I have been recently diagnosed with paroxysmal AF and would welcome comments from the forum as I’ve used its discussions a lot to guide me so far.
Aged 67 and am very active with BMI of 23 with thankfully no comorbidities, hence have a Chads 2 Vasc score of 1. Only aware of AF during a standard doctor’s check-up, and it made sense of some recent issues I’d had hill walking (slight breathlessness on steep hills).
An ECG confirmed things.
In order to understand things better, I purchased a hand held Emay ECG unit that has identified an average of two episodes per week ranging from 2hrs to 48hrs. On first occasion I rang 111 and went to outpatient’s clinic who then released me without any medication as pulse rate had dropped well below 100. Normally my rate is 55 to 60, with BP of 110/70. In the meantime, I’ve watched virtually all of the York Cardiology videos on YouTube which have been very informative as well as the posts on this forum.
Tried to analyse triggers and have found I’m a lot more adrenergic than vagal. i.e. trigger is stress/stimulants/exercise. Doesn’t start after heavy meals or whilst asleep. Hence, I’ve given up coffee, tea and alcohol and reduced the hill walking a bit. Self-diagnosis of my diet showed I needed to increase Mg content, with Taurate supplements that I started 3 weeks ago and I feel have helped reduce frequency and duration. (only one episode last week for 2hrs). Note for years I hardly take any sugar and avoid salt.
Have tried various methods to reset to NSR and found that such techniques as Modified Valsava don’t work. Found the best is entrainment listening to slow heart beat sounds, which has stopped the episodes a couple of times within minutes. Taken up yoga/ pilates that also help my general well-being.
Had telephone discussion with my Edinburgh cardiologist last week to discuss my episodes and to review my echocardiogram results. Thankfully the tests showed my heart was structurally ok with no thyroid or blood count issues. Also seems the atrial was normal size so seems that AF probably not been around for that long.
He was reluctant to put me on anti-coagulants at this stage as I was a “Lone AF” having just crept through the 65-year threshold to give me 1 point on the Chads score. He did however recommend that I initially be put on a low dose of bisoprolol. As I understand this helps reduce adrenalin so should help in my particular situation, though am aware some people have issues with it. Hopefully this medication doesn’t reduce my BP too much as I’m borderline bradycardia. Awaiting details of dosage and prescription.
So it’s been a very scary journey so far, and a huge learning curve. I would welcome feedback as to whether I’m on the right track or missing something obvious.
Written by
Vince1001
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Hello Vince and welcome to our forum of fellow sufferers.
I am mightily impressed by your get-go thinking and how you have informed yourself so well, so quickly. After diagnosis, knowledge is the important first step and so many people, me included, were overwhelmed by the diagnosis itself and unsure of the future. Well done for addressing diet and triggers such as sugar and caffeine and putting any stress which lurks away with your pilates and yoga - I find Mindfulness exercises wonderful.
Unfortunately Valsalvas aren’t very effective with AF but some members report that drinking very cold water can tip them back into NSR.
Bisoprolol is the drug of first choice - some people do well on its influence, others find it slows down everything, not just the heart rate! I hope you find it helpful.
It is a scary journey at the start - we’ve all been there - you seem to have confronted the condition head on - good for you. Keep well.
It’s good to see you taking such a proactive approach to dealing with AF. So many people adopt a “woe is me” attitude and expect the doctors to hand them a solution on a platter.
It can be a challenging beast to deal with at times but it sounds like you are doing a great job. A good relationship with the medical team that supports you is important, as is the confidence to speak up about anything that concerns you. Nobody, except you, knows what it feels like inside your body.
Hi & welcome - sounds as though you are doing all you can to help yourself and good luck with Bisoprolol, which I couldn’t tolerate at all.
I don’t understand this idea that salt is bad for you, I have very low BP and was advised to take 6g salt a day. Avoid sugar, yes but our bodies need some salt - just not a lot so as long as you avoid processed foods which contain a lot of salt - they will always add fat or salt and sugar for taste - you can control the amount of salt you consume.
I found valsalva did work for me, I say did as I no longer have AF episodes, but not all of the time.
The one common factor about AF is that there is no one common factor, we are all very different and react differently to everything.
Eat well, sleep well, manage stress and take regular moderate exercise and keep very well hydrated is the best we can do to help ourselves after that AF treatments are mainly to improve quality of life when we are symptomatic.
Anticoagulants - mmm..... there are many doctors who believe that there is no such thing as Lone AF and AF as a lone symptom will still raise your stroke risk so speaking as someone who really didn’t want to take anticoagulant and had a TIA - reconsider and research for yourself. You can’t undo a stroke.
