Permanent AFib

[Firstbusman]

So I have joined the ranks of being permanently in AFib. This has been for two weeks now, and to be honest it feels better than having periods of AFib. My journey started about 18months ago when I got short bursts of high heart rate and irregular beats. Since then it has got steadily more and more regular that I went into AFib. The bouts always started with ectopic beats and fast heart rate which caused me to take note. I haven’t gone passed the GP stage at the moment haven’t been referred to higher people. I’m on 1.25 Bisoprollo, 10mg Amalopine and 20mg Rivaroxiban. Feel normal getting on with gardening and normal living minus the usual suspects like caffeine etc.

My question is how does this progress. Does AFib continue to get worse when in permanent AFib. I reached this point by it progressively getting worse. , does this road continue? Or does it stay the same. What’s next?

[paulypurplepants]

Hi...sounds like we are on similar paths currently. I have had a few 'issues' that made me get checked out in 2018 but it was the start and this year I had a couple of doses of AF, before going permanent for a month. I had a cardio version which 3 weeks on has been successful. Im on 1.25 biosoprol and 10mg apixaban currently. My cardiologist suggested the beta blocker helps keep out of AF. Had a couple of scares so far, but still in rhythm with a resting pulse around 45bpm. So suggest its a cardioversion for you too.

[Mabal in reply to paulypurplepants]

Hi. I also had a successful Cardioversion approx 3 weeks ago. I now take 5mg Bisoprolol (previously on 10mg) and Apixaban twice a day.

My resting HR is also around 45-50.

Can I ask you- Are you back to usual activities

I work full time, still taking things easy and slowly

Not sure whether I can just get on with life for example run to the car when raining, carrying, lifting ect

Thankyou hope you don’t mind me asking.

[paulypurplepants in reply to Mabal]

Hi Mabel, my Cardiologist said to get back to normal activity after taking it easy for a few days. So Ive played golf, done medium effort work outs on the X trainer and trainer bike with no issues whatsoever. Resting pulse is 43-50 mostly and on the same apixaban dose as you but just 1.25mg of Bisoprolol(Ive always had a low HR)

[Mabal in reply to paulypurplepants]

Thankyou for your reply What is your HR when exercising?

I think I’m being overly cautious and worried about reverting back to AF

[paulypurplepants in reply to Mabal]

I haven't pushed it so reckon max HR has been around 120bpm so far, but will keep taking it further as I get a bit fitter. Will just have to see how it goes.

[Mabal in reply to paulypurplepants]

Yeah, thanks take it easy 🙏🏻 We stay in NSR

Were you newly diagnosed AF ?

[Racquet]

Please buy a copy of the new book, The AFib cure by Day and Bunch. Should answer most of your questions. Published this year.

[Ppiman]

You'll be fine. My friend is eighty-eight and has had permanent AF for years now and is healthy for his age. My son's colleague is seventy-six and, after three ablations, now has it all the time. He still teaches part time and enjoys life. I think it's the racing heart that needs to be sorted, rather than the rhythm, form what I can tell.

My very occasional AF always starts after a racing heart and ectopic beats, too (95-130bpm) although I get the tachycardia far more often than the AF. I wonder if that's common.

Steve

[Thomas45]

I've had permanent AF for about 6 years. The only medication I take is an anticoagulant. The AF causes me no problems at all.

[Belle11]

Hi Firstbusman. It sounds as if you are in persistent AF rather than permanent - persistent is when it's happening all the time, permanent is when it is all the time and it has been decided not to try to put you back into normal rhythm. Your GP wouldn't make that decision - you would normally get to see a cardiologist. You may be offered other drugs, and/or to have a cardioversion, to see if that will put you back into rhythm at least for a while. If it does, you might be offered an ablation to provide a longer term solution.

I was in persistent AF for 9 months, then had a successful cardioversion (staff shortages at my hospital meant a long wait). I'm still in NSR nearly two years later, taking 10mg bisoprolol daily, which keeps my heart rate quite low and less likely to relapse. I've also made some dietary changes, having found that some foods seem to trigger ectopic beats.

Glad you feel better in persistent AF than when you were having sporadic attacks, and hope you can get a referral soon.

[paulypurplepants]

My Cardiologist said that they regard AF as permanent after 7 days. He also said the longer it is in AF, the harder it is to revert to normal.

[Belle11 in reply to paulypurplepants]

It's persistent, not permanent after 7 days.

Described here. "Persistent Atrial Fibrillation. Usually, this lasts longer than a week. It could stop on its own, or you may need medicine or treatment to stop it."

Long-Standing Persistent Atrial Fibrillation is when it's lasted more than a year. "Doctors can use another kind of treatment, such as ablation ... to restore your normal heart rhythm."

webmd.com/heart-disease/atr...

My persistent AF lasted 9 months, and I'm still in normal rhythm nearly 2 years after a successful cardioversion - sounds as if your cardiologist is looking on the gloomy side. All 14 of the people who had cardioversions on the same day as I did, converted back to normal rhythm at least initially.

[paulypurplepants in reply to Belle11]

Fair enough....I probably mis heard , seeing as it was a stressful convo. That's great that 2 years on, you're still okay? editing as reading back.....what have you changed with your diet?

[Belle11 in reply to paulypurplepants]

It is stressful when it first happens, and taking in what is said in a consultation.

On diet - I noticed processed meat (sausages, bacon, even Parma ham) and aged cheese seemed to trigger ectopics after my cardioversion. So I've cut them out in case they led me back into AF. Could be the salt, or possibly the chemical tyramine which is naturally present in some foods and has been linked to AF in some cases, possibly because it can raise BP. Triggers can be quite individual. Lots of people recommend the book The AFib cure by Day and Bunch, which has a lot of useful stuff on diet in it. I haven't gone totally plant based, but do eat a lot of veggies.

[paulypurplepants in reply to Belle11]

Interesting....I see you are still on Apixaban 2 years on and wonder why. I'm hoping to come off them in a couple of weeks, as I was told the risk was post cardioversion for a short period. Also 4 x the amount of Bisoprolol that I am on....seems a big difference!

[Belle11 in reply to paulypurplepants]

It's not me on Apixaban - I've never been on it. I just take 10mg Bisoprolol and 20mg Rivaroxaban. The dose seems to be very individual depending on the patient's needs. When I was sent to A&E with rapid AF - which was the first sign of the condition for me, they started me on a low dose of Biso, and kept increasing it through the day till 10mg brought my HR below 100bpm but still more than 90, and also still v irregular. I had been on another BP medication before AF, and the 10mg dose is to keep my BP down as well as keeping my pulse slow (now usually 45-58), and hopefully help avoid going back into AF. As your pulse is already pretty slow, I imagine more Biso might make it too slow.

[paulypurplepants in reply to Belle11]

yes sorry was confusing you with Mabal......must be all these meds doing my head in!