recently told i have afib

[mrush]

Hi all, i have recently been told by my local A&E that i have AFib , i have been having the symptoms for some time but thought it was just my acid reflux kicking off, anyway as stated told by A&E kept in over night and then sent home next day and told to take 2.5mg of bisoprolol and wait to hear for my cardiologist appointment and err thats about all i know, is this how it usually works??

[BobD Volunteer]

In the curent climate this is likely to be common so first off go to AF Association main websote and read all you can as knowledge is power. then caome back and ask any questions and we will try to answer. There is also a useful link for newbies under pinned posts on the right of the screan.

[mrush in reply to BobD]

hi BobD, thanks for replying, i have read the pinned post about newbies and i have had a look at the AF Association website and from what i can understand this is a condition that is not going to kill me but i have to figure out how best to manage it , there is 1main question i have.

1/ my heart rate is still all over the place ranging from 75 when i wake up to 120 just sat down do i need to speak to my gp reference the meds?

[BobD Volunteer in reply to mrush]

Sadly GPs tend not to be the best people to speak to about AF unless you are very lucky to have one who actually understands it. Normal heart rate is 60 to 100 BPM so you are not far out of range. I suspect that all he would do is say increase bisoprolol s you are on a very low dose. Most of us here can't abide it as it tends to create many unpleasant side effects so it is really up to you as to how good or bad you feel. For sure your GP would not be able to offer any alternative as rhythm control drugs need cardiologists to prescribe in the first instance.

What may be of concern is whether or not you have been assessed for stroke risk which is done using a chart known as CHADS2VASC2. You can google this yourself and work out your risk factors if you are honest in anwering the questions. Just be aware for example that high blood pressure is one of the factors and this applies even if controlled by drugs .AF makes us five times more at risk from stoke. Most of us here were most concerned at the idea of having to take anticoagulants for stroke prevention when first told about them but now consider them to be very good friends.

[mrush in reply to BobD]

Cheers BobD, was told at hospital that didnt need blood thinners as not much chance of stroke (found that a bit weird as am a bit of a lump), the meds don't seem to be causing any probs at the moment so i suppose it maybe best just to give him a ring and see what his thinking is .

[rc-k in reply to BobD]

" I suspect that all he would do is say increase bisoprolol s you are on a very low dose. Most of us here can't abide it as it tends to create many unpleasant side effects "

With nearly twenty thousand members of this forum could you explain your use of the words 'most of us here'. You yourself frequently point out that people only post about bad news, eg unsuccessful ablations, and that members who have been successfully treated tend not to post. Surely this is the case with most medicines as well. I find a small dose of Bisoprolol immensely helpful, and was shocked at the effect of stopping it for a couple of days before a procedure.

[pottypete1 in reply to rc-k]

Regarding your reply to BobD , the fact of the matter is that despite there being nearly 20k members of this forum, even the most popular threads only attract a maximum circa 100 posts. Often responses are in single figures.

There are a hardcore of regulars and I am sure this Bob’s comment more likely reflects the views of these contributors.

I for one found that the beta blocker Bisoprolol had the effect of dulling my senses and made my heart rate very slow. Mind you I already have a very bad conductivity between the top and bottom of my heart.

We are all different and yet I read similar stories often told about Bisoprolol side effects.

All the heart medications affect some more than others, mostly but not always in a either a positive or negative way. The side listed on that piece of paper in the box often runs into two or more columns.

Pete

[Finvola]

Hello and welcome to our forum. That’s what happened to me, except that the cardiologist came to see me in CCU next morning and said he would see me for further evaluation. I had a six week wait but that was in happier times.

As Bob advises, read all you can, look at lifestyle adjustments which you can make and learn as much as you can about living with AF and controlling your symptoms.

Usually, several tests are done - chest X-rays, echocardiogram, perhaps a stress test and perhaps a 24 hour monitor but, depending on where you live and how COV has impacted your medical services, there may be a wait for those to happen.

You’ve certainly found the right place for support and personal experiences of AF. A lifeline for so many of us.

