Firstly, may I take this opportunity to thank each and every one of you who have kindly taken the time to reply with support and advice. Too many to thank you or reply to you all individually!
So, as wisely advised by many of you, I took myself to A&E on Monday at 6am to beat the rush.
Had all the usual tests and then they advised I take 2.5mg Bisoprolol x 2 to try to put it back into sinus.
Sadly, despite my telling the docs that I don’t tolerate it and being offered no other treatment, I took it as prescribed. As expected it sent my BP plummeting and that resulted in an overnight stay - still in AFib, but a tad lower heart rate, which was a relief.
This morning I was told cardiology planned to do a cardioversion. However, whilst waiting for that I went to the loo. Most of you on here will know what I mean by a Valsalver manoeuvre and as I’m a tad constipated I think that’s what I did, because when I returned to the ward and plugged in the monitor I was delighted to see I’d spontaneously gone back into a neat sinus rhythm at 60bpm. Coincidence or what?!?
Then the cardiology guys duly arrived. They’ve advised I take Amiodarone for a few months to keep the anfib under control until I get the planned ablation.
Amiodarone eh?!? Hmmmmm. 🙁 I fear that subject will open up another dialogue.
When I’ve got the prescription I’ll be discharged later today.
Once again I’ll say a huge thank you for all your support. This site is fab. 🙏
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I think I’m looking for some reassurance. 🤔
I’m a 65-year-old female with no other health issues.
I’ve been having increasing episodes of PAF since last October, but they’re now happening twice a week for the past few months now - I’m lucky if I get four days clear in SNR before the AFib starts again. I have failed miserably to identify a trigger or identify something that stops it.
They’re now lasting 2+ days, but this particular one is now well into its third day. How much is too much?!?
This is the second episode that’s woken me up at 2am. Current (usual AFib) HR is flapping around from 130 - 170+. BP 127/74.
What to do?!? A&E told me last year just to “ride it out at home” and only darken our door if you’ve got heart attack symptoms.
I haven’t tolerated any of the usual meds, so I’m only taking Edoxaban 30mg.
All heart tests were excellent.
I’m being put on the waiting list for a PVI ablation, which should take place in approximately four months time. 🙏🤞🙏
I’ve tried increasing my magnesium intake (taurate, bisglycinate, algae, and now ionic), but all to no avail.
My question is: can my heart take this increasingly regular battering without developing longterm damage? Will I make it to the ablation?
It’s all becoming a tad concerning and any reassurance would be gratefully received.
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If they haven't given you rate and/or rhythm control medications to take at home when afib strikes, they should have. Absolutely no reason for your heart to be beating at such high rates for more than a couple of hours.
Tried them all - got side effects/no positive effect from all of them. I can’t tolerate betablockers, Diltiazem aggravated (mild) COPD, Digoxin had no effect and Flec gave me monstrous double vision.
I was not talking about taking these drugs on a daily basis, but only at the onset of an afb episode to at least get your heart rate down to a safe and comfortable level until you converted. I don't see how, for example, take Diltiazem for a few hours to lower your heart rate would aggravate your COPD to the point where you didn't at least feel better at the lower heart rate, but if that's the case, then hopefully the ablation will solve the issue.
Hmmm, nobody has suggested Diltiazem, etc as a PIP approach - only the Flec. It had no effect on the AFib anyway and it rattled on relentlessly.
What’s annoying is when this all started, way back in Jan 2020, I was prescribed Atenolol 50mg, but it knocked me sideways, so I only took 25mg as a PIP for the occasional AFIB, but when the GP found out I was using it like that she refused to let me have any more. 😕
I’ll see if I can get through to cardiology tomorrow, as this is really getting quite concerning now. Thanks for responding.
Under doctor's instructions, I would take "x"mg of fast acting Diltiazem Tabs every "y" hours until my heart rate came down around 100. Then I would take "x" mg every "y" hours to maintain my HR around 100, until I naturally converted.
