After a year with only 3 relatively small arrhythmia episodes, I went into AF on Monday evening last week (annoyingly triggered by a slight over stretch!). By Weds, this had switched to tachycardia with a heart rate of c105/110 bpm. My normal rate is around 60 bpm.
I went to A&E on Thursday as I was a little concerned at not having converted by then, and the cardiologist there was not too concerned because I was in sinus tachycardia, low end of tachy HR range and bloods/observations came back showing no issues so he just increased my meds to start from Friday (Sotalol, was on 80 daily and now doubled). It’s now Sunday, and no change - do I need to give it more time for the increased dosage to kick in? How long would you wait before going back to GP/A&E?
Thank you all.
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Hether8
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I'm just wondering, if this episode started with a stretch might another stop it? My AF episodes would often stop when in the shower I bent to wash my feet. I don't think I would be going to A&E with such a low heart rate as yours is 105/110 unless it's making you feel ill. If 130bpm upwards and making me feel ill then I would go if it had been going on for quite a few hours. Waited almost a whole day at home once when it was 160 and then was told off by a nurse for waiting so long when admitted to hospital.
The following is a list of ways some members on this forum have been able to stop an AF episode, hope they may help:
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 re-entry, 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 exhaling.in the neck while lying down for approximately 5 seconds
Placing very cold (soaked in ICE water) cloth on the face abruptly.
Coughing forcefully
Rubbing the carotid artery - once side at a time only.
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.
So, after discovering that making myself sneeze stops Afib. I have discovered another novel way to stop an attack. It involves drinking a litre bottle of water while holding my nose. It's especially effective if I experience almost panic as I can't get a breath. I don't always finish the bottle but find that's not always necessary to gain the desired effect. Works especially well if I catch an attack early. Kenny
Thank you so much for these Jean. I’ve been trying various tricks so far today to no avail, but hadn’t heard about the yoga moves that you’ve mentioned helping with arrhythmia so I’m going to try those next. As you say, my heart rate is not excessively high and it’s still in the lower tachycardia range, my main concern really is the length of time it’s taking to convert. Plenty of water has often worked previously for me so I’ve been making sure I’m hydrated, and also the modified valsalva worked one time too, but oddly neither have done anything this time. Driving over a pothole whilst I was a passenger knocked my heart back into rhythm one time as well!! Thanks for taking the time to reply, I really appreciate it 😊
Pothole! Funny how the things that set us off can also stop it! Mine often comes on by stretching too far, or leaning over in the shower after a long run, or bumpy roads, or a cough. All of which could also rest things. Lots of good suggestions gathered by Jean! For me the most reliable one is lying on the floor, breathing very slowly and deeply, and relaxing completely. Fingers crossed that you find a reliable method that works for you!
Please do not rub the carotid as vagal maneuver. It applies to young people ONLY when they did not have carotid plaques yet. For people above 50, we start having plaques to some extent degree more or less. Rubbing will detach them and it will cause STROKE.
Just to point out that normal heart rate is between 60 and 100 inside which no treatment is given. 110 is a really low figure for tachycardia and valsalva manoeuvre may well correct it. Jean has some excellent suggestions.
Thank you for your reply Bob, yes Jean has given some great suggestions. Agree, the tachycardia is just slightly over normal range, but was getting a little concerned over the length of time it’s taking. It feels a little uncomfortable as I’m normally around 60 bpm, otherwise feel ok. I’ve been trying the valsalva but doesn’t seem to be working this time although it did on one occasion previously, going to try the yoga moves Jean has suggested instead. I’m sure it’ll sort itself out before long. Thanks again for your reply.
I found it interesting that the stretching set all this off. Both that and, more often, kneeling down can do it for me. I read an interesting study on how the heart (or, at least, the hearts of those who have arrhythmias) can't cope well with being pulled about. Even a bloated stomach can push the heart about, apparently. I believe this can set off a harmless ectopic beat, but that can then trigger AF or tachycardia.
Whether 105 is "low" is not always relevant in my experience, What matters is the efficiency of the heart at what is, after all, an "abnormal" rate. Whilst the heart isn't classed as being in tachycardia until a persistent rate of 100bpm, I can feel as uncomfortable at 85 as at 105, 135 or even 155 with chest discomfort, slight breathlessness, anxiety and tiredness on exertion. The issue seems to me to be not so much the rate as how efficiently the ventricles are pumping at that rate. Well, that's my guess.
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