[mrush in reply to Finvola]

hi Finvola thanks for the reply, i have to agree i have found the right place, i have many answers to so many questions that i had running around my head.

[Fibber222]

Hi mrush. I had the same experience as yourself. I opted to see a cardio privately as there was a long NHS waiting list. (4 months) and I wanted to get it sorted ASAP. It may not be practical in this climate but worth a try if you could run to it. I had an electrocardiograph, and an echogram, prescribed sotolol and Apixiban (for Blood/stroke risk) and Bisoprolol low dose as a backup Incase the AF went on too long. They call it a PIP ( pill in the pocket). I would call your GP for a chat to see where you go from now. Please don’t panic or worry and keep well hydrated in this weather. It will all get sorted and there are lots of us out there with this - you are not alone. I was very anxious in the beginning because it’s a scary sensation but as they say you won’t die. You will find a lot of help and reassurance on this forum.

[Davidv45runner]

If your on the normal nhs waiting list for a cardiologist appointment , book a private one to get the “ official “ diagnosis .

The cardiologist would want to see your ecg from when you were in A/E.

Worth the “reasonable cost “ cost to save what could be 3+ months waiting .

It ( Afib ) can progress quickly in the time your waiting ..

That was my circumstance / what I did .

Without it , I would still be waiting now for an appointment ( and maybe even progressing to persistent Afib ).

By the way I’m currently on 150mg flecainide / day ( 50 early 100 later in day ).

It’s stopped my ( twice weekly ) episodes dead for more than 4 weeks now , so very happy with that.

I have made some lifestyle changes also ( no more very high intensity sport / intervals ) , yet I am back to doing almost as much as I was before - yet all within lower heart rate zones 130-140 max .

Good luck .

Stay positive , but get as much info as you can ,and don’t dwell too much into the negatives on here, as in my opinion it is only partially representative of all cases .

[secondtry]

Acid reflux was a pre-cursor to my AF, suggest you fix that with lifestyle changes and not prescribed or over the counter medication.

[Foxglo]

Thais a dreadful time to suddenly find you have AF I hope things settle soon for you. My AF is well controlled but I had a new episode in April I am sure was caused by worrying about Covid. This brings me to my first point anxiety does not help AF and can bring an attack on. It is easier said than done to stop worrying, a couple of ideas might be to look at relaxation techniques, I will come back to and to contact your Doctor ( try and speak to your own Doctor so you have continuity)to get the ball rolling with a referral as urgent) talking to them will also help get things clearer in your mind, reassure you, they will also have suggestions re the worry and uncertainty perhaps refer you to the area well being service who will have books etc as well as telephone help.

Bisoprolol is a good starting medications it will do the job. I took it for years until it was changed because I have asthma. It was only when I stopped it I realised it had made me tired and a few more lifestyle side effects.

Anxiety can be a huge contributor to AF so doing all you can to control this is good.

Look online at suggestions, good sleep practice, music you like, reading if you are able, I found reading difficult when I was worried prior to my recent AF. A walk setting small achievable tasks in your daily life if possible don’t beat yourself up if haven’t done what you planned. Some of the TV programmes streamed at present are harmless, fun and nostalgic I found them helpful during my resent bad patch because they side tracked my mind and started letting me feel in control.

Hope a bit of the above helps

[Ecki]

Untreated acid reflux led to my AF. I was diagnosed with GORD and a hiatus hernia, put on lanzoprazole which helped greatly. An idiot locum GP stopped my lanzoprazole which led to me going into persistent AF, severe chest pain, A&E certain it was a heart attack, but it wasn't. I now follow the acid watchers diet and have lost 44 lbs of fat so far, both of which have benefitted me enormously. You have a lot of reading and learning to do about AF but the lovely people here are extremely knowledgeable and helpful. The horror will pass.

[mrush]

Thank you all for the kind advice, i have been told i should get to see cardiologist rather sharpish as i'm a hgv driver and it means i cannot go back to work until iv seen him (fingers crossed on that one), i try to keep my mind off the negatives and more on the side of well lets see how well i can do with it, once again many thanks for all your advice.

