sometimes some of these suggestions work, other times not. Also look up vaso vagal manoeuvres as soon as you feel yourself going into AF - they often worked for me. The most affective one was lying down and having my legs raised very quickly and held upright for about 5 minutes. Blowing as hard as you can into a closed such as an empty syringe - the paramedics gave me one as that worked a few times. Certainly saves trips to A&E.

[maria68 in reply to CDreamer]

It’s definitely worse if I sleep on my left side. I tend to eat my main meal by 5 o’clock now and have smaller meals. That has helped my palpitations. Using my new Apple Watch the palpitations at night don’t record as AF. So just ectopic?

I did try vagal manoeuvres that night with no effect. I will try and purchase a syringe and use in the future if I have to.

Thank you CD for your interest and 2 replies. You are very helpful and it’s so lovely to have a reply so promptly.

[BobD Volunteer]

Good hydration (two to three litres of water a day ) is vital if you have AF. Virus often exacerbates AF. Vagus nerve likely at work re starting when you rest. All normal reaction to infections and fatigue.

[maria68 in reply to BobD]

Thanks Bob. Very helpful,