Have you visited the AFA site and read the info on stroke and anti-coagulants?
You may want to also consider signing up for AFA Education Platform - it’s on-line and there was a post about it a few days ago.
Very similar to me in almost all the details you provide. I started this AF lark 6 years ago though and am 67 now. I would say stop all hill walking until AF has stopped and build back slowly as you have a chance to nip it in the bud. Consider taking Magnesium, Taurine as well as other heart friendly supplements for convenience I use nutriadvanced.co.uk/megamag... and partner this with Co Q10 (Naturopath advice). I have no experience of bisoprolol but from what I have read I suspect it will reduce your heart rate. Should you have another episode and go to hospital, I would discuss with the cardiologist whether they can try Flecainide to stop it whilst there (for supervisory purposes) and if all OK give it to you as a Pill in Pocket i.e. just to use if you get an episode - this is often the first step if episodes are months apart. I am on Flecainide 200mgs daily as 6 years I went through a 'hot spot' of 9 episodes in a month and 100mgs didn't stop them. After that lifestyle changes are probably the most important, which can take a couple of years to work into your routine. Consider all aspects carefully as appear regularly on this Forum e.g. on food, as CD says salt is important, but not the cheap stuff in supermarkets which I believe is contaminated with additives to keep it dry and make it pour easily but the quality expensive stuff; the same applies to all food e.g. pasture fed meat, poultry. I hope something there helps.
Hi Vince. It seems to me that you have all the bases covered there, except the anticoagulant thing. Did you see the Sanjay Gupta video about assessing risk? The one with the little cartoon drawings of a hole in the ground? Risk is a difficult concept for most people, and I thought his way of presenting it was great. The decision whether or not to take anticoagulants is a real dilemma when when risk is well understood. My view is that bleeding can usually be treated easily while a stroke much less so. There are exceptions, mainly to do with a bleed in the brain. My father in law died nine months after a fall caused a subdural haematoma, and I wouldn't wish that on anyone.
As for bisoprolol, I found that I was slow to adjust to it but it seems to suit me quite well now. It's difficult to get off it once you've started though, so again a bit of a dilemma there.
Good luck with your journey, and remember that we're all very different and all have different experiences with this intermittent condition.
I take Bisoprolol and it seems fine. I had a nasty bout of SVT in Feb (heart rate 250bpm) and have been fine until yesterday when I was 120bpm for 12 hours. My dosage will probably be adjusted now. It does knock your confidence, but so many people here are going through similar experiences that I think remaining positive is the way forward. You certainly seem to be doing that, so wishing you all the very best.
Your in a good place in this forum, everyone is full of support.....
I take bisoprolo, and have been for ages.....I think it’s worth noting, it can take a while to settle in and it can make you feel a bit like you’re in a lower gear....lots of us tolerate it, some don’t. I do probably feel in a lower gear at times but it keeps the heart rate lower so I balance that up as it’s a good thing.
You sound very well balanced,well done as this afib arriving does pull the rug from under us....it’s a bit of a shock getting told anything to do with the heart...but it’s very liveable and life does get back to normal.....I would ask again though about anti coags as I see my apixaban as my little friend....it ticks the stroke risk box and quite honestly doesn’t cause any problems.
Really appreciate all of the comments – seems that I’ve come to the right place! Here’s my thoughts:
•Hill walking – Yup I need to stop that for now, but will continue the golf as that’s non-negotiable
•I will introduce a little Himalayan salt to my diet
•I’ve registered for the VPE platform in Sept – looks to be very interesting!
•I need to research COQ10 and Mg Glycinate (Nutri Advanced)
•I’ll consider Flecainide as a PIP if I have to go to hospital
•I’m aware of the stroke vs A/C issues and have seen the York “manhole” video which is very illustrative. My stroke risk comes out at 1.3% on the calculator. Not keen on taking any drugs but understand it reduces stroke risk considerably. I’m 40/60 for A/C at the moment and swaying depending on what I last read. I see there are some natural anti-coagulants like ginger, garlic, fish oil etc that I need to research more. (anybody any advice here?). I’ll then bring the A/C issue up with the cardiologist in my next discussion in Sept.
•Still waiting for the bisoprolol prescription. I read in a technical paper that as a diurnal I have a 62% chance of this eliminating AF episodes (if I read that correctly) which I think are good odds.
•I haven’t had an episode for 2 weeks now since I increased the Mg Taurate dose from one to the recommended two pills per day. (2*125mg). Maybe I’m getting less anxious with things now understanding how others have handled this monster. The forum has been a godsend. I’ll hold off taking the beta blocker if I can do it by diet/ supplements alone (thinking positively…)
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