[Desanthony in reply to mrush]

Do you know who you have been referred to? If you do then try telephoning the cardio's secretary and telling her of the fact that you are unable to return to work until after you have been seen and asking if you can take a short notice appointment. I have done that for many things as I only live about 15 mins from the hospital so they can call me if someone doesn't turn up for an appointment and I can be there in 15 mins - while my wife takes half an hour to find a parking space! They also may be able to boost you up the list or put you onto another cardios list and get an earlier appointment due to your circumstances - it's worth a try though in the current situation things are difficult even for private appointments as a lot of private hospitals are being used for standard nursing care where some hospitals are overrun.

[T8746]

I thoroughly believe that esophagitis and reflux led to my AF diagnosis.

I have mostly eliminated it by diet, but have used PPIs at some times.

Here is a study that talks about it:

academic.oup.com/europace/a...

I hope that I got the link correctly as it appears that I cannot paste it in the comments.

It is one of the best articles that I have found about this phenomenon.

Let me know if you have trouble accessing it.

[Hidden]

Not in the US. When I had my first attack back in 1986.I was hospitalized and the cardiologist came to visit me right away. He explained what was happening, what tests would be done while I was in the hospital and how they would try to get me back in sinus rhythm, using meds first. They quickly succeeded in restoring my rhythm with IV drugs. I was in a telemetry unit being monitored 24/7. I had multiple EKG strips run, an echocardiogram, a stress test, and a whole body CT scan within the first 2 days, and they took tube after tube of blood and ran every test in the book. I stayed in rhythm on the drug they continued giving me orally and was discharged on day 4 with prescriptions for Digoxin and Quinidine.

Unfortunately, I continued having attacks and every one meant a return to the ER, until 1999 when I was taken off Digoxin and Quinidine and given Verapamil as my PIP.

Verapamil worked for about 4 years and I ended up back in the hospital when it failed to convert me at home. Once again they ran every test in the book. My cardiologist was at my bedside the next morning and brought in an EP who reviewed everything and could find no reason for my episodes. My cardiologist gave me a loading dose of Flecainide a few hours I was back in rhythm. I went home the next day with a prescription for 100 mg Flecainide daily. I could not take it because my heart rate went down into the 30's, so back to the cardiologist the next day. I was then put on Flecainide 200 mg as my PIP. It has worked gloriously ever since.

In the US if you are hospitalized by the emergency room doctors they contact your doctor and confer with him while you are in the ER. If you do not have a cardiologist or other specialist, depending on why you are there, they call one in. That is how I got my original cardiologist. He actually came to the ER that night to examine me and was in my room every morning during his rounds. It has been the same thing whenever anyone in my family has had to go to the ER.

When I had my blood clots in 2012 and 2017 the ER doctors called my cardiologist. The first time he ordered me hospitalized because I also had phlebitis. He or his partner visited me every morning for the 7 days I was there. They also called in an infectious disease specialist for the phlebitis.

In 2017 my cardiologist and the ER doctor conferred over the phone and since he had seen me the day before and had seen my venous doppler results, he ordered blood work, urinalysis and when the results came back, a shot of Lovenox and a prescription for Xarelto and I went home. I had to follow up with him the following week.

I will take our US system where you see your doctor and get treatment ASAP over waiting for weeks. A friend just had a heart attack last week and within 2 hours he was in the cath lab having a balloon angioplasty and 2 stents place. He was released from the hospital in 2 days. Same thing with a stroke, the Scans are done immediately and if it is a clot you get TPA within a few hours to limit the damage.

[Salvatore68 in reply to Hidden]

What is TPA

[Hidden in reply to Salvatore68]

TPA is a clot busting drug given in hospital emergency rooms to break up a clot causing a stroke. It has to be given within a few hours of arrival in order to limit the damage caused by the stroke.

