I take sotalol and apixiban for my PAF and had moderate 3 day episodes about twice a year for 3 years. This last 6 months the frequency has increased and I often have episodes from monthly to 2 weekly of late.
I was discharged from my EP 2 years ago and now with GP.
Was wondering if this is a sign of worsening AF for the future or just a blip and it will return to longer gaps. Or maybe need to changed meds.
Any advice/comment welcome please.
AF is generally a progressive condition as I am sure you will know so this is not unknown. From what you say your AF burden has been very light over the years as many people have much more frequent events. If your GP is unable to help control your AF then you need to ask for a second referral to an EP for consultation. As I have often commented, sotolol is not a commonly used drug for lone AF here in UK so there will be alternatives.
BobD has given you good advice. "AF begets AF" was reinforced to me by my world-class EP. Your episodes are now to twice a week. The episodes are frequent enough that you should see an EP and soon for a more up-to-date diagnosis. GPs are not licensed to prescribe rhythm control meds, only rate. The latest trial conclude that rhythm is a better route. You are at a stage to evaluate whether sotalol is the right med for you which only an EP can thoroughly evaluate or prescribe another rhythm med. And, you might even want to run ablation by him/her. Don't procrastinate, again, "AF beget AF."
I would go back to your EP shorttail....... the same thing happened to me recently.... I was discharged by my EP as had 18 months free of AF.....then I started to get attacks again, monthly for about six months, which I was usually able to sort with PIP flecainide. However that stopped working for me and one time I fainted on reverting to sinus rhythm, then the following episode I went into atrial flutter and was taken to A & E (220bpm) which wasn’t pleasant. The Staff were great, but it was an awful experience. After that, I contacted my EP privately, (as my nhs follow up appointment for the hospital cardiologist was months away). Ablation was advised. (still thinking 😐) I can no longer take Flecainide. My beta blocker has been increased and I was also started on Apixaban which I feel safer on. (I’ve also lost three stone which I needed to). I am so relieved to be back under my EP again (they really are the experts). Give him/her a call and put your mind at rest
Thanks Mariajoy, sounds like you had a bad time. I will have to go through my GP to get a referral. It was odd as I was discharged by EP 3 months after hospital stay from A&E with first full blown attack of AF.
I will wait, as its bearable at moment to let this latest coronavirus surge abate.
Best wishes/
Afib can be progressive, but for many like myself....you can have good years and bad years. It can "come and go" over periods of time. Only time will tell I'm afraid, but just know that the fact that you're suddenly having more episodes now does not GUARANTEE it will continue to progress. My EP at Cleveland Clinic told me this years ago, and he was right, at least for me, as I've had this up and down pattern for 15 years now.
Thanks sdweller, that's good to know. I am also having cancer treatment and do wonder if the stress of that can trigger the AF.
I will bide my time and see how things pan out for a few months.
PAF. What should my goal be?
PAF or another arrythmia?
PVCs, PAF and ablation 
PAF FLECAINIDE AND SHAKING
Monitoring PAF
