Change in PAF

[cicek]

Hi all. I've been a member for a long time and frequently read the posts on here. Fortunately I have not needed to ask for advice before. My PAF has changed over the last few months. It was always very well maintained and after initial diagnosis has been managed on the same meds for many years now. It is now getting much more sustained. I visited the GP a few months ago when it has been continuous for a few days, who said I could possibly go into permanent AF. I did settle down ago but now it seems to be lasting for much longer periods. My hear rate doesn't go much above 150 bmp. Has anyone on here experience of this? Strangely while this is happening I don't feel symptoms of it like I used to when it happened occasionally. Thank you.

[Hidden]

When I was first diagnosed with lone persistent AF, my heat rate was nudging 130 but I was not overly aware of symptoms. Sometimes I felt a little breathless when walking uphill but generally not too bad. Things changed after the diagnosis with a combination of fear, anxiety and medication. After a CV and 2 ablations, I have been in NSR most of the time but when I have episodes, they are very obvious. We often hear that people adjust to permanent AF very well as their body adjusts and provided the rate is controlled, they appear to lead relatively normal lives. May be you will be one of the lucky ones, let’s hope so....

[cicek in reply to Hidden]

Thank you. I've always known when it's flipped in and out and it has always been quite traumatic. I just thought I was having no PAF at all because I was experiencing no symptoms. Began to think I had probably "recovered" from it but I know that is not possible. While there is no feeling from it now is obviously better but like you I do notice some breathlessness and dizziness when I go up hill or exert myself. Of course I'm checking it more often now (which is not always a good idea) and it is fluctuating quite a lot so I'll visit the GP if I am worried. Again thanks for your help.

[Finvola]

One of the things my EP mentioned during a long discussion about the pros and cons of ablation was that permanent AF 'isn't too bad' as we get used to it, unlike the to-ing and fro-ing of paroxysmal AF which causes us to compare symptoms unfavourably with NSR.

[cicek in reply to Finvola]

You are right there. Much better when you can't feel it flipping in and out of NSR. I think I will go for a quick GP visit just to check everything is OK with the fluctuation rates. Thank you.

[Buffafly in reply to cicek]

Mine did that last time I had a long episode (7 days) It varied between 80bpm and 160, 80 was ok but 160 had me lying down 😞 I thought it was the start of permanent but a too hot curry shocked me back into NSR!

[Hidden]

My second ablation for paroxysmal AFib led to a suspected intraoperative TIA (transient ischaemic attack) and persistent AFL (flutter). I have not regretted my refusal of a third ablation.

A low normal BMI and regular modest exercise have helped me come to terms with my permanent AFL/AFib. I have titrated my beta blocker (nebivolol) dose to keep my resting heart rate around 75 in flutter and 60 in AFib, and no more than 110 on the exercise bike.

I do most things I did before, though not so quickly, and no longer have to suffer those former feelings of dread that a few ectopics might indicate another bout of AFib on the way.

For me, permanent AF/AFL has proved surprisingly compatible with a normal life.

[cuore]

You have not stated what you want to do. Is it your goal to go into permanent AF because that is the track you are on? When your AF is continuous for a few days, it is time to see an EP, and get to see him/her as soon as possible. Your GP is not a specialist in AF, so for him/her to say "I could possibly go into permanent AF" is entirely off base. Also, keep in mind your GP is not licensed to prescribe anti-arrhythmic drugs. It sounds as if you are at a stage of med change also, unless, of course, your goal is to go into permanent AF.

[cicek in reply to cuore]

Thank you. Still not back in NSR so think I should ask to be seen by an EP again. Heart flipping around all over the place at anything from 70 to 150 but I can't feel it. Usually run around 45 - 52. I was offered an ablation a few years ago but was managing really well then and didn't want to go down that route. Your words have helped me a lot. I am really scared despite my sister having two ablations and being OK. Time to be a big girl I think and make my own decision.

[cuore in reply to cicek]

Your GP did you a real good deed by referring you to an EP the first time round. You were lucky to be offered an ablation a few years ago when your AF seemed to be in its early stages. Some are not so lucky. My GP got me to persistent before he finally decided to refer me.

One way to overcome being scared is to read and watch youtube about the procedure. We are so lucky that we have the internet to view procedures. You are lucky to have options. Look at the cup half full. You will feel so much better.

[Ianc2]

Ask to see an EP. It may be that an ablation can resolve your problem forthwith?

[cicek in reply to Ianc2]

Thank you. I think you are right.