I was diagnosed with P-Afib last June (when my heart went bananas at rest after a high intensity gym session and too much caffeine). I've always had ectopic beats but this was regarded as normal so I didn't worry. I was so upset and worried about P-Afib and had a thorough set of tests which ruled out any underlying heart condition. Everything normal, thank goodness, which was a great relief. I was put on 2.5 Bisoprolol to prevent any further attacks. Roll on Dec 2019 and another attack struck (self inflicted) as I forgot to take my tablet and then went to a Christmas party where I had a few drinks followed by caffeine (yes, I beat myself up for days after this). I had a good moan to you lot about how guilty I felt. I think it's the caffeine that triggers it as I will often have a few gins which doesn't start anything off and in fact, relaxes me.
Nothing since my guilt-ridden night in Dec. I exercise most days and feel great. I am a secondary school teacher, so always on the go. My questions are: do you think I should be taking blood thinners? I've heard mixed feelings about this. I'm 45 years old and female...so although I am relatively young, 'female' ups my risk of stroke apparently (York Cardiology Dr on YouTube referred to this). I would consider myself "low risk".
Plus, For both attacks I have taken myself to hospital as I panic like mad (which doesn't help). Do most people stay at home and just take an extra tablet? My episodes last up to 7 hours and then disappear.....I hate having this as I feel like I don't want to go abroad or anywhere where I don't know how to get to the hosp if I need one (which, I know, sounds insane). I go from feeling okay about this diagnosis to sheer worry! I think the more I read, the more I worry....perhaps I should stop reading about P-Afib.
Advice very much appreciated!
Julia
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Julia7
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Alcohol and coffee are known triggers for Afib. You should stop drinking gin for sure and limit coffee (light roast) to one cup a day. Sugar intake is also a trigger as well as hectic schedules.
I don't like coffee so that doesn't affect me...it's caffeine in drinks such as Coke etc, which I have given up. As long as I avoid it, I should not have another episode, fingers crossed. I will only stick to one wine or gin (have to have something to relax after manic working week). Saying that, I'm even considering going part time to reduce stress - maybe one day off a week from the next academic year. I think P-fib is very common by the sounds of it?
I wish I was wrong! Here's the factual skinny on coffee roasts and caffeine when measured by weight, not volume. Measured the other way, you are right. Measured this way, I'm right: Dark-roast coffees measured by volume with a scoop actually contain fewer coffee beans due to their larger size, resulting in a weaker brew and less caffeine per cup than a light-roast coffee measured in the same manner. Bottom line, you're not getting the most from a dark-roast coffee if you measure it by volume.
On the other hand, dark-roasted coffees measured by weight require more coffee beans for brewing since each bean weighs less than a coffee bean that has been roasted lighter, resulting in a full-flavored brew and more caffeine per cup than a light roast. Measuring coffee by weight is the method adopted by many folks devoted to their joe and strictly adhered to by any reputable coffeehouse.
Thanks for replying.....that makes sense as the nurse specialist I saw (who worked closely with the cardiologist) didn't recommend them. Neither did my own GP. Being female increases my risk, apparently? I am otherwise very fit and healthy and have no other medical complaints, thank goodness.
It’s probably best to talk to your doctor about anticoagulation. Although it sounds as though you are low risk, you only need an elevated blood pressure to be nudging 2 on the scoreboard. As far as going to the hospital is concerned, it’s really your choice. Many say there is little point because A&E often do little unless you are experiencing chest pains or acute breathing problems which is obviously a different matter. Having already gone to the hospital a couple of times, maybe you can assess whether or not you could do what they did in the comfort of your home but it has to be your decision.
Lot’s of folk travel with AF and provided you take simple precautions to prevent stress and anxiety, making sure your travel insurance is adequate then give it a try! Maybe try a break nearer home first before venturing abroad and then a short hop to Paris to build up your confidence. Click on the link below then click on “Living with a condition” then open the section on travel and you will find lots of useful tips......
Thanks so much for your detailed and informative reply; much appreciated. I am not living in fear everyday, thank goodness, but would also hate to be in an unfamiliar place if it happened again.
