hi all. I am new to this group. Pleased to join you all. I have just reverted back to sinus after 8 days in AF. This is the 3rd time in 6 months. Each time reverted back in about a week. Unfortunately this time I’ve gone back to sinus but have contracted a stinking cold/flu. Are there any pain killers I should avoid? I’m assuming anything with caffeine is a no no. But what about paracetamol or asprin? I’m very cautious about what to put into my bloodstream now. Any guidance most welcome. Thank you.
pain relief for headache/sore throats... - Atrial Fibrillati...
pain relief for headache/sore throats after AF
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OscarN
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What medications are you on is probably the leading question .... anticoagulants, if so which ?
OscarN• in reply to
not any thinners. GP said my risk was low so they didn’t push me to take.
Check with your doctor, especially if on anti-coagulants. What are you doing to to treat/prevent these episodes. You're knocking on the door, or have just entered "persistent" afib territory. Now is the time to take action, because if your episodes get longer -- and afib tends to progress -- your treatment options down the road will be fewer and your outcomes not as good.
When I started to get week long episodes, I got on a daily dose of the anti-arrhythmic drug, Flecainide. That practically eliminated the episodes and when they did occur, it converted them in hours. That bought me more time to figure out if I wanted to be on drugs or have an ablation. I finally decided to have an ablation.
Jim
wow. That’s super helpful. Yes my first episode was 8 days. 2nd was 4. And latest was 9. I hear your advice. I’m assessing ablation but I’ve not heard of the drugs you mention. I will definitely explore Flecainide. Thank you.
You should be speaking to an ep (electrophysiologist) at this point, but would not wait too long. The aim is to keep the episodes as short and infrequent as possible so that the heart does not start to remodel which will make future interventions more difficult. Flecainide is one of the more popular and effective anti-arrhythmic on the market. In your case, they would probably put you on a daily dose to help prevent episodes with instructions to take extra if you go into afib. Other than the first two weeks on flecainide, I've only had one afib episode in close to a year and that was while I had Covid. Some are happy to stay on Flecainide forever, but I really don't like being on these drugs, so have opted for an ablation.
Keep in mind that some of these drugs, like Flecainide, are very powerful and have to be monitored by a cardiologist and preferably an ep. In my case, an echo and a stress test was required beforehand to make sure my heart was structurally sound. Afterwards, they do periodic ekg's to make sure the drugs are being tolerated well.
Jim
wow. This is so helpful. I will take this up tomorrow. I hear you about the reforming. I’m a keen runner 10k a day or more. Can’t imagine life without it so I’m going to explore both options you point out Flecainide and Ablation. Thank you so much.
Sounds like your heart is most probably structurally sound. Hopefully you would be a good candidate for either. You should know that endurance athletes can be more prone to afib and sometimes modifying workouts helps. Good book on that is "Haywire Heart" by Dr. John Mandrola
Jim
Priorities I would say are:
Private consultation with a cardiologist. Flecainide at the right daily dose level has helped keep me AF free for 9yrs. It is a powerful drug but for physically sound guys under 70 I understand is relatively safe, tried & tested. I started at age 60 with no added 'partner' BB or CB drug. As has been said get this sorted urgently so the heart doesn't get into the habit of 'slipping out of gear'. An ablation may be offered but I would try the pills for a year first.
Second ease the running, cut distance in half and at half the pace until AF is stopped. This change may be difficult but trust me it will be a whole lot easier than the results of continuing AF.
Lifestyle changes - check on this Forum for the many suggestions made, which are key and can bring other benefits to your wellbeing ie turn this scare into an overall benefit.
Sorry, forgot your main Q, paracetamol fine, not Ibuprofen.
Hi
o NATS e.g IPHEPROPHEN, ASPIRIN, No ANI INFLAMMATORIES.
You can take paracetamol 2 x 500mg x3-4 times a day.
After last operation not heart I was given OXY-NORM and panacetamol 500mg.
Codeine OK but side effect constipation. Eat Kiwifruit/figs/prunes/corn
I went flying across the room hit my head on hardi-glaze but missed the wooden structure behind. I had St Johns check me who said nothing hit coccyx so they
found me sitting on bag of frozen soya beans!
I'm on PRADAXA 110mg x twice a day.
