AF episode in the heat: I was afraid... - Atrial Fibrillati...

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AF episode in the heat

CDreamer profile image
65 Replies

I was afraid that the heat would affect my Mg - which then affects my heart. Well it happened just after lunch yesterday, the first AF I’ve had without a virus - but then again I have got a UTI and on antibiotics which is another story. HR wasn’t excessive - average 135 so I could cope pretty well.

What I wanted to say was I did 2 things differently - firstly bearing in mind a comment of Etheral’s on exercising in the heat to acclimatise to the heat - so I walked uphill in the mid-day sun, not for long or for very far as it wasn’t intentional! Next I pulled out the emergency Coconut Water and diluted 50% with cool water and sipped for next hour or so. Like magic - Normal Service Resumed. In total the episode lasted about 2-3 hours, which is quite short for me.

I’ve felt much better ever since and been up and about since 5am, house cooled after night temperatures did dip and all windows and doors open since 5 - closed up now the sun is up.

So today is the hot one - get your Coconut Water at the ready and remember it’s about keeping the electrolytes balanced as much as hydration as all that water will dilute your electrolytes.

Take care.

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CDreamer
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65 Replies
Ewloe profile image
Ewloe

Ohhhh the heat and the heart rhythm’s 🙈🙈🙈. I’ve PAF, and waiting to see EP for SVT and a broad complex tachycardia. They’ve been bouncing around doing my head in🙈😂😂. They seem to mix together so I’ve no idea which is doing what. It’s tiring. I go to the cardiac gym with good air con but as I’m hot going in it’s not really helping. Went swimming yesterday, so nice in the pool heart peaceful but then had to sit in car afterwards and wait for muzzy head and fatigue ( and for some reason I get ringing in my ears) to settle as a mixed up song playing in my chest. Then there’s getting up from sitting to standing- could be the medications of course. I find people don’t get how the heat makes you feel with a heart condition.

Anyway sorry to moan, that’s my moaning done for the day 😂😂. Thanks for listening. I’m off to dance to a few rhythm’s.

CDreamer profile image
CDreamer in reply to Ewloe

Moan away. Even MORE important you keep up the electrolytes if you exercise.

GrannyE profile image
GrannyE in reply to CDreamer

I find that any sort of exercise when it is hot is a complete no-no and just cannot do it. Being quiet is all I can do.

ILowe profile image
ILowe

Good point: keep those electrolytes balanced. Not for nothing they promote and sell re-hydration drink.I lived and worked in a hot country. Frequently I had to walk home in the afternoon sun after a day of work. Several times I have had to hang on to lamp posts to fight a spell of dizziness. When I got home I would not feel hungry. This is natural, and is quite useful if you want to lose weight. But I would have some fruit (sugar and electrolytes) with my drink.

In one hot summer my baby could not cope. Rehydration packets were out of stock everywhere. So we fed her Knor onion soup.

My personal favourite now is diluted non-diet Coke!! or Tonic Water. I drink them like cordial. I find that I need a bit of flavour in my water to encourage me to drink, so, flavoured rehydration drink, as you said, sipped slowly, with some Vitamin C.

Buffafly profile image
Buffafly in reply to ILowe

Ginger ale for me

CDreamer profile image
CDreamer in reply to ILowe

Knorr chicken stock has got me out of a few situations when I couldn’t eat but in the heat cucumber and mint cordial is good - just made a batch. Buffafly - Fizzy drinks are a no no for UTI.

Buffafly profile image
Buffafly in reply to CDreamer

Many many years ago a gp told us that the best thing for rehydrating was 7up but you have to let it go flat first, luckily I don’t have a UTI

CDreamer profile image
CDreamer in reply to Buffafly

Too much sugar for these times.

Buffafly profile image
Buffafly in reply to CDreamer

Should have said after D&V, not regularly!

GrannyE profile image
GrannyE in reply to Buffafly

I would not allow my children to go anywhere near Coca Cola but 7 up does not have all those bad ingredients and let them have that instead although now I know better would not give them so much sugar.

Gumbie_Cat profile image
Gumbie_Cat in reply to ILowe

When my children were young and had tummy upsets , the doctor recommended flat cola if they shunned the proper dioralyte drink, or if none was available.

ILowe profile image
ILowe in reply to Gumbie_Cat

Interesting. I did not know that flat Cola was so popular. Diluted of course, otherwise the other ingredients inhibit sleep.