This not only put less stress on my heart, but made me comfortable enough so I could go about my daily business until I converted. After I converted I stopped the Diltiazem. What I have described is one standard rate control strategy for an afib episode.
Many use the same rate control strategy by substituting beta blockers for Diltiazem. Some use a combination of both drugs to get their heart rate down during an episode.
I really haven’t had anyone address this properly in the last six months. GP said he doesn’t know anything about cardiology and just tells me to contact the hospital. The cardiology here take approx 24 hours to call back. I’ve just been left to get on with it.
Quick update. It woke me up at 5am, so I’ve come into A&E. Receptionists aren’t happy when I said I’d been told to ride it out at home.
Good luck and I hope you get the support you need. Unless you have been through the stress of AF you don't understand how it impacts your life day to day.
I do wish the consultant had told me that! I think I’ve taken what he said far too literally.
I’ve been in here since 6am. They’re trying Bisoprolol to get the HR down and then send me home. Oh, and start back on digoxin again - but it had no discernible effect the last time I tried it.
They’ve also said cardiology will see me in person soon. Fingers crossed.
Hospitals seem to vary enormously . Both times I have been in to a&e they have initiated treatment but cardiology have come down to see me and both times admitted to a ward until I was back in nsr and given a follow up appointment . And my heart is structurally normal am told. No medals for suffering in silence, it’s your heart taking a battering , I think 24 hours for me is quite enough . I do hope you are back in nsr soon, extended fast AF leaves me feeling washed out and tired for a couple of days
Sounds like we’re pretty similar. But here in Plymouth the cardiology department are overwhelmed, and I’ve never been taken to a ward by them. It’s always gone back into SNR and I’ve toddled off home. This episode is well and truly stuck in there.
It’s now 8pm and I’m sitting here in a chair on a ward being “monitored”, but the plan is to send me home if the HR comes down under 100 consistently - which at present (two hours after taking a second dose of Bisoprolol) isn’t looking hopeful. 😞
No bisoprolol doesn’t do it for me either and I can’t tolerate the stuff. Has no one suggested cardio version ? Or would that not be appropriate? That was next on the fun list for me
i was told to go into A&E when I get an AFib episode, as my heart rate goes very high. I couldn’t wait it out at home as it’s unbearable and it worries me. I was told by a senior Doctor, that I wasn’t wasting their time and it was important to try and stop it. I have always found them quite good in Leicester.
Interesting, I am under Leicester hospitals (Glenfield) and I have been told to sit it out unless I feel particularly unwell with chest pains and/or breathlessness. My episodes tend to go for 30hours at fast heart rate. I take Sotalol apixaban. Which consultant are you under?
I came into A&E at 6am (when it’s quiet 😀). They’re trying Bisoprolol to get the HR down and I’m to start back on digoxin tomorrow. Bus hasn’t worked yet and HR is still up around 130. That’s down a bit, but not under 100 yet. They’re also referring me to be seen urgently in cardiology. Fingers crossed on that one.
Try to get a prescription for a beta blocker or CCB to take every day . You could say you are worried that the high heart rates will prejudice the chances of your ablation working and you are prepared to tolerate the side effects till you have the ablation. It is not always a good idea to tell our GPs everything . They often stick rigidly to their "one size fits all" prescribing protocols. I am prescribed 1.25mg Nebivolol daily. I actually take half of that. As soon as an afib attack strikes I take 5mg . It brings my heart rate down and makes me feel more comfortable. When NSR resumes (usually after 8-12 hours )I take the 1.25mg for a couple of days then drop back down again. I find this suits me and I don't care if it doesn't suit the doctor.
I am lucky in that I have a good GP. But that did not stop him from prescribing Cipro for a suspected UTI. I do know my body and I knew I hadn't got a UTI - the urine test came back negative. It was my last exposure to Cipro and the one where I found out about the horrible scenario of " floxing". I realised I had had reactions to previous exposures that I had not connected with the antibiotic- after all who associates tendon pain with antibiotics? I do not really trust doctors that much due to various misdiagnoses and I trust the meds they dish out even less.
