Methods to get out of AF if your PAF - AF Association

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Methods to get out of AF if your PAF

mjm1971 profile image
23 Replies

Hi All

Day 4 and still in AF .

Taking 200mg Flec and 2.5mg bisoporol daily

Had my ablation 6 weeks ago

Been 1 week since I tested negative after Covid

I know I need to relax , I know it’s early days and I know Covid will be playing a part

But is there any things people have done to get themselves out of AF even if it’s a bit out there ?

Heart Rhythm nurse at ST Barts ( they are brilliant ) said to call her back after Easter if still in AF but not to panic etc .

But I’m struggling to stop thinking about it Etc



23 Replies
BobD profile image

If she is as good as mine she will likely arrange a cardioversion (DCCV) but in the mean time, stay well hydrated do the deep breathing exercises and try to relax.

mjm1971 profile image
mjm1971 in reply to BobD

Hi Bob , she said that as I’m not really suffering : a bit tired and very very minor spacey feeling . They would probably try and ride it out as it’s so soon after after the ablation.

My heart rate is 85bpm average so not really racing .

It’s just driving me nuts and I’m trying hard not to get obsessed and chill but failing lol

BobD profile image
BobDVolunteer in reply to mjm1971

Some of us would kill for a rate like that. Are you sure it isn't ectopic beats, If it is the breathing trick will sort that right away.

mjm1971 profile image
mjm1971 in reply to BobD

Hi Bob

Apple Watch says AF

When I check my BPM on the watch it constantly jumps between 60 and 125 .

I would say I’m mainly around 85bpm when I check When I’m resting

When I walk round it’s obviously up nearer 125bpm

How would I know if it’s eptopic beats

BobD profile image
BobDVolunteer in reply to mjm1971

get a kardia if you really must check your heart all the time.

mjm1971 profile image
mjm1971 in reply to BobD

Hi Bob

So are they more accurate than the Apple Watch ?

Some people have said I may not even be in AF but Apple just states that to be safe etc .

BobD profile image
BobDVolunteer in reply to mjm1971

agreed. Kardia is accepted by most EPs.

Pete-Benje profile image
Pete-Benje in reply to mjm1971

I have just purchased a fit bit charge 5 excellent watch

Tudee profile image
Tudee in reply to mjm1971

I am in persistent AF and my h/r is about 80/85bpm, I lead a happy active walk, as long as I am symptom chest pain no breathlessness, this is my normal, so please do not panic..

FlapJack profile image

It’s normally used to stop tachycardia but it might be worth trying the Valsalver manoeuvre. Check it out on Google and best tried in private!! Take a deep breath, squeeze your nose and keep your lips tightly closed. Clench buttocks, crouch and try to force the air of your mouth and buttocks without releasing the pressure on either your lips or bum!!

Highly amusing to watch but very effective for stopping tachycardia so well worth a try. If it doesn’t work, push hard for a cardioversion……..good luck!

sotolol profile image
sotolol in reply to FlapJack

Hi I had two cardiologists doing VM it didn't work tried at home myself 5 days before. Kept in overnight to be starved

and frozen to death air conditioning was horrible.

Then zapped in the morning. Stopped straight away lovely to breathe again. AF turned into tachy. Got told off for leaving it 5 days. Can't win.

Best wishes to you all.

mjames1 profile image

Hi Matt,

Sorry your're back in afib.

Before Kardia and the Apple Watch, I asked an ep how I could tell at home if I was in afib versus having ectopics. She paused a second and then said, "well if your heart rate jumps up higher than expected when you get up and move around, that suggests afib". So unless you're normal response when walking around is 125bmp, then that suggests afb.

But more diagnostic is the Apple Watch. I have both the Watch and Kardia, and while the Kardia may be more medical grade, the ecg tracings on the Apple Watch should be more than adequate to tell afib from ectopic beats and have been accepted by my ep in the past.

Want to emphasize that it's the "ecg tracings" that are adequate, not necessarily the Watch's diagnosis of Afib. And btw this holds for the Kardia as well. So, unless you know how to read the ecg tracings, I suggest you email it to your heart rhythm nurse. That said, while I have had false afib calls on the Apple Watch, they are usually intermittent. Never had consistent afib calls when it was ectopics and I've had up to 20 ectopics a minute at times.

As to getting out of afib, ask the nurse if you can take another 100mg of flec as a PIP and if it doesn't work the first time, ask if it can be repeated and at what intervals and how many times.

Lastly, I find the Apple Watch not far off regarding bpm, even in afib -- but if you're unsure -- on a 30 second Apple Watch strip, just count the number of QRS complexes and multiple by two which will give you the beats per minute. You can search online for more guidance.

Hope things work out.


jeanjeannie50 profile image

A few days ago I re-discovered these tips that I'd saved from this forum. They're for getting the heart back into normal rhythm, give them a go:

I am a therapist in private practice for over 20yrs.One of my therapies is yoga based. Having quite an accurate knowledge of anatomy, neurology and physiology also having PAF I have found this technique helps me immensely when my heart is fluttering like crazy. Make yourself comfortable either on a bed or lying on the floor,position a pillow under you head, Raise your left arm in an extension position as if you are doing the backward crawl,Stretch as much as you can and imagine that it is stretching your heart muscle...I bend my arm and position my hand under my head palm upwards.. Stay in that position for as long as you can or until the fluttering subsides...At the same time I think of something pleasant.It does not matter what you think about as long as it is a pleasant thought for you. This stops my heart jumping about almost instantly....I also place my right hand over my heart area...Don't panic and just keep calm thinking pleasant thoughts....I do hope this helps you. Kind Regards.C


As someone else who finds yoga breathing and some positions helpful, I would love to try (xxxx) suggestion, but lying down flat tends to make things worse for me. My most helpful position, taught me by a lovely yoga teacher, is based on a yoga forward bend. I sit up with my legs outstretched in front of me and a pillow under my knees, and then bend forward from the hips not the waist, with my arms relaxed but outstretched towards my ankles, and breath deeply and slowly. It's not so good on a full stomach and is more comfortable with your knees slightly apart, and I guess you have to be a bit flexible to find it comfortable, but it has proved to be a great help.