NZ doesn't stock yours.
cheri JOY. 74. (NZ)
thank you.
Hi there , began my AF journey a few months ago, the only painkillers killers that don’t cause any issues are paracetamol for me . Hope you’re feeling better soon . Keep well hydrated. 😊
Hi I was told only paracetamol unless prescribed and to check with pharmacist about any over counter items first I hate taking tablets so I know how you feel
got it. Thank you.
Also have found a pain relief gel called Biofreeze which doesn't contain Ibuprofen You can get it in Tesco or off Amazon
I use Biofreeze on my back to manage after pain from shingles it's very good x
Was so made up when I found it I had sciatica for 9 weeks
thank you
While in hospital with covid and pneumonia, I was given paracetamol for my sore throat. I was quite amazed at how it reduced my throat pain, it would have been the last thing I would have thought of using for that. My regular medication is beta blockers and anticoagulants.
Jean
perfect. I will do that too. Thank you.
I think the only safe painkiller is paracetamol. This is because substances such as aspirin and ibuprofen can easily cause minor bleeding in the tummy and intestines, and, in the presence of an anticoagulant, this could increase seriously. I have read that codeine is mostly safe, however, usually taken as co-codamol (8mg) available over-the-counter (or on prescription co-codamol 15mg and 30mg). It can cause constipation and, in higher doses, strange mental effects in some people.
Steve
Sorry, no advice re painkillers.
However, I just want to emphasise the importance of getting comprehensive blood tests for any deficiencies that might be affecting your arrythmia.
Specifically I want to emphasise the importance of Vitamin D for all health issues. Vitally it reduces the inflammation which seems crucial to the aetiology of AF. And it seems the general population of the UK unfortunately have levels lower than the current medical best practice.
One recent article about Vitamin D is interesting . ..
And don’t take decongestants! They are the worst…..
Re the running, I assume you don’t run while in AF, but just in case, although AF is very rarely fatal, stressing your heart further is a way of getting into the ‘rare’ category. It is ok to exercise but not to raise your heart rate too high or get very breathless.
This is the only thing I can take. Corididin HBP. Make sure it has the HBP on it. I do not have high blood pressure but I am on blood thinners and it's the only thing my EP told me to take.
Coricidin HBP
Re running, If exercise is a trigger, worth modifying your regime to try to avoid going into AF. if my HR goes over about 140, it triggers AF. I therefore now run only steady pace aiming at 135 max. and this keeps me out of AF. No more hills / HIIT sessions. Been AF free for 3 weeks now despite running 3 x per week. I’m on Flecainide 50 mg twice daily.
great advice. Maybe I was pushing it. I’m 57. I was running 14k at 5mins 45secs per K before last episode. It started after I got back from my run.
AF manifests itself in many different ways. Currently I get it quite specifically during exercise. Others find exercise actually brings them out of AF! You might want to maintain a log of all potential triggers and episodes with timings. I previously had A AFlutter, for which once settled, I identified that it occurred the day after either a big drinking session the night before or a hard exercise session the day before. It usually resolved itself after a few hours. I note now that a common factor would have been dehydration which may have taken a while to impact. BTW I’m also 57 and at 135 bpm cover 10k at about 5:45 pace! I take Flecainide 50mg twice daily. I believe Flecainide knocks about 18 bpm of my Max HR. On beta blockers I just couldn’t run - the impact on HR made it miserable. From memory maxed out at about 110!
Triggers can include: exercise (note different types / intensities and length), caffeine, alcohol, stress, certain foods, lack of sleep, even sleeping on certain sides. The latter tend to be associated with the Vagus nerve stimulation and is a particular manifestation.
Hope you find a way to minimise episodes whilst you decide on how you want to manage it long term.
