I am new here. I just wish to introduce myself. I am a 72 year old caucasion woman. My story is as follows:
February, 2019 I woke up at around 3:30 am and felt as if something was not right. About half an hour later I got up to go to the washroom. As soon as I stepped out of the bed I felt lightheaded. I held on to the wall as I walked to to my bathroom. I felt very dizzy. On the way to my bed I fainted and fell on the bathroom floor. With great deal of difficulties I managed to clime on to my bed.
My heart was raising and my wrist hurt badly. At around 5:30 am I called an ambulant. They took me to the nearest hospital. Here I was told that I broke my wrist and that I have Paroxysmal Atrial Fibrillation.
In couple of hours being in the hospital my heart went into NSR. The cardiologist on call admitted me to stay over night for observations. I begged him to release me. He hesitantly did. As soon as I got the cast on my wrist I left the hospital.
At that time I did not take Afib to be a serious condition. I must admit I was totally clueless. Was I ever wrong!!! Since then I have been in and out of the ER many times. Things got so incredibly bad. My Afib is vicious and has truly stollen my life from me.
I should mention, I am (was) very active person - did yoga 3 to 4 times a week, went to gym 3 times a week, took long walks every day, swam, did my own housekeeping and gardening... I eat healthy - mainly plant based diet (animal derived food maybe once or twice a week - mainly sardines), no dairy, never drank alcohol, never smoked, no drugs of any kind, no other health issues either. I was not on any medication before Afib. And my BMI has always been at around 18.5. My blood pressure always was at the lower end (around 105/65). My cholesterol level was at the optimal level. Triglycerides very low. All the test indicated that my heart is structurally healthy.
So it is a mystery to me for why I have developed Afib.
When I asked the cardiologist (I saw 5 of them so far) what is the cause of my Afib was, some of them answered that they do not know, but some claim it is the age.
Cheers.
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Ruza2020
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Welcome Ruza to the place you would rather not be. The short answer is Don’t Know! Often AF can develop in folk who have perhaps, not taken the best care over the years, but unless you are telling us porkies, this does not apply to you. Some younger people who indulge in extreme sports can also fall foul of AF but that is due to the immense stress they place upon their heart. Unless you are able to establish a trigger which might cause you to go into AF, it might just be due to the ageing process! The good news is that once your AF is controlled by medication and that includes anticoagulation which is crucial to reduce the risk of having a stroke, AF does not cause premature death.
The best thing you can do is to learn as much as you can about the condition, how it can affect you and the various treatments available to help control symptoms. To help you with this, click on the pinned post to the right of this page headed “Useful Links for Newbies and Oldies”. It’s then easy to navigate around the AF Association webpages to find the information that will help you.
Finally, I see you have met a number of Cardiologist’s but ideally you should talk to a Electrophysiologist, known as an EP (a Cardiologist who specialises in Arrhythmias). This is because in simple terms, AF is an electrical malfunction of the heart. EP’s are electricians whereas Cardiologist’s are generally referred to as plumbers, but don’t quote me.....hope this helps.
It’s not always easy but when your GP agrees to refer you, you are entitled to have some input into who you see. It helps if you have done some research into EP’s who work in your area which is why we encourage folk to learn as much as they can about the condition. Some decide to see an EP privately with a view to assessing the best route forward for them making it clear that ongoing treatment would be undertaken on the NHS. It’s also possible that some Cardiologist’s when asked, will make a referral because their expertise is limited to treatment with medication. Sometimes it pays to be a bit assertive, but always polite but there are no easy answers.
Thank you FlapJack for your input. I have omitted to state one of the possible causes of my Afib. I have lived extremely stressful life for the past many, many years.
As for seeing an EP, one of the cardiologist I mentioned above is EP. I have seen him in February of this year. He recommended an ablation procedure. I have not fully committed to this, but did agree to have my name added to the wait list. In meantime, he suggested that I take 200 mg of Flecainide and Bisoprolol an hour after the onset of the Afib episode. I tried only once - my heart converted to NSR about 20 hours later - so I am not sure if it was Flecainide that helped or it was a spontaneous conversion.
I had my first electrical cardioversion five days ago after being in Afib for four weeks. After the the procedure the cardiologist put me on an anti-arrhythmic medication.
I have tried number of different medications with not much success for the past six months. And I do take anticoagulant- Apixaban.