Gumbie_Cat profile image
Gumbie_Cat in reply to ILowe

My youngest (twins) are now 30, so it’s very old advice 😂

CDreamer profile image
CDreamer in reply to Gumbie_Cat

And it really works for tummy upsets, we used when crew got sea sick, but not for replacing electrolytes me thinks.

GrannyE profile image
GrannyE in reply to ILowe

I make half bowl of chamomile tea and leave to cool and then top up with cold water. The bowl cools much more quickly. Sometimes do other flavours of tisanes. Not sure if all those C02bubbles are good for the planet.

Hi CD - sorry to hear about your AF but glad to hear it wasn't bad and resolved quickly. What's the benefits of coconut water, do tell - this is a new one on me :)

So, my hot weather story is from last week when, admittedly, the temps weren't on a par with yesterday & today. It was the first day of the current heatwave, and we're about to head off to a week in gorgeous Devon. I thought I'd get in a 30 minute cardio session on my trampoline, but because it was really warm I did take it easy. Very soon afterwards I felt very 'off colour' and so fatigued I could have laid down and gone to sleep. I do these trampoline sessions several times a week and usually they don't phase me at all, and I feel energised by the exercise.

After a 3 hr drive in the motorhome ('im indoors doing the driving) we arrive, he plugs in the motorhome and I'm so fatigued and still feeling very 'off' that I stretch out on the comfy seat and am dozing off when I suddenly feel my heart. I take my pulse and it's in the 80s which is waaay higher than my usual resting HR of low 50s. This feels exactly like my first ever AFib episode a year ago, which also occurred after exercise - though on that occasion I'd overdone it after not exercising for a few weeks. I panic a bit as I'm 95% sure I'm heading into AF and in an attempt to head it off I take a 1.25 mg Bisoprolol PiP & Apixiban, just in case. Apple watch says not in AFib. I fell asleep, woke up several hours later and by now my pulse is down in the 60s but jumping all over the place. When I take a continuous reading on the Apple watch usually the pulse is changing every second or couple of seconds, up a beat or two if I'm anxious or usually going down by a beat or two at a time. This time my pulse was changing rapidly, several times a second , and jumping up and down by multiple beats, very erratic. I'd never seen it acting like that before. But Apple watch still saying no AF.

So, here's the interesting bit. Having read about it on here recently I'd taken the leap and bought a vagus nerve stimulator - the one I bought was Nurosym (made by Parasym). They're really expensive but I was able to get a 'nearly new' one off eBay for about half price. I'd only received it the day before and had done a 60 minute session the day before and on the morning that this event was happening. I'd been a bit cautious about doing any more that day, as 60 mins is the recommended amount and I didn't want to 'fry' my vagus nerve but I decided at that point to do another 30 mins, which I did and then fell asleep and slept all night. The next morning I woke feeling absolutely fine and normal service was resumed! And I've been totally fine since then, despite a week of tramping around for miles every day, up hill and down dale, in pretty serious temperatures. Mostly uphill I should add - how does Devon and Cornwall manage to have so many uphills compared to the number of downhills?? :)

I will be doing more of a post about the vagus stimulator thingy but figure it's really soon to tell anything. But that was interesting and may mean something or nothing, but it was encouraging.

CDreamer profile image
CDreamer in reply to

Coconut water is excellent for hydration and contains a good mix of electrolytes, is a natural product rather than a processed one.

I will be interested in the outcome of your vagus nerve stimulator. Do you know if it’s Parasympathetic or Sympathetic response that’s over active?

in reply to CDreamer

Good to know (about the coconut water).

As far as I can tell my AFib is mixed (adrenergic & vagal) going by the patterns of my episodes, if that's what you're asking? Though I am more sympathetic overactive so that seems more likely the trigger.

CDreamer profile image
CDreamer in reply to

I am asking as I’m wondering if the device works by stimulating either the Sympathetic or ParaSympathetic system or if there is a switch? Do you track your HRV - Heart Rate Variation? I found that I could sooth my Sympathetic reaction by a variety of methods thus stopping an AF episode, if caught in the early stages. I also found that my nocturnal AF stopped after Sleep Apnea was diagnosed and treated. I still had episodes in the day, but no longer at night. I also had mixed adrenergic & vagal.

You may find this blog useful as to the explanation of vagal AF richardbogle.com/blog/vagal...

I’d be really interested in how you get on so please do post.

in reply to CDreamer

No, there's no indicating of either sympathetic or parasympathetic, it's purely an electrical stimulus to the vagus nerve via a clip attached to the tragus of the left ear.