There are quite a few threads on here about exercise and AF and also the impact of various meds. Always worth discussing with your cardiologist/ EP
this is great advice - thank you - if I am honest I am sure that, in addition to caffeine, alcohol excess is something to watch along with a long run the next day - the latest episode was the first time I couldn't point to caffeine as a cause - I had been running 13k each morning for 10 days (quite fast too) and had been drinking quite a lot at the same time - and then one morning after the run - bam - headrush/faint feeling and that was it . In the past I had adbstained from alcohol whilst in AF but one time it reverted back after a relaxing night with friends where I drank a fair bit. So maybe the "relax" of drinking helped re-set? The latest episode (last week) was different because I stopped running after going into AF for obvious reasons but kept drinking during the week following. After 7 days, I decided to "test" by stopping the alcohol and within 48 hours of stopping I had reverted to sinus. I agree that there is some interplay between alcohol and long distance running - and hydration levels - I really appreciate your thoughts and am delighted to know that running at 10k at 57 is not weird! I am talking to my cardio today and will ask about Flecainide. Thanks again
Many AF sufferers on this site have given up alcohol completely, some reporting that just a single drink will set off their AF. For me, it was when I had A Flutter that the binge drinking and long exercise caused symptoms (through dehydration?) but now I’ve sorted AFlutter but acquired AF, I don’t appear to become symptomatic from alcohol, though I’ve only pushed it a couple of times. I generally have a couple of glasses of red / beer most nights with absolutely no effect.
So many different manifestations!
BTw do you wear a heart monitor when you are running? if so which one do you like?
Yes. I use a Garmin chest strap as this measures the hearts electrical activity as opposed to the wrist / watch that monitor pulse (blood flow). I believe these are much more accurate / relevant. There are other good makes too. The Pulsar gets good reports. This enables me to monitor HR real time whist running / cycling, though not swimming, although my HR during swimming is closer to 100 bpm so well below AF tipping point. I use an old Garmin Fenex 2 - still going after 7 years though it won’t seem to sync remotely and I have to plug into the PC.
great - I will research it - thank you how do you work out your AF tipping point btw- you say 135? Interesting to hear your comment about beta blockers putting a ceiling on HR so you can't really run at all - 110 you say.......I am minded to come off mine now I am back in sinus but will ask Cardio - thanks again
They like you to be on Beta Blockers if on Flecainide to help prevent potential problems associated with taking Flecainide. I was initially on Bisoprolol with Flec but in agreement with my EP, and because of the -ve impact on any exercise of the BB, and so my QOL (Quality of Life), we agreed I would drop the BB), the compromise being worth it. Managing AF is all about QOL and so each individual may have a different view depending on their lifestyle.
I established my max HR by trial and error and by checking and logging on each run, my HR just prior to going into AF - HR would spike from 140 to about 215. Interestingly, I would only know I was in AF by noticing it on my HR monitor as although HR through the roof, I neither felt it nor did it impact my running. I suspect however after about 15 mins in AF at 215, I would start to seriously flag!
Once in AF, if I slowed down, my HR would drop down to 120 and early on I naively thought I was dropping out of AF. In reality, it was AF at low exercise intensity. It would usually last 6-10 hours and I would take extra Flecainide as PIP (Pill In Pocket) as soon as possible and this would get me back in NSR.
The 110 ceiling on HR on BB is from memory. It may have been 120 but which ever, it crucified any serious running and was absolutely demoralising as being able to exercise is a big part of my life. I may later try to check from my Garmin records as to what it was. I’ll have to work out when on BB and find runs at the time, lots of data now and useful to have as it all blurs in memory with so many changes (cardio version / 2 x ablation / change of meds etc.)
Good to know all this is of help.
Best of luck finding what works for your particular incarnation of AF.
wonderful insights and reassurance - running also for me is a massive part of my life, central physical and mental well being - keeping a record is a great idea - maybe I was in AF and didn't know it on my last run when I had the last episode -my cardio said today that working out your max the old rule of 220 minus your age isn't a bad rule of thumb - I have no idea what mine was before my last AF episode so will be keen to see now - I did notice my speeds really got faster in the new year once I had been off BB for a while but this could be just co-incidence and getting fitter. Anyway wanted to thank you again for your counsel
I need one of these straps right ?
amazon.co.uk/Garmin-HRM-Tri...
plus a Garmin fennel watch?
there appear to be 3 levels, Dual for £47, swim for £62 and Pro £99.
I have the dual which is good for all dry sports (I believe it would not be able to communicate to your watch if you watch is under water), the swim which maybe just for swimming (you’ll need to check) - I believe the idea is that it records and retains info whilst you swim and down load to your watch later, and Pro which combines both of above.
If you don’t swim then dusk would be ideal. In retrospect, I should have gone for the Pro.
