Have not posted for a good while but check in every day and learn a lot. I have PAF for 20 years. For 18 of those I would have one or two episodes a year - always self-converted. In 2020 I had a lot of stress from other health issues and lockdown because of Covid. I had episodes every 7 to 10 days. Towards the end of the year the episodes were every 3 weeks or so. 2021 started well with 2 episodes in 5 months and has now gone back to every 7 to 10 days. The difference now is that after conversion to NSR almost every day I have ectopics, skipped beats, extra beats. The day before yesterday I went into what I think was A Fib seven times. They only lasted seconds up to a minute. There were also some ectopics.. Yesterday everything was fine until 3 pm when I went into A Fib and converted to NSR at 11 pm. All OK today so far. I have not slept well for weeks getting between 4 or 5 hours a night. Should I look into this? Could this be the road to persistent A Fib? An echo last March told me that my heart structure had not changed from the previous one (14 months). I am on 7.5 mg Bisop, Coverysil for BP and Warfarin. I love walking but am afraid to walk much now. Anyone have similar experiences?
Changing Episode Patterns: Have not... - Atrial Fibrillati...
Changing Episode Patterns
Have you had an abalation for your AFIB?
Thanks your your reply. No I have not had an ablation. This was discussed with my cardiologist. I am 80 years old in September and that seemed to be a concern mostly if I needed more than one. I agreed when it was discussed but to be honest am now wondering whether I should. I don’t want to spend a lot of time recovering from the procedures at my age but if the A Fib is getting more frequent then it’s a bit of a toss up.
I was just thinking as you had this terrible condition for 20 years that you should have been offered it years ago so has your cardiologist and you both agreed to try and and control your AFIB with meds?
It was only a year ago that I was offered it. We are trying to control it with Bisop. He says if I get to the stage where I have an episode say every second day we would try Dronedarone as rhythm control as opposed to the current rate control.
I think you should address the lack of sleep. I have had to take meds to sleep after knee surgery and have had no AF since September. A lot of rest has helped I think
Thank you for your reply. I think you are correct. I have had problems sleeping since I started on beta blockers but it has become worse in the last month or so. I seem to manage on six hours sleep but am not getting even that now. I have been considering being referred to a sleep clinic . Your suggestion has spurred me on to do it. I know there is a relationship between poor sleep and AF. Thanks
My PAF has gone from good to bad over a 6 month period. For 15 years or so prior to that I had an episode maybe once or twice a year, then it began happening about once a month, and then every two or three days.
I was started on propafenone about 10 weeks ago and that keeps me in sinus rhythm as long as I take it! Twice I’ve skipped a dose by mistake and I’ve gone into AF just when the following dose was due.
I was told years ago by an EP that the condition usually worsened with time. Until recently, I had hoped that I was an exception to this because my PAF had been stable for so long.
I find myself wondering if the stress and many changes that have occurred as a result of the COVID-19 pandemic are what has caused my PAF to increase in severity. The condition seems to be worsened by stress, not so much in the short-term, but over a longer period.
Yes, I think you could be right re long term stress being the culprit. Thinking positively and with the Vagus Nerve in mind (sorry no pun intended), I think what causes the problem can also relieve the problem - so start today working on a comprehensive relaxation programme on all fronts as it will take a while to reverse the past, never too late though and it could help your wellbeing in many other ways.
Thanks, sounds like very good advice!
Many thanks. Stay well
Flecainide didn’t work at preventing episodes for me with taking one 50mg twice a day but works brilliantly at stopping them once they have started usually in a couple of hours and often less - with added bisoprolol if very high heart rate- I take 2 as PIP but as episodes are occurring 2 or 3 times a week I’d like to investigate other drugs and wonder how the one you mentioned does. I’m 77 and used to be fit and healthy!!!
I'm on propafenone because my cardiologist is concerned about using flecainide due to a strong family history of coronary heart disease.
I used to take flecainide as PiP and I thought it suited me better than what I take now. The propafenone causes a taste in the mouth and has made me more breathless on exertion.
Oh dear that’s disappointing especially for you- my chap did mention there was another drug so perhaps that’s it but it will be a few more weeks before I get to see him (or a member of his team)!
Ablation for my husband was discussed at age 85 but because of other complications it was decided to go for drugs so after a loading dose to get him from persistent AF which had lasted for about 2 years, he started on Amiodarone. It took 2 months but he gradually realised he would be in NSR for periods which became longer and longer until NSR established and was maintained. He’s still on a maintenance dose and has had the odd short episode but QOL is so much improved and ejection fraction now back to normal despite valve problems.
Hope that helps and gives some encouragement. I do think ablations are great for younger very fit people, but recovery can be very slow, no guarantees it will work and it is an invasive procedure which carries risk.
Many thanks. Glad things worked out
Glad you are considering a sleep study. I definitely see connections between poor sleep, stress, and alcohol and my afib/rhythm irregularities. I use a cpap. Hope you can get better sleep either way!
Many thanks. Yes, I am definitely following up on that.
Hi president. You may not be heading towards persistent because you’re afib s changed mate. Mine has changed over the years too but I’m still PAF. my EP once told me that afib is very unpredictable and sometimes you have a good run then things can for a while then settle down again for no reason. It may be a good idea to speak to your cardiologist for some reassurance in the meantime. I know someone who’s been PAF for 40 years. And he gets good years and then can get frequent afib some other years.
Many thanks. That’s very comforting.
I have had permanent AF now for 3 years. Before that I had paroxysmal AF for more than 10 years. I wasn't sure what to make of it when it first happened, but slowly over time I came to realise that I could live a completely normal life.
The problem was that no-one else seemed to have any idea what was "safe". And for me the biggest impact was actually worry. So to start with I slept badly too just out of worry and not feeling "normal".
So you may want to try my approach and gradually try things out and see what happens. To give you one example, a few years ago I was out doing some mountain walking in Scotland when I had an episode. What to do? Sit down and call Mountain Rescue? I decided to carry on -- dying doing what I enjoyed if it came to that. 6 hours and 15 miles later I had had a lovely day!
Thank you so much for your reply. I note a number of posts over the years have indicated that permanent A Fib is not as scary as it sounds and you can live a mostly normal life. I need to stop stressing and just get on with life. I suppose the change from one or two episodes a year to two or three a month has thrown me. Thanks for the advice.
I think you must monitor your situation closely. I had PAF for best part of 18 years and episodes became more frequent and lasted at least 24 hours. In 2018 it was evident I was having episodes 2 or 3 times a week. I was then offered an ablation and accepted. So far, so good. Biso has some awful side effects. I wouldn't be surprised if it affects sleep patterns. You don't mention when your episodes start? Due to Biso lowering my HR at night- most of my episodes started at 2.00 am. It was like an alarm clock. Good luck going forward.
Many thanks. Many of the episodes start whilst I am in bed but not all. I have had them start at two and three o clock in the afternoon and in the evening. My cardiologist knows that my heart rate can be down to 46 at rest. He does not seem to be worried. I have frequently wondered if this low rate could be influencing the episodes. Good to hear things are working out for you.
Sinus Rhythm with Supraventricular Ectopy after PAF episode.
Just to follow up
Odd episode at the train station 
