any topic suggestions for psychologist?

[rosyG]

Hi everyone,

Hope you are all very well. Our EP medical director and I are having a zoom chat on Tuesday with the psychologist from the Brompton who is going to talk about anxiety during Covid/ AF etc at the next meeting of surreyasg on 5th August at 5pm. The medical director will take questions about AF afterwards(on 5th)

This post is to ask you if there are particular areas you would like her to discuss- I will put these forward to her if you email [e-mail] Also e mail if you want to join us - there is still room for a few more people and the talks are very useful...

Perhaps she can advise me how to avoid having AF when I have a knee replacement in August....!!!

[Lucymoo]

Hi Rosy,

I’m intending to attend the zoom event on the 5th and as you say the events are really useful and informative.

Luckily I’m pretty laid back about my PSVT / AF but I’d be very interested in how to involve your family without creating unnecessary anxiety if that makes sense.

Kind regards

Gill

[CDreamer]

Hi Rosy - You might have guessed that I would have a word or two to say!

From experience I notice that physical symptoms of anxiety precede and coincide with the onset of AF, yet this is rarely talked about. Personally I often experienced what I can only explain as the feeling of an Adrenaline rush prior to the onset of AF. I learned that if I could stay calm and practice breathing/heart imagery exercises that I could often lessen the affects of the episode and even lower my HR whilst we all know that if we get caught up in the ‘worry thoughts’ HR increases.

From my training and experience as a psychotherapist I could be the observer of my own symptoms without getting caught up in the worry thoughts of what was happening to me and found that this keeping calm was my biggest ally in coping with frequent and often quite scary episodes.

I am constantly amazed and disturbed that this element of coping with AF has been so neglected over so many years and it is only in the last couple of years that we are hearing of Psychologists being involved in the management of AF so my question would be - why has it taken so long? I believe psychological support essential for many symptomatic AF sufferers and think that many patients will be helped by educational support groups led by Psychologists who understand and can teach the benefits of CBTMindfulness and Relaxation and Breathing Techniques, especially online.

One of my main problems when offered a place on such a course at our local hospital 3 years ago - for which I was on the waiting list for 2 years - was that the time taken to travel there and back, to attend a 3 hour session (far too long) meant that I finished the day too exhausted to feel any benefit and often in AF from the stress of trying to get there on time and park - virtually impossible at our hospital and sit in a small, dark, uncomfortable room quite unsuitable for the purpose of teaching relaxation and Mindfulness. It’s not an expensive operation - it has the potential for enormous benefits for both patients and overstretched EP’s and Arrythmia Nurses by gifting patients the ability to self-sooth so why is it still not mainstream and widely available? And why aren’t more EP’s pushing for such a service which has the potential to help so many for whom expensive procedures such as ablations may not be appropriate or wanted.

Psychologists often pass over the physical symptoms of anxiety and focus on the psychological and cognitive issues and symptoms. Doctors sometimes also assume that anxiety is psychological and then use the word psychosomatic. Often when patients hear the word psychosomatic they immediately assume ‘the doctor is telling me that what I am feeling is all in the mind and I know it’s not!’ Many of us have had the experience of doctors telling us that our AF was just a few palpitations caused by anxiety but for the patient to distinguish between AF and an anxiety attack is really, really hard and very distressing.

So a general ‘map’ of AF symptoms and when to seek immediate help, when to ask to see a cardiologist and how to identify an anxiety or panic attack might be helpful?

I would suggest that a full meaning of the word ‘somatise’ along with a brief outline of the Autonomic Nervous System and how it works be discussed.

During my practice I found it very helpful to clearly explain the varied and intense physical symptoms of anxiety and their similarity to symptoms experienced by many when in AF. I found it also helps if people understand how the sympathetic and parasympathetic nervous system can be soothed with various practices and it’s close relationship with AF.

Whilst this may not, probably will not, stop an AF episode - it really helps one to cope with it!

[rosyG in reply to CDreamer]

Very helpful thank you. Will pass on!

[Adasian in reply to CDreamer]

I so agree with you. From all I have been reading, most people with AF suffer from anxiety. Why not treat the cause as well as the symptoms. Does anxiety drive AF or does AF cause anxiety!? Interested in knowing too about the vagus nerve and it’s relation/cause of AF..

[rosyG in reply to Adasian]

Read up about vagal AF. Different triggers so worth exploring. I have vagal Af and have to be careful about pressure from lying in left side. Find better sleeping sitting up and on back!!!

[Adasian in reply to rosyG]

First I heard about Vagal AF but someone mentioned the vagus nerve causes burping. My Dad did this a lot and he passed from Coronary thrombosis at 60. Also Sometimes I have trouble sleeping on my left side as my heart keeps thumping. I revert to my back and ended up buying an adjustable bed. I

find elevating my head and shoulders also helps with reflux. Will research it more. Thanks

[secondtry]

Hi Rosy, CDreamer makes a very good point when she talks about sessions' in a small dark uncomfortable room'. My question - Why can't sessions be held in a relaxing rural place close to Nature?' I am sure this would increase substantially the benefits for all concerned.

I was lucky that my cardiologist recommended a professional to combat anxiety and I had 6 sessions which helped not just my AF but my overall wellbeing. I have always been determined from the beginning of my AF journey to use it as a tool (with various lifestyle changes) to better rather than worsen my QOL.

[rosyG in reply to secondtry]

Well done!

[wilsond]

Could I suggest a question around coping with the psychological response to AFib AFlutter diagnosis in that it is not seen as 'curable'? I find it very hard to come to terms with and quite depressing at times.

I try and keep optimistic and positive but not always very well!

It's also hard for family and friends to understand that this condition is so difficult to eradicate . In modern times we kind of expect medicine to sort everything out!

Hope your knee op goes ok xxx

[rosyG in reply to wilsond]

Hi Wilson

That’s a good question. Have you emailed us so you get a link to the meeting? It’s [e-mail].

[wilsond in reply to rosyG]

Will do thank you xx