I bought one of these (Polar) which will connect to my iPhone-= the Garmin watch looked quite pricey - was this one of the one's you meant as being popular when you mentioned Pulsar?
amazon.co.uk/Polar-Monitor-...
sorry I meant Polar - pulsar would have been a misspelling.
Also, I have a Kardia mini ECG device (about £99) that I use, once symptomatic, to confirm that I am in AF and then monitor it until back in NSR. It’s a small device that links to your mobile and records an ECG Trace. I would take a reading as soon after AF starts and then either every few hours or if I sense a change (normally a drop from say 110 to 80). The Kardia gives a medical grade single lead ECG trace that is recognised by medics and confirms several arrhythmia. I then keep the first, any material change in rate and the first in NSR. Gives me more data!
hi there. I’m getting used to my polar. Thank you for the suggestion. I am now watching my heart rate carefully whilst running. I try not to go above 150. Means going slower and sometimes pausing. My max is 163. (I’m 57). I now think that before my last AF episode (before I bought the polar) my heart rate would be at least 160 or more. Was running quite hard 5.45mins per k for 10 to 14 k. I can’t give up exercise so am trying to find a good balance. What has been your experience of running? I don’t count myself as anything remarkable - I run for mental as well as physical benefits. Love to hear your experience of running and AF.
Hi Oscar.
Glad to hear you are finding the Polar and HR feedback useful. I’ve only ever been a club runner for general fitness, entering the odd 10k / half marathon race just for interest and something to focus on. I’m 57 and generally looking to run at 9 min miles (5:40 km miles) so pretty much the same as you. Following the resolution of AFlutter via Ablation Nov ‘21, I slowly acquired PAF such that by Sept ‘22 I was getting episodes once a mth. The frequency increased and from keeping a diary I identified a sole trigger of HR during activity. For the last 5 weeks, I’ve been running to a Max HR target of 140, but trying to keep around 135 - 140.
(Note that my understanding of taking Flecainide that I do, 2 x 50 mg daily, “holds back” your HR at exercise (no impact at rest) by about 12%, so although my theoretical Max HR is 167 (220-57) I should not be able to actually get it above 143. In reality I believe I could probably get it to a true Max HR of 160+ so either the 12% drop is lower in my case or my theoretical max HR is higher).
I have not had AF during the last 5 weeks and long may this continue. This results in a usual pace of 9 min miles whist on the flat but needs slowing up on gradients and even more so on hills. No more HIIT sessions for me therefore so resigned to maintaining this pace which I find relatively easy. I will still enter distance events as there’s a social element through my run club.
I’m resigned to the fact that my AF may progress but I’m hopeful that by avoiding episodes, any progression is slowed and I can continue to exercise at or close to my current level. As well as running, I cycle and swim, though neither bring on AF due to lower HR. I have also stopped any HIIT sessions within each sport and I think my spinning days are behind me.
Hope this is informative and happily answer any more questions you may have.
FYI, my EP believes that the AF emanates from the 4 Pulmonary veins and an Ablation should resolve this. This remains an option should I find it difficult in future to avoid episodes or indeed if I wanted to remove the limit to my exercise regime but of course this is not without risk and would need a long time out at lower exercise frequency / intensity during the recovery/ blanking period. Having said that, the longer it’s left, the bigger the impact due to my advancing years!
Hope it settles and you are able to continue to manage your exercise and avoid AF episodes.
thanks. Yes my cardio said the same about the pullumory veins and why ablation is a good option. But I wasn’t aware there was a big “blanking” period after the op meaning you can’t go immediately back to running like you were before? I’d better research that. HIIT what does that stand for ? High intensity training? I’m not taking the Flecanide on a daily basis as my cardio said use as a pill in pocket to start. I’m curious to learn more about its effect on high heart rate when running. Thank you again.
if we are same age 57 then our theoretical max is 163 right? I’m not taking Flecanide daily so haven’t got that advantage but I find 150 feels about safe. That said I’m sure I was pushing past 163 before my last episode and felt fine - albeit this could have triggered the last episode. My instinct is that caffeine is a problem for me. I’ve cut it completely now. There’s a lot of scary stories on here about ablation I see - doesn’t always work, needing 2 or 3 goes etc. I will research it some more. My cardio was quite reassuring. Good luck to you.
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