The system of board certification in America did not prevent the " floxing" of hundreds of thousands of patients. Even after the FDA black box warnings on FQs doctors were still dishing them out like sweets. The corrupting power of Pharms money ensures that the system keeps using dangerous and defective drugs for years after they should be withdrawn from the market.
Worth a try. I couldn't tolerate Flecainide or bisoprolol either. My EP is a well respected Professor and believes it's an excellent drug for afib, especially those with very symptomatic fast episodes.
Your experience certainly shows how different we all are! Such a pity the medics fail to realise that and think we are all much the same! Do hope you find something that works for you! Good luck!
I was given bisoprolol and that did nothing. My doctor wanted to up the dose and I wasn't having that. I asked to be referred to my local community heart doctor who said I was an ideal candidate for an ablation.
I'm glad I didn't get given Flecainide or I would still be on it. And, quite likely, singing its praises.
I’ve been told I’m an ideal candidate for an ablation too. Hopefully this visit to A&E, and the fact I can’t tolerate any of the meds, will get it sooner for me rather than later.
I sympathise as I cannot tolerate any heart meds at all and always felt far worse when on them, Beta Blockers especially. I’ve ridden out many an episode and best thing was go to bed, rest and keep well hydrated and stay very calm. Getting upset and anxious only makes your HR worse. Not everyone can tolerate the drugs and thankfully there are other options and I hope that your ablation comes around very quickly - telling cardiology how disabling you find it and how many more episodes you are experiencing may speed things up. My neighbour saw cardiologist and had ablation the following week so some sort of triage was operating.
Having had AF on and off for 15 years all I can say is I have no known lasting damage unless your HR is 200+. My father had AF and never even mentioned it and was never treated, as it wasn’t back then. It’s only in the last 25 years that AF has been treated. It is unpleasant and interrupts life but not immediately life threatening although it sometimes feels as though it is.
I wouldn't trouble your GP for advice. If funds allow, I would make a private appointment straight away, hopefully see him/her in 2 weeks, discuss any medications not tried, if one is identified try it in the months leading up to your ablation.
I would also do as much reading here and on the resources page of the AF support charities with particular emphasis on lifestyle changes - everything from supplements to dental health to breathing to daily x2 brisk walks.
Doctors at Stanford University have studied various breathing techniques and one meditation technique to reduce stress. The recommendation that resulted: The instructions are simple: Breathe in through your nose. When you've comfortably filled your lungs, take a second, deeper sip of air to expand your lungs as much as possible. Then, very slowly, exhale through your mouth until all the air is gone. After one or two of these deep sighs, you may already feel calmer, but to get the full effect, Spiegel recommends repeating these deep sighs for about five minutes. Exhalation activates the parasympathetic nervous system, he said, which slows down heart rate and has an overall soothing effect on the body. (Sorry I didn't keep the reference.)
Interesting. Better breathing is definitely near the top of the list for AFers - be it to reduce anxiety or by breathing in through the nose for more nitric oxide to benefit the heart.
Like you I can't remember the reference but I read that breathing in through the left nostril only, boosts the parasympathetic system and relaxes you; I use this if I wake up in the night and want to go back to sleep.
I recommend James Nestor's book 'Breathe'; also view him on YouTube.
The Stanford University study didn't address which nostril to breathe through. Each of us can do our own study. Put L, R, BOTH. on separate pieces of paper and write down the result day by day could be one approach. Does holding left nostril closed result in fewer afib episodes or whatever quality of life metrics are important to you.
Closing the left nostril to breathe I understand will activate the sympathetic 'fight or flight' nervous system so maybe beneficial or not for AFers. I haven't had AF for years so haven't experimented with this.
I’ve been doing deep breathing and yoga nidra. Strangely the last two episodes woke me up at 2am. This one kicked off at 2am on Friday morning and is still rattling away.
They’re trying Bisoprolol to try to get the HR down. Trouble is I don’t tolerate betablockers well as they drop my BP too low. Fingers crossed something gets sorted out soon.