It always difficult to know what to do for the best but I have had 2 ablations and would not hesitate for a 3rd if necessary but it is very much a personal view. Paroxysmal AF appears to respond better to an ablation and because it is generally a progressive condition, most EP’s encourage patients to have it sooner than later. I had lone persistent AF and therefore will not be surprised if at some stage, I may need a third. I’m sure the Flecainide contributed to your return to NSR, after a cardioversion but before my ablation it would often take 20/24 hours to revert. On the occasions I have used it after my second it only took an hour, sometimes less. Here in the U.K. ablations are not necessarily the first course of treatment but in the States, I understand the situation may be different.
In my opinion it was stress as the main factor that brought AFib on,as well as some lifestyle changes that were needed.
I had a difficult few years with parental care responsibilities ,a very busy job and a family .Much of this stress has now diminished and AFib is less of a problem,although I do take meds.
This is an excellent forum for info and support
The leaflets on here are very useful too
Best wishes
I was told I had lone paroxysmal a fib meaning no other obvious causes. I was 63 when my first episode happened. The first 18 mo were bad as, like you, I was very symptomatic. I havent had any a fib in over two years now. Dont really know why it started or why it quit. Only big change in last 2 yr is I retired from a stressful nursing job. My life is much slower and relaxed. Who knows why... thats one of the hardest things about a fib, it is unpredictable. I used to say it was like an unwelcome house guest.
Re meds, yes and no. Most of my 4-5 years of a fib I have taken flecainide as needed, called PIP( pill in pocket) where I only took it when I had a fib. Last year I had 2 back to back knee replacements so I took flecainide twice daily for about 6 mo as I was afraid the pain and stress of surgery might stir up the a fib. Currently I am back off the flecainide and only take a low dose betablocker metoprolol and xarelto( prevent blood clot) meds. The metoprolol keeps my heart rate low and relaxed. It has taken this long and no a fib for two years for me to mentally get to the place I dont think about a fib daily. Sometimes I forget I even have it!!!
The hard part is a fib is sneaky. Who kniws why Ive been blessed with no a fib for over 2 yr. But knowing it could return anytime is anxiety producing. I can say I no longer fear the beast, if it knocks on my door... I will be angry at it but not afraid. I have learned controlled breathing, meditation , staying hydrated and rested, etc to help me out. A few times, mostly in the evening after over eating a forbidden food, lol I feel like the a fib is ramping up. I sit back and do my breathing exercises and eventually it goes away. I do have an apple watch which is nice. I can check my heart rate and rhythm with it. Gives me reassurance Im not having any a fib Im not aware of.
Best wishes for you on this journey you didnt sign up for. None of us want to be here. This is a great group of people you can trust and get good info and support. 💜
A cardiologist who is often on the radio here in Australia says the best thing you can do to avoid heart issues is chose your parents well as a lot of problems, including AF can be in the genes.
Mine affected my life dramatically initially - hospitalisations, procedures, complications - I had to take a year off work. Thankfully my last ablation has done the trick and apart from an occasional bump (usually tachycardia) I’m great now. I did wonder in that year off whether this was it, whether my life over, whether I ever work or travel or “be normal” again.
Stay positive, hopefully your doctors can get the balance right with medication or procedures and you can get on with your life too.
I started with paroxyl AF when I was 58. It comes on every 3-5 weeks lasts between 12 and 16 hours. There is no reason, healthy heart, bp normal, not overweight, no other condition etc. I do have a naturally very slow pulse. As for triggers I think anxiety has quite a lot to do with it. I am not considered bad enough for an ablation and no medication seems to stop it. Fortunately my symptoms are not as bad as yours appear to be and I can continue more or less as normal when it comes on
I am under two cardiologists and they keep trying different things. I am on apixabin anti coagulants which I really didn’t want to take. But it’s important to take them and I am ok on them.
All very strange. My mother never went to a doctor whatever illness she had but I have a feeling she had afib. So yes probably genetic in some cases
Hi Ruza - and welcome. You will find yourself amongst friends who share and know about all the fear and frustrations of symptomatic AF.
As the others have said, sometimes there are no obvious reasons and although age in itself will not cause AF, certainly as you age it becomes far more common. It sounds as though you are doing everything you can regarding lifestyle because the conditions which can trigger AF are:- thyroid imbalance is an obvious one. In the UK the first test which is done is one for thyroid function and I would imagine you would have had that ruled out? High BP and other underlying cardiac conditions, diabetes, lung disease, reaction to a virus, alcohol - especially binge drinking, flying fighter jets and endurance athletics and I am assuming you don’t fall into any of those categories!