I have just been reading about SVT.....what's the difference between Afib and SVT?
Supraventricular tachycardia is rapid but regular heart beat whereas AFib is fast or slow irregular heartbeat
This is where I need to make it clear that I’m not medically trained! The only way to be sure is to have an ECG. For us poor mortals it might be difficult to make the distinction by feeling the pulse. You might find a Kardia helpful (google it) but the danger is becoming obsessive with these gizmos!
Yes, I can become obsessive, lol. You sound so wise about it all! I've only ever had two episodes which lasted for about 7 hours. Hoping to live an A-fib free life from now on....avoiding caffeine and remembering to take my bisoprolol!
Hi Julia, re your question about going to hospital, you have had all the tests to show your 'plumbing' is fine so unless you have symptoms which indicate your heart is under too much strain (chest discomfort, breathlessness, faintness, sweating) you can stay cosy at home with plenty of water to drink and something distracting but relaxing on TV.
I personally hate A&E/ER and don't go even when I should sometimes, especially after the time I recovered as soon as I got there but had to sit on a chair all day waiting for an x-ray and my blood test result 😕
It's understandable you have lost your confidence at the moment but if you look at the posts you'll see people are jetting/sailing off to exotic places - you just need appropriate insurance and a bit of preparation. Most people feel as you do to begin with but you'll get used to the situation in time, best wishes 💜
I have days where I don't even think about it and days where I feel very panicky. I'm sure it is linked to hormones and the perimenopause....even the Dr in the hosp said the same. I would love to stay at home but I begin to panic and pace around the house wondering if my heart is ever going to stop pounding and fluttering. My rate goes up to 160 - 170 - 180 / 190 bpm. The nurse said just to take an extra Beta blocker and try to calm down. Easier said than done, lol! The panic keeps my heart rate up! I really need to see a hypnotherapist or a meditation specialist to help with methods of staying calm. I completely freak out! I'm hoping that if I stick to the rules (no caffeine etc) I'll never have one again. Who knows? I need a drug that I can depend on to stop it quickly if it starts.
There are apps which feature calming exercises, some highly recommended here but unfortunately I don't know the names so if you are interested you should put up a separate post. As you know your 'coping method' is the worst 😁
Hopefully you won't have another episode but practising some kind of calming exercise should also help prevent it.
Hi Julia , I was diagnosed with PAF just before Xmas while on holiday in vegas. I stayed in hospital for two days and missed my flight home. I have since seen a cardiologist and have been prescribed 1.25 bisoprolol and flecanide as pill in pocket, although I haven’t needed to take it yet. I am still getting used to this diagnosis and have good days and bad days. I’m 54 and have no other health issues. I’m waiting for a heart monitor I have to wear for 72 hours at the end of February. I am due to travel to Vietnam end of March and have thought about cancelling, but my cardiologist have told me I will be fine and I can take flecanide if I need to. I am also not on any anticoagulant. I also score a1 for being female. It’s hard not to worry and hopefully we will feel better in time. Best wishes
Hi Julia Because of my upcoming holiday to Vietnam I told Cardiologist/Ep of my worry of traveling again because of what happened in Vegas. He told me I should still go and he would prescribe me Flecanide. Some people take it daily, but he suggested if I were to get an attack I could use it as PIP, when and if I needed to. It’s supposed to get you back in to NSR within a few hours hopefully or maybe longer. Maybe you can ask your Doctor if it’s something you can try if you need to. Best wishes Julia.
Please don’t worry about travel. I am 72 and female and have been PAF on Apixoban for the past 5 years. Refuse to let afib define me and travel to Australia every year . Tokyo and Denmark included last year.
Also drink coffee every morning and a glass of red most evenings. I know lots of people can’t tolerate those but doesn’t affect me so far! 🤞🤞
Hi. Coffee is fine for me too - I have P AF and I also can tolerate red wine or a gin but I only have one or two every so often. Research tends to say caffeine is not as bad as thought but there are certainly people who report they do react after taking it
From my own experience pacing the room under stress is the last thing you shoul do but I have been there myself in the early days. I know how panicky your feel. It is a situation of mind over matter however- I now MAKE myself lie down to relaxing music and do deep tummy breathing I also have a big drink of cold water which seems to help. Yoga will also help you find ways to help you relax generally and for specific occasions.