And yes, interesting that you mention HRV. I've been tracking this for decades due a biofeedback system I've long used (Heartmath) to help me calm down and to assist my meditation practice. It was this that prompted me to get the Apple watch back before my AFib started last year (which also tracks my HRV). My HRV has been really low for a long time and I was concerned about that. The vagal nerve stimulator is really bringing my HRV up significantly, it's immediately obvious after a session but the effect is lasting. That on its own has made me feel like it's been a worthwhile purchase!

And thank you for the link, I'll be interested to read that.

CDreamer profile image
CDreamer in reply to

I also used HearthMath back in the early days - circa 2010 and found it really useful. Unfortunately my devices changed and weren’t compatable and I didn’t update but the iWatch also tracks but you don’t get that instant biofeedback as you did with HearthMath. I looked at being a HeartMath trainer but life moved in a different direction.

in reply to CDreamer

I discovered it when I was living in the US in the 90s. I'm on my third iteration by now. I'm sure you would have been a great Heartmath trainer :)

frazeej profile image
frazeej in reply to CDreamer

I have a HRV tracker on my FitBit Sense watch which tracks the HRV when sleeping; mine is pretty constant (?) at 20+/-2 milliseconds. BUT, I've yet to find any credible information on the significance of HRV. What's normal, what's bad, how to change it, etc., etc., so it remains a piece of unexplained data to me! Can anyone inform me?

in reply to frazeej

my.clevelandclinic.org/heal....

There's quite a lot of info about Heart Rate Variability online if you look. It seems to be one reasonably useful indication of health, heart, mood etc. Exact numbers are not so straightforward as we're all unique but I have an advanced (ie expensive) health app that links with my Apple watch and uses all my health & heart data, including HRV, and it seems to be only happy when my HRV is 50 or above. Below that and it tells me I'm under pressure, stressed and need to chill out, Since my HRV has been often running around 12/13 I was getting that a lot!

frazeej profile image
frazeej in reply to

Thanks Helen: I did read that Cleveland Clinic article, and it did have quite a bit of information, except a definitive normal/abnormal, and when do I die if it's "abnormal"!! Seems to be a consensus of no consensus in other articles I have read, some even saying they don't have a clue-actually, they use more polite words, like "not clear", "not understood", etc. The only allegedly definitive answers I've seen are in the ads for heart monitoring products! Your statement that "we're all unique" I think pretty much sums up the "knowledge in the field"!

CDreamer profile image
CDreamer in reply to frazeej

Certainly does. HRV tends to be extremely variable to the individual, age, fitness and mental well-being. I’m most happy at around 35 ish. Used to be higher when I was younger and fitter. Of course when in AF it can soar!

CDreamer profile image
CDreamer in reply to

Good article, some explanations leave you scratching your head, especially the calculations athletes use and the way it’s calculated.

GrannyE profile image
GrannyE in reply to

You must tell us about it.

in reply to GrannyE

I will!

ozziebob profile image
ozziebob in reply to

Hi Helen, I see you are as busy as ever. I wish I had such energy. And just thinking about your trampoline workouts leaves me breathless.

Something you wrote in this Reply however has slightly confused me and it's about your stated use of Apixaban. I understood from your previous Posts that you are not taking Apixaban on a daily basis because of appropriate concerns, also expressed by me, about the daily use of anticoagulants. But in this Reply you said that, on this occasion, you took Bisoprolol as a PIP, and Apixaban, just in case.

So I'm wondering if this use of Apixaban, seemingly as a PIP, has been authorised by your medical team? or is it something you have decided yourself is best practice for you?

I am soon to discuss my anticoagulation situation for the first time with an appropriate anticoagulation team, and would like to know if official advice still resists using Apixaban as a PIP? But I am well aware other Forum members do report using Apixaban, or other anticoagulant, as a PIP during an AF event and for a specified period afterwards, but not on a permanent daily basis.

But is this use of Apixaban as a PIP now an accepted NICE recommendation, or not.

Your experience will be of help to me. Thanks.

And others are welcome to shed light on this matter as well. Thanks.

Keep bouncing,

Bob

in reply to ozziebob

Hi Bob - no, I'm sure 'my' cardiologist would have a fit if I said I was using it that way! I just happen to have a month supply of Apixaban as I was given it at the hospital when I attended A & E for my first AFib episode. I looked up on the makers website how long it takes to become effective (I think it was 2-3 hrs) so I figure, since my episodes usually last 10-14 hrs it was worth taking it. Better than nothing anyway!