The other biggy is STRESS - especially accumulated stress over time or chronic stress which we often don’t notice as it accumulates - we think we coped with life well and then bang!
The hope bit:- I developed very symptomatic AF in about 2006, I had to take early retirement at 61 and for several years my life was quite miserable. I tried the drugs, then ablation but the final treatment of implantation of a pacemaker seems to have worked for me. I have not had any AF now for quite a long time and continued to feel better because of it. AF is exhausting isn’t it?
There are treatments and many find they work but you need to find a good specialist in Electrophysiology - there should be a list of specialities on the website link below - with whom you can establish a good, long term working relationship with as AF is normally a chronic rather than an emergency condition so certainly in the UK, cant speak for US, you will not be treated for AF in the ER (we call it A&E - Accident & Emergency) because AF is not normally considered an emergency, although it certainly feels like it to us! So - my experience has been I may be monitored for a while but unless my HR stayed very high, BP very high or low or my electrolytes were out I would be discharged as soon as I returned to NSR and certainly because I attend an out patient clinic I would not be treated.
Very often in life we don’t know ‘why’ things happen and as frustrating as that is, we just need to accept that is how we are. But plenty is known about how things work and what the pitfalls are.
To answer you question above:- when would you be referred? No answer really because what I have found is that until you have to have the knowledge to ask the right questions and find someone you think has the right specialist training and with whom you click, the most common scenario is to be given a Beta Blocker to keep your heart rate down when you are in AF.
Because AF is SO common and they call it the quiet pandemic - and that there are so few EP’s for the number of patients you hardly ever get an automatic referral here in the UK unless there is concern that you have dangerous underlying conditions which are potentially life threatening. In other words you are triaged.
May I suggest that you start your education and your potential treatment options by visiting the AFA website for the US - heartrhythmalliance.org/afa/us
And make sure you are anticoagulated as a priority.
Hope some of that helps and do keep posting and ask any questions as we have SO many knowledgeable people with good experience of living with AF who are here to support and help if we can.
Oh ok, look ou for Engmac on the forum he’s also in Canada. Every country seems to have different healthcare resources so you may have to do a bit of local research research to see what sort of treatment is offered in Canada.
I really sympathise, you are asking the same questions that many of us ask when we are first diagnosed. My health profile is very similar, and yes, when I was diagnosed over four years ago I was utterly baffled and it took some time coming to terms with it. But I found this forum and it became (and still is) my 'go to' place to visit every day; I learned so much and keep up-to-date with everything AF related.
As Flapjack says, the best person to see is a good EP who specialises in electrical problems of the heart. There is a lot that can be done to relieve your symptoms , either through medication or an ablation. You haven't mentioned any medication, but I am presuming that you have prescribed anti-coagulants.
If this is your house, that's a lovely view to wake up to!
Relieved to hear that. The Holy Grail for me and many others is to cut our medication to the minimum but at the same time not being foolish about what can help control what is a very debilitating condition. But anti-coagulants - no question over these at all.
I got my first PAF at 72, five years ago. I get the normal medication (Eliquis, Bisoprolol, Telmisartan in low doses for anticoagulation, slowing the heart, lowering blood pressure). Still I was getting PAF about once a month. Than I started to keep a diary of my PAF attacks, in which I noted down time of the year, hour, whatever I did eating, walking, digesting etc). At the end of two or three years I understood that my PAF is circadian and very much dependent of time (month and hour of the day) and meal time and food amount. Now I have changed my medicine time according to the probability of getting PAF in the next few hours and according to the month, and things are going much better. No use to explain all this to my cardiologist....
Well done you - I do think methodical recording & looking for patterns does help & not nearly enough is known about circadian rhythms. I found I have to stay very still & quiet for a good 20-30 mins after eating - I used to jump up & rush onto the next task & once I learned I needed to stay in rest & digest mode, it was no longer a trigger.
Thank you mirtilla. Very interesting - I have noticed some possible triggers you had mentioned. I should pay more attention and should start keeping diary.
