Is there no pattern to this AFIB stuff?

[Doggiemomma]

My episodes have increased to almost once a month which is very disappointing because they used to be almost a year apart. I go to emergency & get chemically converted. PIPs have not worked. Last year, an IV of metoprolol (beta blocker) got me back into normal sinus rhythm, but the last couple of times, the IV of metoprolol didn't work & I needed 2 doses of diltiazem (calcium channel blocker), given an hour apart, to convert me. These episodes were diagnosed as SVT.

Why would a beta blocker work one time and not the next time? Three years ago when I was first diagnosed, I went to emergency with squirrels playing in my chest. I was hospitalized & the intravenous calcium channel blocker doses did nothing, but a beta blocker converted me. Is there really no logic to this? Sometimes a drug will work, & other times another drug will work, and the same drug that worked before won't work, even though the diagnosis of SVT is the same? I have more questions but I'll save them. I get very weepy over this whole thing. Thank you!

Doggie Momma

[BobD Volunteer]

Atrial fibrillation and SVT are two quite different arrhythmias and whilst some drugs may be used in both there are others which can actually exacerbate SVT.

I know some things are done differently your side of the pond but rather than going to emergency if you get an event why not go and see an electophysiologist and get a proper treatment plan in place before your condition becomes more of a burden.

[Hidden]

I guess the the quick answer is no, apart from it generally being a progressive condition which generally means it passes from paroxysmal to persistent to permanent but this is not always the case. Very often we hear from people saying that their drugs seem to be less effective and looking out for alternatives which might be better for them. Often they may need several changes, it’s all very variable.

I know that sounds gloomy, but so many folk have evolved into permanent AF or were diagnosed with it in the first place and provided they are on medication to keep their heart rate within normal range and are taking anticoagulants, they often lead relatively normal lives with normal life spans. It’s often the transition which is the most difficult to come to terms with.

I know you are from the States, but the principles for treatment are much the same everywhere. Either you continue to manage the condition or you investigate the suitability of alternative treatments such as an ablation. That is best done seeing an Electrophysiologist (cardiologist who specialises in arrhythmias) and if you are deemed to be a suitable candidate, then the general view is the sooner the better. This is because ablations are more successful if carried out nearer to the first diagnosis. Have you seen a specialist and discussed these options?

[Buffafly]

What kind of SVT? Because if it is flutter it could be caused by the Flecainide you are taking converting AF. SVT is a bit of a catch all diagnosis, I would want something more specific.

[Doggiemomma]

My apologies for not including that I've been under the care of an electrophysiologist.

As for what kind of SVT, I didn't even know there were different kinds! I've since (a couple of days ago) found out that there is Atrial Fibrillation (is this the one where the squirrels play in your chest and your heart has no steady rate/rhythm?), paroxysmal SVT, and a combo of atrial flutter and atrial tachycardia.

I'll be emailing my EP and asking which kind of SVT Ihave. I'm so hoping to manage this with meds because of the COVID-19 pandemic and the burden the virus places on hospitals and medical personnel. Thank you all so much for your helpful replies & support!

[Singwell]

It sounds like you are now working to get the advice you need. Electrophysiologist is the way to go. A good one will be able to offer a drug regime that controls arrythmia and -if needed -rate. Many of us are on two or three meds for that reason. Try to stay calm in this scary environment -it's the same for us here in the UK -focus on one or two nice things each day to remind you that life can still be OK.

[mjames1]

Google "modified vagal maneuver for SVT". It's a first line treatment for conversion in many ER's and something you can do at home, preferably with a partner, but can be done alone to an extent using some pillows or a piece of furniture to raise your feet. Clear with your EP of course. As mentioned, you might want to get a more specific diagnosis from your EP and consider getting a Kardia or Apple Watch to record these events now that they are becoming more frequent.

[Doggiemomma in reply to mjames1]

I actually do have the 6-lead Kardia, and have unsuccessfully tried the modified vagal maneuvers for SVT -- no success at all, not even once. Thanks for ringing in with the suggestions, though, as perhaps they will be new info for someone reading this forum.

[momist]

To reply to the original question, no, there is no pattern and everyone's experience is different. Just because it is now happening once a month or thereabouts doesn't mean that it will continue like that. I went through a period of frequent events, and then they calmed down again and I've not had one now for a few months. If you are getting anxious about it, that is only likely to make it worse, and more often. I think it's best to get advice from your EP and then try to get on with managing it as best you can, without getting too hung up on it. Of course, when it happens it's awful, but you can get through this, and if you look after yourself it is unlikely to cause problems.

Good luck.

[Tomred]

Hi i was once getting afib once every couple of years then once a year to twice to four times etc now once every 10 -14 days pip never done much for me now on daily pills of bisoprolol and multaq it does quieten afib down but still a horrible thing

[Larachez2102]

Hi whatDoes your heart rate hit when you get these. Mine 210 bpm for around 7-10 mins very tired amd drained after