No, not really. I very quickly developed issues with all the meds they tried and two cardiologists have told me they’ve run out of options. That’s why I’ve been sitting here for months with bad AFib and only a DOAC. This lot in here aren’t happy about it at all. Hopefully getting referred to be SEEN in cardiology (for the first time) might shake things up a bit.
I am surprised Diltiazem aggravated your COPD because I’m on it because bisoprolol isn’t suitable for asthmatics. So atenolol, which can cause breathlessness and bronchospasm shouldn’t have been prescribed in the first place.
Hi. I’ve been in here, in various departments, since 6am. They’re trying Bisoprolol to boot it back into sinus, but it’s not worked yet. On the upside they’re referring me (urgently) to be seen in cardiology. Fingers crossed.
I never self convert so at that rate I would have been in A&E immediately for a cardioversion. However I go to the big trauma hospital not my local hospital as the latter would just dose me up and then make me wait for a cardioversion for weeks and I'm virtually unable to move when ifn afib. Hope yours settles soon xxx
Not sure I have anything to add to the comments here, but I’m so sorry you’re going through this - especially without the support of a good cardiology department. Hope A and E do something to help today, and you receive better support going forward.
I suspect many people have AF as you do. Mine is much less frequent but increasing. I take 1.25mg bisoprolol to calm the heart rate when it happens, but this past month have been told to take that dose daily owing to increasing AF and palpitations.
You likely know this already, but it was explained to me that a fast rate in the top of the heart, the atria, such as caused by AF and AFl, mostly won't lead to important long-term problems, but that a persistently high rate in the bottom of the heart, the ventricles, can, affecting both the valves and the heart muscle itself. For this reason, treatment is usually initially aimed at lowering the ventricular rate (i.e. the pulse), most often with a "beta-blocker" such as bisoprolol, or a "calcium channel blocker" such as diltiazem. I find that bisoprolol does this well but takes about an hour or so to work.
Edoxaban has no effect on the heart, either rhythm or rate, and is given only to prevent stroke, which can result from the AF causing small blood clots to form in a part of the atrium called the appendage. It is different drugs you would need to slow your high heart rate, but you say you cannot tolerate them. Which ones have you tried? Before my ablation for atrial flutter, the only one that helped was a combination of bisoprolol with digoxin.
The coming ablation is probably what you need most of all and will, hopefully, stop the AF altogether and allow normal life o resume once again.
The short answer is no ,it takes a lengthy period of time ,years,for any significant effect from AF or Flutter. I had at least 3 years of frequent AF and Flutter with long periods in both before my ablation.
Worth letting your team know you would accept a cancellation at short notice ( if you would) they are usually very pleased to refill the appointments.
I see you are intolerant of rhythm / rate drugs, have you tried the various heart calming tricks people mention on here?
Long slow breathing sometimes worked for me and gave me something to focus on when I was scared.
The consultant in my local hospital said if it was AFib rvr (high heart rate) to come in after two hours for monitoring. I'd have lived in there. My episodes usually resolved at ten hours. What I found shortened them was 1.25mg valium, no idea why, but it did. You really need to go to a and e, because that length of time will exhaust you, and be more likely to cause a clot. So I would say in future let it run a day but no longer. Don't understand these doctors saying ride it out. That's impossible with high heart rate. I suppose I'd be concerned if you have multiple long lasting episodes in the six weeks coming up to ablation that there would be a clot on the day. Ring the eps office and get advice.
I was rather similar to you. I was having long episodes of up to 30 hours every couple of days. It had been going on for a long time. When I was in hospital ten years ago they said I had AF but I didn't take it seriously because I had no way to measure it. I could feel it when it started but not when it stopped.
You could say I was asymptomatic apart from occasional lightheadedness which didn't seem directly connected. After all that I think my heart now is in quite good condition so you don't need to be too concerned.
Hi, l couldn’t tolerate any of the drugs so l have a pill in the pocket (Bisoprolol) for when l have an episode of AF. That way l have no effects. I have been much better now l have started to take B vitamins especially B12, vitamin D, magnesium skin spray (can’t tolerate pills as they upset stomach). Have you had a blood test recently to check your electrolytes because if these are out of sync it won’t help. I would not continue as you are and ask to see your Cardiologist who can put your mind at ease. Good luck.