I have an episode every few months now And will only consider going to a and e if I had chest pains or it continued for longer than 12 hours
Final thing. Irregular heart beat - take your pulse as advised irregular is where beat will be v fast then miss a few beats then normal beats then fast. etc in other words All over the place. Not just missing a beat and otherwise normal. At least that is how it presents in my exp
“My questions are: do you think I should be taking blood thinners? “
Depends on your CHADSVASC risk. If you are at CHADSVASC 1 anticoagulants need not be taken in the opinion of some doctors. That said, some doctors advocate taking them even if you are a CV1. It’s easy to calculate your score if you have not done so already.
“Do most people stay at home and just take an extra tablet? My episodes last up to 7 hours and then disappear.....I hate having this as I feel like I don't want to go abroad or anywhere where I don't know how to get to the hosp if I need one (which, I know, sounds insane). I go from feeling okay about this diagnosis to sheer worry! “
I have PAF with episodes of a similar duration. The advice I was given by EPs and GPS is as follows:
1. If you have an episode of PAF take an extra half -tablet of Sotalol and wait for 20 mins. You are probably not on Sotalol but should take whatever extra they have advised you to take. Don’t take extra medication unless you have been specifically told this is OK.
2. If your heart rate is below 90-100 there is no need to go to A and E ( I put 90-100 as some clinicians gave a figure of 90, others of 100).
3. Go to A and E if your heart rate is above 90-100 for more than 20 minutes.
4. Also go to A and E if you have chest pain (or pain in the arm or neck) and/ or an episode of PAF is more protracted than usual.
5. Go to A and E if you have any (for you) “unusual” symptoms or feel dizzy or breathless.
The anxiety question is more difficult to deal with. I wouldn’t claim to have mastered this myself. I have found that *if* you can remain calm during an episode it is generally shorter, and the heart rate is lower. I also discover that if I eat during PAF that speeds the heart rate up (but perhaps that’s just me)
However bad AF might feel it's not an accident but may feel an emargency though rarely is . The last time I went to hospital for Paroxysmal AF was in the early days of diagnosis sixteen years ago when my GP rang the hospital asking what he should do as I'd been in AF for about 12 hours. They said call an ambulance. When I arrived they just monitored my condition. After two hours of being monitored my heart went back into NSR without any intervention..
When I had episodes I'd try to get to bed to sleep . Normally rest was the cure.
Hi Julia just like you when I first was diagnosed with pAF 8 years ago I used to go to the hospital each time I had an episode. I soon found that it actually made them worse and last longer with the stress of going. I took my courage in hand equipped myself with blood pressure monitor, heart rate monitor, read up all I could about it and had the support of all the sufferers on this great forum and bingo it worked and for the last few years I have managed the episodes at home keeping them to a minimum length. Give it a go and you will soon see you can. 😉
It seems like the main issue is anticoagulation. IMHO the risk of a stroke and permeant disability is much more important than the risk of 2 tablets a day of apixaban or other NOAC. Consult a cardiologist.
Hi that was me 2018 I have par afib didnot want to go any where want to know where hospital were worried all the time now my tablets are working great can go out no worries still have my off day but much better you will be fine
I have found that the best way way to deal with an attack is just relax and accept it and get on with life. By sitting down and doing some deep breathing while trying to relax your body as much as possible, the effect of the episode lessens, I find. After about 10 minutes I then just resume what I'm doing and try not to think about it. With me it reverts to NSR anywhere between a couple of hours and 12 or so. I don't think about which it will be. I just try and ignore it and sometimes I find I've gone back into NSR without realising. I think going into a panic or going to hospital is possibly going to make it worse and just be a waste of your time.
My AF is permanent. It never reverts to normal sinus rhythm. I can't feel my heart beating though so it's not like Paroxysmal AF.