The only FDA-approved treatment for ischemic strokes is Alteplase IV r-tPA, also known as tissue plasminogen activator. Alteplase IV r-tPA works by dissolving the clot and improving blood flow. If administered within three hours (and up to four-and-a-half hours in certain eligible patients), Alteplase IV r-tPA may improve the chances of recovering from a stroke.

My father in law received it 2 hours after arriving at the hospital. Upon arrival he was paralyzed on one side and had difficulty speaking and swallowing. By the next morning he was up and about in his hospital room, speaking just fine eating breakfast and showing no signs of weakness on the side that had been paralyzed. Really amazing stuff.

It is pretty routine in the US to give it once they determine that the stroke was caused by a clot and not a hemmorage. FYI he was on Warfarin when he had the stroke.

[JJHRT]

Forget the cardiologist go straight to a good EP. they specialize in afib. Push for an ablation. It becoming more acceptable as first line therapy. Drugs simply never work long term. No guarantee with ablation but they’re very safe and sometimes make drugs more effective if you still need them. The sooner you have an ablation the greater chance of success. Afib is not curable. But it’s very treatable if you stay on top of it. It’s a lifelong battle but you can enjoy a long, high quality life with proper care and attitude. Good luck!

[cuore in reply to JJHRT]

Great advice!

[Singwell]

Fraid so - exactly my experience except I went home after 6 hours. They then leave you to it. And that was before the pandemic. Find out as much as you can on your own behalf. This forum is a good place to start. Many of us have noticed links between digestion and AF episodes. It might be worth looking into your acid reflux. Are you on PPIs? I think I'm correct that there's a link between these and development of AF. You might want to consider looking into a diet that addresses the acid reflux. I've done this - no idea if it's 'cured' my AF but I feel miles better and more able to cope with it.

[mrush in reply to Singwell]

HI singwell whats a ppi, if you dont mind me asking?

[Wannna40]

I was recently diagnosed too but they put me on metroplol and Eliquis. I still hear my heart quiver sometimes but overall it helps my blood pressure to be normal and my pulse rate normal as well. Just dont know how long i will be on Eliquis cos they very expensive

[Morzine]

Hi oh poor you we’ve all been u And all felt the confusion as to what’s gonna happen next.....but you’ve got the main message and that’s it’s not goung to kill you.

I’ve been in bisoprolol two years it took a while to settle in but I’m ok with it now...it tends to help blood pressure and pulse a tad lower...well I think I’m right but we are only speaking for ourselves.,l

Tricky time in uk I guess right now so maybe u may wait a bit longer to see cardio,,l,l

I’d imagine he would put I on anti coagulant tablets we all seem to be on those.....mothers little helper to avoid strokes I’m pleased to say....but who knows.

Main thing is not to stress and make yourself get uptight.........as time goes on this will seem more a blip than the huge beast it seems right now....

Sue

[mrush in reply to Morzine]

hi morzine , yes been put on bisoprolol and to begin with nothing seemed to happen but in the last 2 days my rate has come down to about 70 so it feels better , the advice i have already got from this forum has helped me calm down a fair bit, just need to see cardo and see if i can get back to driving HGV as am only 45 and want to carry on.

[Morzine in reply to mrush]

you’re young, I’m sure you will get back on track . I found once I saw my cardio it helped as he made me feel it’s no big deal, whereas before I was shocked and bewildered. As everyone says, it’s not going to kill you. Before this happened I never gave my heart a second glance . You will prob find you will feel every twitter or jump now.....don’t worry it’s just that’s what the heart sometimes and is normal, it’s just that you weren’t listening for it before.......seeing the cardio, reading the helps sheets and ask question here ,......life does go on😁😁😁

Sue

[Wannna40]

I tought you hv to call and make follow up appointments maybe its different in every place or country

[mrush]

hi all, since about 11pm last night my heart rate is a bit all over again and for some strange reason everytime i go to get up i'm finding am going light headed and dazed and a rush of blood to the head is this normal as am still taking bisoprolol and have been fine until this point?