I'm also working on taking a clove of garlic daily as it has anticoagulant properties but I have to say, it's pretty foul :)

Good luck with your meeting - let me know how it goes.

ozziebob profile image
ozziebob in reply to

Thanks for quick reply ... whilst exercising? There's still a problem for me because I'm sure others on the Forum have reported using it as a PIP and a period afterwards. So it's still confusing, and I will bring it up with the Anticoagulation Team. I think one problem is that the research needed to prove either way has not been done, and there doesn't seem to be incentive enough for such studies. I suspect it's a developing and changing issue, along with other anticoagulation concerns. Maybe someone else will find my Reply here and add their own experience. If not, I might have to create a new Post.

in reply to ozziebob

Yes, someone on here has definitely told me that their EP accepts using Apixaban as PiP and for a week after an episode, but I can't remember who it was. I'm sure it's not NICE guidelines.....I just read the NICE guidelines for AFib this very morning, in fact. It's the first time I've read the whole thing.

As you say, I doubt very much that anyone is going to invest enough time and money into studying the efficacy of PiP anticoagulant, there's too many variables and there's no incentive as a daily anticoagulant seem to be well tolerated by so many people.

Jalia profile image
Jalia

I hadn't thought of extra hydration diluting the electrolytes....silly me ! Can you tell me which cCoconut water you buy please ! There is so much in the supermarkets and some quite pricey so don't want to waste money on rubbish.

Jetcat profile image
Jetcat in reply to Jalia

I’d just buy a coconut, pierce a hole through the base and drain the water.👍

Jalia profile image
Jalia in reply to Jetcat

A bit wasteful.....I wouldn't want the coconut itself.

Jetcat profile image
Jetcat in reply to Jalia

If you able to crack it open you can hang them up outside for the birds. The birds love them. 👍

GrannyE profile image
GrannyE in reply to Jetcat

I am sure they do

Jalia profile image
Jalia in reply to Jetcat

...and the cats love the birds.😬 !

Jetcat profile image
Jetcat in reply to Jalia

Oh yes.

CDreamer profile image
CDreamer in reply to Jalia

I wrote a reply to you yesterday which has gone awol but saying coconuts are hard to come by in UK but some supermarkets do stock them but they are expensive and often small.

Jalia profile image
Jalia in reply to CDreamer

I was hoping that you were going to point me in the direction of a carton I could buy from the supermarket shelf !

CDreamer profile image
CDreamer in reply to Jalia

I did! Above originally but seems to have disappeared. As long as it says pure coconut water and not Coconut Drink it will be ok. Look for Innocent or Viva.

Jalia profile image
Jalia in reply to CDreamer

Thanks CD !

GrannyE profile image
GrannyE in reply to CDreamer

Absolutely

mjames1 profile image
mjames1

Sorry about the episode but glad it resolved and thanks for the tip about coconut water. Heat acclimatization by exerting in hot weather is probably left for younger athletes with no heart issues. I used to love the heat but started getting heat intolerant in my 60's after a mild case of heat stroke. Now I try and avoid any sort of exertion when it's really hot outside.

Jim

CDreamer profile image
CDreamer in reply to mjames1

It wasn’t actually intended - had to walk home in the heat of the day and it was a bit of incline! I tend to agree with you that best left to the young and fit!

mjames1 profile image
mjames1 in reply to CDreamer

Oh yeah. The guys that talked to me about heat training were all elite kayak racers in their teens and 20's. They would actually train not only in the heat but without water to build up tolerance for race conditions. I actually tried it a little but it was over 20 years ago but I hydrated

GrannyE profile image
GrannyE in reply to mjames1

You can do things in your 20s that are total no-nos in old age unfortunately.

Auriculaire profile image
Auriculaire in reply to mjames1

If you live in a country with hot summers you acclimatise to the heat by carrying on your normal activities like gardening or housework as summer gets hotter. I go out and garden in the hot sun till the temps get to 33/34° in the shade . I reckon in the sun here in July it's approaching 50°. Then I stay indoors and tackle the housework which normally has to wait for a rainy day. I don't overdo and take frequent breaks for hydrating and a 10 minute rest. I sweat a lot which is probably good as I was reading that one of the dangers with old people overheating was their reduced ability to sweat. I am less heat tolerant than when I was younger but can still manage to do things. I find cooking a problem as there is added heat to cope with.

mjames1 profile image
mjames1 in reply to Auriculaire

Yes and I imagine anything you do starting when you're young works a lot better than trying it later in life.