Welcome, I don’t believe anyone can explain why we develop afib. Some folks go to all kinds of reasons, from diet to activity to phases of the moon and the color of our eyes. For me, I spent a few weeks trying to figure out why and then just gave up on the why and concentrated on getting thru the episodes. The first couple of times scared me to death. When I finally realized that the biggest risk was a stroke, I became religious in my anticoagulant. Because my episodes occurred between 1:30 to 3:30 in dark night, I still woke up A bit frightened. This changed over time to disconcerted and then just a bit ticked off. After several months of medication with increasing episodes, I opted for an ablation which held for a year and a half until another condition which required Significant prednisone kicked me back into afib. Approximately 2 months of persistent afib, I woke up one morning back in rhythm and have remained in rhythm for the last two months. My EP and I are puzzled by the result, but aren’t looking a gift horse in the mouth.
So hang in there, get an electrophysiologist to take a look and follow their advice after learning as much as you can about this condition. It is different for everyone. My experience is unique for me. Yours is too.
- Strenuous exercise that pushes your heart rate close to its max (which naturally drops as you age), there's a statistical correlation, I believe, for AF in athletes, so good fitness can be a cause, rather than a protection.
- Oral hygiene - gum disease (even mild, if it's been going on a long time) allows bacteria into the bloodstream (potentially also a cause of Alzheimer's, I think), and untreated abcesses
- intestinal (food) intolerances ... (can be to ANY food). Human physiology varies a lot less than the human gut which can host very different bacterial flora that give people very different intolerances, so that other people's food triggers are unreliable indicators of your own. Also intolerances can can be mild enough that you don't realise/care, and they can change over time.
- Nervous crosswiring (like synasthesia), causing nerves from one vagal organ (stomach, lungs) to stimulate another vagal organ (heart). (Reflexology relies on assumed "linkages" between parts of the body that share nervous pathways to simulate one part of the body from another apparently unrelated part.) Could potentially explain some people's experiences that chiropractic manipulation can help.
None are answers, just ideas to consider. As others have said, I don't believe anyone knows for sure. It's also entirely possible that there isn't a single cause - in my experience that's often the case when evidence appears to contradict.
Thank you Zozzy. Some of your ideas here do speak to me - especially the one about food intolerances and vagus nerve.
And I do agree, seeking for cause and effect may be extreamly difficult. All we can do, I guess, is go by correlations.
As for the intence exercises, they never triggered my Afib. However, my cardiologist warned, and asked me to stop....
Cheers
I am 76 year old female very similar to you in that previously healthy and fit with similar diet to yours so guess it must be age and bad luck! I use flecainide as a PIP with some low dose bisoprolol sometimes, which successfully works to stop episodes for me- what we learn in this forum is that we are all different and must find what works best for us- after two and three quarter years since I was finally diagnosed, I have still not discovered what works really well for me in the way of preventing episodes - I take the anticoagulants as a friend's husband died from a pulmonary embolism after a successful operation as he hadn't taken them but I feel very tired much of the time so still searching! It's useful to get a Kardia to help track episodes and encourage you that you are fine a lot of the time! Good luck with your search!
Thank you SandiBee. We definately are very different and thus same approach does not work well for everybody. My next door neighbour, for example, has permanent Afib for at least seven years now. He doesn't have any symptoms - his afib was discovered during annual physical. He is totally functional - has lots of stregth and energy. The only medication he is taking is anticoagulant.
Thanks again SandiBee. I wish you find better solution too - especially to your fatigue.
Wish someone would gather all our experiences and do some useful research but sadly research mostly funded by drug companies mostly concerned to make money! Soon after I was disgnosed I saw an item on someone who was going to do tesearch but when I approached them it was no longer happening!
Hi Ruza2020. Where are you in Canada? Even Canada has vineyards in many places so this does not help me guess.
Based on your health situation, my guess is you have spinal issues. You may wish to find a competent chiropractor and at least check this possibility. Most chiropractors do not know how spinal adjustments affect the heart. Or at least this is not their focus. In Canada, they are not allowed to say they do anything to the heart; so unless you ask them directly and say you understand they cannot say this, you will likely not find out if they know anything about spinal adjustments and the heart. Heart doctors definitely don't consider this possibility. Look at some of my other posts where I say much more about chiropractic. If you agree, I can message you with more information.
Thanks EngMac for you suggestion. I definitely will talk to my chiropractors (husband and wife owned the clinic) about it and see if they are knowledgable in this area. I suspect not.
I am so desperate to get off of the blood thinner.
Cheers
I am 64 & have had paroxymal AF for maybe 12 years. I too was told there is no known reason as my heart is strong also.Many trips for me to ED The only thing I cannot accept is the constant tiredness. Somedays I feek like a cement block!I was always on the go but now I am worn out by lunchtime. As long as I am still breathing I guess.😉🤗
Thanks for sharing. How frequent are your Afib Episodes? Also, are you taking any medications? More than not the medication cause great deal of side effects, including fatigue.