In addition I have been an asthma sufferer for 46 years and I wear knee length compression socks due to lymphoedema in my lower legs MN I'm 74and 6 feet 7inches tall, and before many journeys I've thought "what if*.
September 12 2018 was a significant date for my sisters and me. It was the centenary of the death of our uncle in the first world war. While my sisters went to the war memorial of the town he was born in, I went to the cemetery in northern France where he is buried. Before I went were the thoughts of what if this or that happencs while I'm in France. The cemetery was 5 miles from the nearest hotel. Public transport was sparse. On the way back from the cemetery I had a choice of staying in the nearest village for three hours waiting for a bus or walking 5 miles. After a quick risk assessment, what if I collapse on the way, what if I had an asthma attack, or worse. I had insurance, somebody would find me and sort me out, so I walked, often taking rests. I ended up with blisters on my feet, but that's all
To a certain extent having an anticoagulant is insurance for some people with AF. Check as Bob says, whether you should be taking an anticoagulant.
Hi do you have tonic with your gin? Tonic is bad for afib deffo.
As for the worry, yes of course you will fret about it, for one thing you are young and the second we’ve all been you, it’s such a shock to be told you ha e afib, we think oh my god it’s my heart.....but it’s very common and trust me as time goes in you will focus in it less and less........as for anti coagulation, I’m happy to take mine, it’s Zapps the strike risk down and doesn’t upset me. I dint see it as a big deal. But you are younger than me.
Afib does makes us feel vulnerable as it’s a cloud over us but it gets less of a cloud the longer you ha e n bother from it........
As for travel.....i was like you.....i live in France, initially we popped thru tunnel to Italy fir a holiday but I remeber clearly my fears of even goung out to eat on that trip......a year on I did long haul to Oz ,so what I’m saying is, it takes time to adjust, time to go from vulnerable to confident again.......I still freak if my heart makes a few jumps and wriggles and instantly take my pulse, of course, but generally now I don’t think about my heart........so try not to overthink....i overthought all the time....I let it rule me.......these great folk on the forum are good support.
I know afib amd alcohol .......nit being able to drink much is a huge upset to social life .......I loved my wine.....cardio told me to not drink white wine at all.....I found out by chance after drinking tonic and getting afib thrn chevking it online that tonic is pretty much a no no........I can drink a beer or two.....or two glasses of red if I go out.....I do drink lots of water too, to be in safe side,,,,,I think some folk can tolerate, some it’s lethal......
I hope this helps you.
Chin up.....try not to panic, go rest in the bed if it happens, breath calmly......
As for the future try a weekend away.....long weekend......as for abroad get an EHic card.......try a small break in Europe...France, Spain,Germany.......you will be fine......just imagine you are getting on with U.K. days fine so why should it go wrong just cos you ate in a diferent country.....
You are describing to a tee the way I feel. I was diagnosed the same time as you and really hate the speeding basketball game in my chest. I for one still not used to it.
Ask to see an EP they are the real experts .
I too am not on anticoagulants and have a 0 Chad score but still worry about it. There is the worst issue about Afib the anxiety and worry.
It does change your life. However the other way to look at is you have now had the warnings and the lifestyle changes are all good for you and will help your health and heart.
I still feel very negative about Afib and the best thing you can do,in my opinion, is use this forum and you will learn and be reassured
Only thing to add to the good advice from other responders, concerns your prescription for bisoprolol. First, it was prescribed by a medical professional so you should continue taking it as prescribed regardless of my input. Second, bisoprolol is a beta blocker that is typically prescribed to treat high blood pressure but also serves to limit your heart rate. You did not indicate that you have high bp so it sounds like this was prescribed to keep your heart rate down relative to the afib. This is ok for most folks that live a fairly sedentary lifestyle. But you also mentioned you did high-intensity gym workouts where you will need the high heart rate temporarily to be effective. If you find workouts are more difficult to complete and they are important to you, talk to your cardiologist about the real need for bisoprolol. I don’t take bisoprolol for this reason. If exercise triggers an afib episode, I take a flecainide and rest for a few minutes and usually return to NSR in a few minutes.