I agree with (xxxx) that staying calm and focusing on something pleasant is a must, and I've even fallen asleep like this as most of my episodes occur at night. All the best Liz


Finally, like AV nodal reentry, some people have recurrent rapid rhythms that are infrequent and easy to self-control by using various methods to increase neural slowing to the AV node (so-called, "vagal maneuvers"). Using these maneuvers, one can sometimes stop the arrhythmia. These maneuvers include:

Bearing down forcefully like you're having a bowel movement for 5-10 seconds, then slowly the neck while lying down for approximately 5 seconds

Placing very cold (soaked in ICE water) cloth on the face abruptly.

Coughing forcefully


There's a yoga breathing exercise that has worked for me before. Lie on your back, bend your knees up so they are above your hips and your lower legs are at 90 degrees. Take a breath in for a count of 4 then breathe out for a count of at least 8. As you breathe out, bring your knees into your chest so you curl into a ball. When you think you've got all the air out of your lungs, try and breathe out more! Breathe in again for 4 and release your legs out to the starting position. Repeat several times. It helps to reset the diaphragm and focus should be on a good long out-breath.

Hope one of these suggestions above can help, they've already put one person back into their normal rhythm this morning.


OldGrit profile image
OldGrit in reply to jeanjeannie50

Those are the kind of things that I discovered worked for me but unfortunately the stretching started to force my pacemaker out through the skin ….. I’ve got a new one now buried deeply so in a couple of weeks time I’ll be stretching again (gently) ….even if I haven’t got a PAF attack brewing its calming to do …

jeanjeannie50 profile image
jeanjeannie50 in reply to OldGrit

Ooh sounds horrible your old pacemaker being forced out by exercises. Hope you will soon be able to cardiovert yourself again once new one settles in. Good luck. Jean

Izzle profile image
Izzle in reply to jeanjeannie50

I'm in PAF generally for about 5 days but it does vary widely. Over the 25 years since my first episode, several triggers to return me to NSR have occurred. The following have done the job on multiple occasions:-

- Walking up a short sharp rise.

- Easy ride on e-bike.

- Mowing the lawn.

- Climbing step ladders to clean my campervan solar panels.

But this week the most unusual action was to have my ear wax removed by suction....must have sucked out a bit of brain as well. Can't explain that one but sure enough, when I came out my pulse had self-reverted.

In summary and I'm guessing, but some form of exercise or stress for the heart works for me. We are all different so listen to your body but don't overdo it.

jeanjeannie50 profile image
jeanjeannie50 in reply to Izzle

It's odd because years ago I'd mowed the lawn full of self pity because I felt so dreadfully unwell. I had to do a bit and then rest and so on.

Later I remember thinking how it had made my heart sore. Then the next thing I knew I was back in sinus rhythm. This happened more than once. I think at times a little exertion, can put you back in rhythm.


mjm1971 profile image

Thanks for all your replies I will be on it tomorrow

BigArnie profile image

Hi, I am loathe to propose this as I’m definitely not a doctor and no doubt you may have been advised on this matter already, but as it’s not mentioned here…. I have PAF and take daily Bisoprolol (2.5mg morning and evening) supplemented by a PIP approach when I get an episode. Basically I take 100mg Flec and another 2.5mg of Bisop when the episode starts. 2 hours later if it’s still going then I repeat. And then another repeat 2 hours later (only happened once or twice!) Also if the second one is needed then more often than not it only takes another 30 minutes or so. Now obviously you are different and your regime is different (and bear in mind that my understanding is that 300mg per day of Flec is the absolute maximum), but I do just wonder if trying an extra 100mg of Flec and Bisop PIP dose just might work - but do get medical advice first!

Mikeski profile image
Mikeski in reply to BigArnie

I’ve done the same, taking an extra 100mg Flec seems to do the trick for me as well.

Afibflipper profile image

It’s very hard to relax but you must try, my heart is 70-140 awaiting CV and had ablations x2. It can take some time to settle both the ablation needs to heal and drug needs to get into your system. Try doing something to take your mind off it (take your watch off for a bit so your not compelled to keep checking it.) Stress won’t help and in mindfulness you move off the thought that’s driving you nuts by doing or thinking of something else - anything from relaxation videos on you tube, a puzzle or just even concentrating on slowing your breathing down - hope you do feel better soon though

tunybgur profile image

Hi Matt,

Have you tried high dose Vit C?

A number of studies have indicated that Vit C helps to prevent going back into AF after Cardioversion or Ablation, and there is some accompanying logic to explain this.

You can find these studies on the net, it might be worth a try.

The advantage of Vit C is that it's not toxic in high doses and is just expelled by the body in urine when its had enough.

They are cheap as chips so won't break the bank, always get quality supplements though as there are a lot of fakes out there.

I take 1000mg/day which is about 10x RDA.

Might help, although as always it's difficult to prove a negative.

I've been in SR for 3 years now, I also take 150mg of Flecainide but recently had a very short episode of AF a few days after my 3rd Covid jab, could be the reason?

Good luck

Snowgirl65 profile image

I know this seems horrible at the moment. Can you possibly arrange for a cardioversion nearby? I had a prolonged a-fib episode soon after my first (cryo) ablation. My EP told me to go to my hospital ER where he met me, and took me down to the arrythmia area for a CV. It took no time at all, and I was on my way home in NSR.

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