After being diagnosed with AF in July at my GP surgery. Things have moved very quickly and have been fortunate to of had an echo done, seen my cardiologist and he has booked me in for my cardio version next month. I’m on 2.5mg bisporlol and 60mg edoxoban too.
Thing is I’m just shattered all the time. I’m a window cleaner up and down ladders all day. I’ve got it in my head that AF isn’t a big thing and something that can be managed with a well balanced lifestyle and meds. I do over do it and that’s something that needs to change. I feel shattered at the end of the day and don’t have the energy to get my work done like I could do say last year. Im not sure if I’ve let my self become unfit or if it is the AF? Last week I felt under the weather. Just very tired, head ache and shivers. Then on Monday I stood up off the toilet and collapsed. I must of lost concioness for a second or two and landed against the wall between the toilet and bath. Luckily I didn’t bang my head! I went in to A and E as this has never happened before and they put it down to my AF and viral infection as the cause. They did do an echo on Monday and compared it to the one I had in August and they said my heart pump has gone down from 50% to 40%. They said it’s subjective to AF though and sure that the cardioversion should sort things out.
Does anyone else get fatigued and tired from it? I’m in AF all the time. My heart rate isn’t that high. Just a mad rhythm all the time.
Just hope I’m feeling better after the cardio version or I’m going to have to consider another line of work away from my business.
Thanks
David
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wordzo
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Hello David, I’ve been reading through your brief history both in this forum and the British Heart Foundation. I’m not medically trained but over the last 7 years or so, I have attended a significant number of talks on AF related subjects from NHS medics who are experts in their field. Generally, the audiences tend to be well over twice your age therefore the content often reflects on what might be best for more mature patients. Cardiologist’s tend to focus more on medication based treatments and Electrophysiologists ( EP’s are cardiologists who specialise in arrhythmias) are more enthusiastic about procedure based solutions such ablations. The general thrust of the EP’s argument is that because AF is recognised as a progressive condition, if possible it is better to minimise the need for quite potent medication. The reasons often given are that over time, doses need to be increased and should they become less effective, they may need to be changed for a stronger variant. For many this can mean that the side effects can become more of a problem than the symptoms they are endeavouring to control. When faced with a patient of your young, tender years, I believe EP’s are genuinely concerned that someone is likely to face over 40 years of increasing medication when they may be able to offer an alternative form of treatment which may result in needing significantly less medication and sometimes, no medication at all. In addition, EP’s will say that if an ablation is required, the sooner it is done, the better to achieve the best results.
By the way, both types of medic are likely to stress the importance of life style changes should they be appropriate as this will reduce the burden of AF. Assuming you are in persistent AF, which is why a cardioversion has been offered, it will hopefully revert but sadly, it is unlikely that your heart will stay in rhythm for ever. However, no matter how long you stay in rhythm, it will mean that you are a likely to be a good candidate for a successful ablation.
The purpose of this rather long reply is to encourage you to think hard about the options you may be faced with after the cardioversion, so that you can work WITH your specialist to determine what is the best treatment plan for you. I’m not trying to influence you one way or the other but I hope my reply prompts you to ask more questions as the treatment progresses so that you can make some informed decisions about how you live with AF. You may also find some of the information contained within the link below helpful as well, good luck…..
I was diagnosed around same age as you. I’m now 35. I also take bisop 2.5mg and yes unfortunately fatigue is one of the symptoms.
It takes some getting used too and you’ll find that you can’t do quite as much as you were able too before.
When I was first put on bisoprolol it was accompanied with riveroxaban, they then changed this too flecainaide and took me off the riveroxaban. Long story short I did not get on with flecanaide and was moved back to bisop and wasn’t half as bad the second time around when the anticoagulant had been removed. This was either due to the lack of an anticoagulant or due to my body adjusting but I’m more inclined to think it was the former as the gap between 1st and 2nd use was around 8 weeksish.
I’m not medically trained and I’m sure your docs will know better but unless you have other co-morbidities I’m not sure why you would be on an anticoagulant due to your age? I was put on them at the start as well myself, as the docs at A&E that diagnosed me were not experienced with af and I continued to take these until my appointment with cardio roughly 5/6 months later If I remember rightly. You may be lucky and find that if your able to come off the anti-coags (with your doctors say so of course) and may have the same experience with a slight lift of fatigue as I did. Not many people on here report anti-coags as the cause of fatigue but most people are on anti coags permanently due to age so probably never get to experience the difference.
I’ve been back on anti coags due to my ablation. Started back on them roughly 3 months ago now and to start they put me back on riveroxaban which instantly gave me the major fatigue issues again. Changed me to edoxaban and haven’t had same problems. Maybe you could try a different anti coag and see how you get on if you can’t come off entirely?
Anyway try to take it easy for the time being. I know it’s hard when your only young and I’m assuming your like me with young kids? I try to think like I’ve got a battery in me that gets charged every night. Only so much juice in the system before it’s empty so pick your moments throughout the day and see where you can save some energy and do less. I run a business myself as well (electrician) so I know how difficult it can be. Just need to try and do as little as possible outside of work so you’ve got the energy to bring the money home and use whatever energy you’ve got left after work to spend some time with kids before your completely empty.