Hi Julia, first, don't worry, stay coll. I will try to help you telling about my case. Our cases have some similarities. Excuses for the long story and bad English. I am Brazilian, 73. I am coping with P-AFIB for 8 years now. I run regularly since I was 30 and I always felt extra beats but the physicians considered them normal. My first AFIB episode occurred when I was 65, during a mountain running competition. As an "amateur senior athlete", I was in a pretty good shape for my age because I did a lot of aerobic activities as triathlon, mountain bike and running. After some time trying to understand the AFIB phenomenon, I bought a small ECG device (one channel) and since 2016 I have been monitoring my episodes. I also saw 5 or 6 different physicians. The duration of the episodes vary from 15 minutes to 2 hours. Ah! Important: I am not a physician; only a curious old man.
What I have to say to you about my P-AFIB is):
1) Coffee or caffeine doesn't have any bad effect in my case. On the contrary, a couple of coffees help to abbreviate the episodes. I normally drink a lot of strong black coffee, without sugar.
2) Bisoprolol worsened my problem: gave me a LOT of ectopic beats. Unbearable. I stop Bisoprolol after 6 month suffering. My opinion about the cause: It makes my heart beat slow, 48-52 pbm during the day and probably less by night. Effect? Another parts of my heart try to participate of the job. New focus of electrical activity. Just conjectures...
3) Nebivolol (another beta blocker). I was on it for more than one year. Less ectopic but the same bradycardia. I lowered the doses to the limit of 1.25 mg two times a day. Then, recently, I stop.
The problems with beta blockers is that my heart beat doesn't rise when I make physical activities. The heart doesn't respond properly to the stimulus. I tried indoor biking under Nebivolol and my heart went from 56 (resting) to 80, maximum effort. Without Nebivolol my pulse goes from 60 to 140 easily.
Since I stop Nebivolol (one month now) I don't have ectopic beats and, better, I am back to the gym and workout. Up today, no AFIB episodes.
4) About anticoagulants. I am on Xarelto (rivaroxabana) since 2017. I am not sure that I need this stuff. The frequency of my AFIB episodes is low. Sometimes I pass two month without any manifestation. But during the period I took beta blockers I definitively need blood thinner because my heart beat was erratic. These new generation blood thinners are highly recommended by physicians but you don't make blood tests to evaluate the effect. You need to believe...and I don't like this. We don't know about long term effects. CHADS2VASc risk classification does not make difference between permanent and paroxysmal AFIB. And there is a huge difference...Today I take one pill everyday and have AFIB only once a month. I had increased risk of bleeding during 29 days and use only one day protection against clot formation.
5) What triggers AFIB in my case. Definitely, after a lot of tests, it is beer (unhappily...). I can't get a glass of beer. It is not the alcohol, I think. It is something in the chemistry (preservatives, perhaps). Some brands are worse than others. With beta blockers the effect of beer was awful. Now, without beta blocker, I am considering to test distilled drinks (liquors). Just to confirm my conjectures about beer. This is it Julia. Be welcome to this ship and enjoy the trip.
Julia—I had cryoablation in April 2017 due to 4 months of P afib with up to 8 Hr episodes. After ablation I began to experience ectopics like crazy and finally decided to take liquid magnesium which I can purchase at Sprouts (Eidon Ionic Minerals Magnesium)..it’s magnesium chloride. It has made a huge difference. I’m almost back to normal. I also take metoprolol 12.5 mg am and pm, and a blood thinner due to my age(75). I stopped caffeinated and alcoholic drinks. I miss my daily cup of coffee but since I only had wine occasionally I’m doing ok without it! I try to walk daily to keep heart functioning well...
I travel a lot and have only had trouble with my AF when I didn’t manage my meds well with a change in time zones. You have a choice here of gradually (over several days) adjust the time you take them so that it’s not too inconvenient whilst away, then you have to adjust back on your return. My preference is just to stick to my UK times - even if it means waking up for a few minutes in the middle of the night - its a lots easier and saves the risk of unwittingly getting times wrong and going into AF.
(I am on blood thinners but I have diabetes too which thickens the blood.)
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