Hi. They’ve dosed me with one 2.5mg Bisoprolol in an attempt to get the HR down to under 100. Just had a second dose. If/when it comes down they’ll send me home.
I have been to A/E several times and they did the same to me. Once they get you stabilised they send you home and pass you on to Cardiology. You will be ok. You need pill in pocket like me probably but you definitely need some help to control this monster. Remember it’s not life threatening and hope you soon get sorted out. 🥰 Thinking if you.
Don't take any notice of supposed medical treaters telling you not to darken their door unless you have heart attack symptoms! How absolutely appalling and unethical! If you're worried, go to Emergency and tell them you need help. You have absolute right to do this. Try another hospital if you are able. I'd be reporting them to a Medical Board or other appropriate Authority. The lack of care is unbelievable.
Hi. Hmmmm, got my knuckles wrapped for “sitting it out”. So, I’ve been here in A&E since 6am. Dosed with Bisoprolol at 2pm and just had a second dose at 6pm to try to get the HR down to under 100. Now on a ward being monitored. HR still around 130. 🫤
I’m also being urgently referred to be SEEN in cardiology; hopefully that’ll be better than the last phone consultation I had in January. 🤞
Maybe, just maybe, they’ll do the ablation sooner rather than later.
Hooray! You're being taken seriously at last by the sound of things. Good on you! Bisoprolol is terrific for slowing AF down, as the medics certainly know. I'm appalled and dismayed by the standards of care being offered patients today. Once would never have happened simply because most doctors were caring doctors who also were alert to first signs of problems. You have to fight for your rights these days in many cases. And then they have the nerve to accuse you of being the cause of problems if you dare to complain! The arrogance of just about all I've met over the last several years, is alarming. And to boot, they only know how to push pills and not truly treat the source of disease anyway. Competent naturopaths can help a lot - and especially, Dr Sanjay Gupta on YouTube has some amazing videos that ease the anxiety with heart issues. Very sensible, down to earth senior Cardiologist who takes the B-S out of medical advice - and he admits this is why he started producing the videos: to do just that! Highly recommended by all, as you'll see in the comments. Am pleased to hear you're presently being seen and apparently looked after,
P.S. Forgot to add: try not to stress as this is only going to up the heart rate - things will settle down. Dr Gupta I know will ease the concern and give you sound advice. I prefer to pay him for an online consult (he's in York, UK and I'm in Australia) than any other local cardio I've seen since my AF was diagnosed late 2021.
beta blockers should help your heart rate, but they do lower BP and yours is virtually perfect st the moment
Try not to worry about a couple of days in tachycardia (even though it’s doing a marathon). If it helps I have had periods of 4-5 weeks since last October roughly 168 (although on the past 240 was a norm) and although very breathless and lifeless I’m still here
I might be having another ablation soon
I hope you feel better snd it was a bit naughty of A&E saying that to you. Paramedic told me to call an ambulance for dnuthing between 110-130
well more than one paramedics have told me, but also if I’ve ever said anything about going into hospital I have been told by doctors better safe than dorry
I don't have the answers for you, but weight loss; walking; taking deeper breaths periodically; diet changes to eliminate gluten, gas-producing vegetables and alcohol; smaller meals; and change of sleep position to avoid sleep apnea have kept me free from PAF for the past 6 months. I am sure you have considered those things and more. (I was having Afib every 2 weeks, or so.)
It is good not to rush into risky meds and surgeries, but it seems to me that 2-to-3-day-long episodes should concerning for your doctors, not just yourself.
I hope you find answers for reducing your Afib onsets. Don't let the stress of it feed it!
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loving the Christmas songs!! Here’s my effort based on my experience - to the tune of Last Christmas by Wham. 
Dronedarone/Multaq 
Using the Alivecor Kardia Mobile post ablation
Post ablation short of breath