Flapjack has covered a lot already. I'm just going to add that my main symptoms of AF are breathlessness, fatigue and dizziness, so I recognise what you say. I'm only in my 40s but had it for 17 years. Last year, prob covid related, it got quite a bit worse so am now on meds (wasn't before, managed with diet, exercise, meditation, lifestyle etc). Had a cardioversion recently that has been semi successful...nothing to worry about by the way... another thing to note is that I, like many people, didn't tolerate bisoprolol well and found that made me more tired and breathless. Definitely worth talking about all options. I'm hoping to go down the ablation route. All being well. Best of luck to you!
Hi Dave. I’m a cyclist and runner and in AF all the time. I’ve had 4 cardioversions which put me back in normal rhythm for 1 year, 18 months, 2 months and the last one for only 24 hrs. So now I’m having an ablation on Saturday (I declined it previously but have to admit the cardioversion is no longer an option). My ability to exercise is significantly compromised when in AF compared to normal rhythm. In fact I liken it to to being at altitude ( I was a climber before I was put on anti coagulation). If I stand up too quickly I get a wave of light headed ness and nausea. Especially if I’ve been sitting for a while. Walking up the two flights of stairs in my house has me breathless, even though I am fairly fit. I can easily imagine how tiring climbing up ladders must be.
I’ve found that I need to be mindful of my breathing. As your blood flow transports oxygen to your muscles and brain, any degradation in blood flow (as in AF) is going to affect you in exactly the way you describe.
Try to slow down and start breathing deeply in preparation for climbing. In fact, I’d guess that stopping halfway and taking a few deep breaths would allow your oxygen transport system to catch up. Getting faint up a ladder doesn’t bear thinking about!
I hope you have the same relief and great feeling from your cardioversion as I did. I felt like the million dollar man after a day or so getting used to normal rhythm again.
Good advice given. I do think fatigue is normal and unfortunately Bisoprolol and similar can exacerbate that. My AF was diagnosed at 63 so obviously a lot older than you but I can tell you that for the entire year before I was knackered on and off. I put it down to ageing. I was wrong. I think I probably had AF for a while before diagnosis and when not in AF my heart was too slow.
If you can afford it, find a new job, even if only for a couple of years. In the early days of AF the increased anxiety plus your body adapting to new drugs can be very tiring and disorientating. You need all your energy devoted to getting better, reading up on AF & quizzing your medics. In the long run a change(s) can be beneficial.
Bisoprolol is my energy zapper. It was really bad on 2.5 I had legs like lead no energy at the beginning if a walk some days.....he reduced to 1.25 it did the same job reducing the pulse level, and it got much easier....perhaps ask if reducing is a possibility....but I’m no expert just saying what happened with me......I do hope you get feeling more normality soon as it’s draining mentally when everything is a chore energy wise
I have had a similar experience with fatigue - challenge is the Doctors don’t know if it is a fib or Bisoporlol !!!
When I spoke to my Arrhythmia nurse about fatigue in late afternoon / evening - she had all my records - she recommended that I take Bisoprolol at evening / night. I had taken it in morning.
It has made a massive difference. I have returned to work, long days and have so much more energy. I rest up at weekends to pace myself.
Maybe ask your medic team whether that is an option.
Gaz
Hi wordzo, hope you have found these replies helpful.
Overwhelmed by everyone’s time they’ve taken to respond to my post. A lot of valuable information and advice that I can learn from. Reading about AF online is nothing compared to listening to your journeys and experiences. Very educational and will make many notes for my next appointment.
I do take my beta blockers in the morning, so switching to the evening is defiantly worth asking about. I have been taking the beta blockers since July. But only started the anti coags two weeks ago as even though I scored zero on the Chads Vacs. Having a history of valve disease, that overruled the chads vacs.
My cardiologist hasn’t explained about an ablation or anything else after this. I’ve not met him in person yet. Just a chat over the phone. All he said was that I may be able to come of the anti coags a year after the cardio version. But from reading on here things aren’t that simple.
Lifestyle changes need to be made. The number one factor is my job and it’s only me who can make changes. Less hours. I’ve just been stuck in a rut. I could do with having someone part time with me. But know that will bring other stresses on. So having a look at my books now and considering getting rid of some work to take the strain off me at the moment. I generally need a better work life balance anyway for my wife and three year old girl. I haven’t had drink in over a month now. I haven’t found the motivation to start exercising yet. Last year I did go for regular runs. But this year haven’t done any. However I do like walking and did a big walk in June up in Scotland. My heart rate was going insane on my watch, which I’d never seen anything like it and this was a month before I got the diagnosis with AF, which was picked up accidental during a routine appointment. So I have been nervous of overdoing it exercise wise and like I say just don’t have the energy.
I’m trying to lose a couple of pounds ahead of next month. Will keep you posted how I feel post CV. Just need to do everything I can to help myself anyway.
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Dealing with AF
Living with AF
Permanent AF 
Has a cardio version caused a different arrhythmia for anybody else?