Jim

Threecats profile image
Threecats

I’m glad to hear your heart resumed normal service relatively quickly, CD and that you’re feeling better today. I certainly find that having an electrolyte drink can shorten an episode for me. Still experimenting to see if I can find an optimum amount to prevent them happening in the first place, though - that’s more of a challenge! I hope your UTI clears up quickly x

Singwell profile image
Singwell

Very useful post. I too have been moving in the warmth though not hottest part of the day. I think acclimatising is sensible for those who can. I'll get my coconut water out this evening

Sorry you had a blip CD!

I managed to get through work yesterday with ready salted crisps and 4 litres of water. Still felt like I was melting into a pile of goo after making 3 beds, I had a headache for most of the afternoon which was my body saying drink.

oscarfox49 profile image
oscarfox49

I've been astonished just how bad I have felt for the past week in the heat wave. At first I tried to keep up my regular exercise regime, just doing short walks in the shade and watering in the garden etc. But I found life was getting more and more difficult over the days, including sleeping at night in the heat, feeling exhausted and breathless and of course, lots of AF. Suddenly yesterday as a storm broke and it rained, and temperatures fell rapidly, I found I was feeling so much better again. It is astounding the difference created by 40C rather than 31 or 32C. The lesson for all us is to stay hydrated and stop believing we can just continue as normal in the heat.

pusillanimous profile image
pusillanimous

I live in South Africa where it can get quite hot in the summer!! over 30C in KZN where I live, and for me there is nothing like water straight from the fridge (I boil tap water first and then refrigerate it)- delicious! I eat a banana and an orange everyday, and sometimes take a dip in my pool, One thing I do not do is have my daily exercise on my static bike which lives on my semi enclosed verandah-I guess I'm like Prince Andrew, but I do not sweat very much despite having drinking water with me all the time at home. Love the warmth of the sun, but never lie directly in it - I suppose we are all different!

secondtry profile image
secondtry

Good to hear the coconut water worked. I stopped an episode some years ago by drinking the same straight from the fridge. I put that result down to it being very cold and drunk quickly (as I have an 'irresponsible' Vagus Nerve) but you are making me think the coconut may also have been involved 🤔.

doodle68 profile image
doodle68

Commiserations CD. I hope you feel better now.

My next episode of AF was due on Monday (every 8 days) and I even ate a tiny lunch on Monday in the hope of delaying it but went into AF at 1pm till 10am on Tuesday Morning.

I have discovered that a faster heart rate is more difficult to cope with than the irregular rhythm so immediately took an extra beta blocker (with my doctors approval|) and lay down for a bit feet raised ho help with blood flow.

I drank lots of chilled water with a slice of lemon and in spite of my fears the episode was no worse that usual in the heat though I slept very little. The worst part was popping out in the heat to take my aged dog out, I couldn't breath very easily but that could be down to my asthma.

I don't feel the need for 'special' electrolyte drinks, I get magnesium and potassium daily in food and a magnesium supplement also a little salt . The main thing for me is to drink little and often during an episode to stay dehydrated and this also applies when we don't have a heat wave .

bassets profile image
bassets

Thanks for this advice - I'll try coconut water :)

Auriculaire profile image
Auriculaire

Glad your afib episode resolved itself . Hope the UTI gets better soon. I have bought some coconut water on your past recommendations and I am having a small glass twice daily. I didn't think about diluting it - will try that. Yesterday the temps dropped a bit here from 40° on Monday to 34° . I thought I might go out and do an hour's gardening . We had breakfast on the kitchen balcony as usual , then I went inside to read the posts here. A terrible smell started to come in through the window and there was a bit of a haze. I thought it was some idiot burning plastic but it turns out it was the smoke from the Gironde wildfires that a change in wind direction had bought to us ! It did not dissipate till 10pm so another day shut up in a darkened house. This is what I find so difficult about the heatwaves - not the heat per se but the necessity to stay indoors in darkened rooms during the day - it messes with my sleep as well.

CDreamer profile image
CDreamer in reply to Auriculaire

Oh no! We’ve seen the devastation of heath & forest fires, very dangerous. France and Spain have really suffered. Stay safe.

Auriculaire profile image
Auriculaire in reply to CDreamer

I was very surprised as they are more than 150km away but apparently the smoke got as far as Paris.

Nigel2000 profile image
Nigel2000

FYI I find that iced milk (whole milk over ice with a dap of vanilla or almond essence) is super refreshing and “good for what ails me” when it’s hot and my heart is acting up.

CDreamer profile image
CDreamer in reply to Nigel2000

Glad it helps you, unfortunately, like many people I’m lactose intolerant so avoid none fermented dairy and hate milk anyway. It’s supposed to be better for hydration than pure water.

Nigel2000 profile image
Nigel2000

Too bad! Yogurt and kidder drinks are good too.

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