I am on 50mg Metropolol morning and night Flecinaide 50mg morning & 100 at night plus Xeralto. Somefimes vision problems but not too bad.Thinning hair but that might be age related ☺Nausea after taking morning pill .Cardiologist app start of July so will question dosage & possiblyi8 of dufferent meds 🤔
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Gosh you are younger than me (I'm 76 and was only diagnosed 2 and 3/4 years ago) but my heart was fine when I had an echocardiogram shortly after diagnosis - I too am very tired much of the time - and it seems more than old age and it's been some days since I took PIP stuff to stop an episode. I see you are taking the drugs regularly which made me even more tired which is why I stopped taking them regularly except for an anticoagulant! Hope there will eventually be research to find more individual treatment to work for us as "we are all different"! Someone should compose a song!
Hi SandiBee. Thanks for your reply. You said you do not take pill in the pocket any more. I'm just curious. Did it work when you did take t, and are you right now in NSR?
I have stopped all my medications except Apixaban. None worked for me.
About three weeks ago I went for my first electrical cardioversion. It worked. Unfortunately it lasted only 8 days. Right after the cardioversion I took that horrible medicine called Dronedarone. It did not prevent my heart going back into Afib. So I was dealing with the the side effect of the Dronedarone and the Afib symptoms, which I believe Afib was a lot worse with the medicine. I stopped talking the Dronedarone about four days ago.
Today My Electrophysiologist will call and hopefully will have some answers for me. He is an ablation proponent.
Honestly Sandi, it annoys me when doctors blame age for everything. Mind you my cardiologist told me about three months ago that my biological age was around fifty - that included heart health. It s this stubborn Afib condition that is damaging our hearts - all doctors I spoke to claim that Afib remodels our heart - meaning it creates scar tissue in our heart. In turn, remodelling causes more frequent and, in long run, permanent Afib.
Yes- it's odd that they just assume that things are going to get worse whatever you do and still think that everyone is the same and reacts in the same way to drugs though our experience of this (and the reactions to the new virus) clearly show that we are all different and react differently to drugs (and viruses!). You are fortunate to have a reasonable EP though I wonder why they are so keen on ablations when they are so rarely successful! Surely there must be a pleasanter way of encouraging one's heart to behave sensibly (as with children!) Getting on for three years since my diagnosis, I finally have an appointment with an NHS EP tomorrow afternoon but it is going to be by phone and with a "Registrar". I'm not holding my breath. Sorry not to have replied earlier but only get these things weekly rather than daily. Thanks for your good wishes- I've been feeling very tired a lot of the time - it must either be some post viral (not the virus) thing - never been the same since a bout of shingles - or reaction to the anticoagulant or the drugs I take when I have an episode.
I guess it is reasonable to accept that age might have something to do with it as at 76 I'm in the bonus years but if one has always been fit and healthy it is a shock (and then there are the young athletes who get it!!!)
Sorry, I do take flecainide as a PIP, I just stopped taking it regularly as I still got episodes and an increased dose tired me out. I take low dose bisoprolol then too and most episodes are over in a couple of hours though some longer) I thought I had replied to that bit earlier on my phone but it doesn't seem to be above!
Hope you got to enjoy the recent weather and that we all feel better soon! Congratulations on your youthful heart - how much younger than the rest of you is it?
Hi, I was the same age when I developed AF, didnt think it would be
much of problem, how wrong I was. I will not go into detail here too
long a story. Briefly, I was first offered a pacemaker, silly man I was fit as a fiddle walked miles, tackled any task the last thing I needed was a pacemaker. I decided on an ablation, which I was certain would do the trick., of course it didnt and things got a lot worse.
So think long and hard about your options whatever are offered,
Your consultant will know whats best for you heed the advice.
I do think age has a lot to do with how well you respond to treatment
and being older isnt good start.
But I was sorted in the end, but definately not the way I expected.
At the start of my Afib, I associated all my episodes to IBS and GIRD, and sleep issues. Now, I finally have full control of my IBS and GIRD, but it may be kind of late. Like I said to my previous reply, I believe the Afib has created great deal of scaring already.
At the onset of my Afib (about 16 months ago) episodes lasted only few hours, and now they are persistent. One episode lasted four weeks. And the only way my heart went into NSR was via electrical cardioversion.
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