hi. I’m a 61 year old female. I have had palpations for about the last 18 months. Only lasting a few hours to start with but from october 2022 they’ve been lasting longer and more frequent. I have a history of pulmonary embolisms that have occurred after surgery and after long haul flight.
Finally saw my GP in December 2022. Was told to go to A&E when the next bout started.
March 2023 whilst on holiday in Weymouth, started again. 36 hours in, decide I should really get to hospital.
My treatment was second to none. Only 1 other person in A&E at the time. I was taken straight in to resus and put on 2.5ml bisoporol. As my pulse wasn’t responding, was given another 2.5ml bisoporol. My heart rate was up to 200 on arrival but the meds got it down to the 90’s
The doctor in the hospital was fantastic. He asked me if I wanted to start investigations whilst I was there on holiday. I chose not to thinking I’d sort when I got home. The doc told me I needed an urgent cardiology appointment. I told him tongue in cheek that I loved his optimism about getting an urgent appointment back home (north west uk)
Having private medicine through my last employment, I decide to use it to get things moving quicker. The guy I spoke to initially was less than helpful to be honest. He mentioned something about an operation (no details) then arranged an echocardiogram. Went for this, was told no my heart appeared fine.
Made an appointment to speak to the doc again to discuss my echo. I see him on Friday this week
On Sunday just gone, despite being on meds, went in to af again. After 40 hours, spoke to a gp who told me I needed to go to a&e.
So today I went to a&e. had bloods and ecg. Bloods all fine. Was told by doc to increase my bisoporol to 5ml.
The private doc has told me I’m getting af due to being overweight. I am overweight but can he just assume that that’s why I get af?
I know for a fact he wants to do an ablation.
My question is, is my condition bad enough to need an ablation or should I just keep taking the meds?
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Ablation is just one arm of AF treatment and whilst I am a total fan (had three for AF) life style is most important. I always say diets don't work but life style does and aiming for a BMI of better than 26 is very important. I'm not totally agreeing with the doctor who told you you have AF because you are over weight but it sure aas heck doesn't help and many people do find that life style does reduce AF burden.
In the mean time why not go to our main website (Atrial Fibrillation Assocation- We sponsor this site) and read till you drop as knowledge is power.
Hi Macy, there’s folk on this forum who can answer this much better than me - but just wanted to say it’s quite normal for an echocardiogram to show the heart structurally sound despite the electrics being off kilter as they are with AF. It doesn’t make your AF any less of a scary experience.
It’s nonsense to say any one factor “causes” AF. Of course there are general life style factors that put us at risk - anxiety, lack of sleep, too much alcohol, age, a poor diet and yes, being overweight. But it’s not your doctors job to make you feel like you caused the problem! I’m a healthy weight, eat very well, drink little alcohol etc but still got AF for my 70th birthday despite being previously very fit.
I’m on a waiting list for an ablation. The idea terrified me til I came on this forum and met so many people who’ve been through it and out the other side!
The private doc has told me I’m getting af due to being overweight. I am overweight but can he just assume that that’s why I get af?
Listen to him well.
Losing weight, if needed, is probably the single most important thing you can do to potentially decrease, or even eliminate your afib burden. (See link to article below)
Without losing the weight, you are potentially wasting a good catheter ablation because you are stacking the chips against it working even before you start.
If the traditional diet, etc, doesn't work, some really great recent drug breakthroughs even rivaling barbaric surgery for results.
It is well known that drugs like Ozempic only sustain weight loss as long as they are taken. They work by decreasing appetite and on discontinuation appetite returns and most patients put back a good % of the weight lost. There is little to no long term data on taking these drugs for life and on top of that they come with side effects , many of which are not to be sniffed at. Weight loss is a very complicated subject - it is not simply a matter of eating less and exercising more. There can be other factors involved like degradation of the gut microbiome through over exposure to antibiotics and for some of us women failure to recognise and correctly treat hypothyroidism. Bariatric surgery also comes along with a host of complications. What needs to change is our entire modern food culture which encourages people through advertising to eat junk but that is unlikely to happen as the industrial food companies have too much power. Reducing exposure to endoccrine disturbing chemicals would also help but ditto for the power of the chemical industry. Stopping fluoridation of the water supplies which encourages hypothyroidism would be a good idea too .
Yes, I agree with much of what you say 😀 Other interventions such as diet, should be tried first, but as you mention, don't always work. Just pointing out that drugs like Ozempic, are now being more widely offered. It's a matter of weighing the risks of the drug against the risks of being overweight, including the context of being in afib.
I agree with most of your post. My take on fluoridation is the jury is still out. There are definite pros and cons. I am not an expert but tend to swing to what is good for the larger population be this right or wrong.
Hi Macy, you’ll find a lot of good advice from the very helpful people here who share their wisdom and experience.
Nobody should be blamed and stigmatised for developing AF or any other condition and to be told you have AF because of your weight is not helpful or informative. I was told it was my age. I had my first known AF episode at 59!
And here’s all the rest…I’ve never been anywhere near overweight in my life, I have very few vices, I was already following a plant based diet before AF happened, hardly touched alcohol, and I’d quit caffeine a few years previously to help my ectopics (didn’t help at all), and quite honestly, there wasn’t much for me to “change”. The harsh reality of this situation is that we aren’t doing a deal with fate, that if we’re all good boys and girls we’ll get the good life and the good health we “deserve”. No, life isn’t like that. There’s no adjudicator punishing the bad and rewarding the “good”, and we certainly shouldn’t be punishing ourselves.
There are many people who have had lifelong struggles with their weight and been on and off diets all their lives and it’s rarely worked. It’s not for the lack of trying. It’s a hugely complex issue where genetics, epigenetic and food environment interact, not to mention societal pressures.
It’s great news that your heart looked OK on the echocardiogram so that must be a relief. At this stage I think it’s a question of how often and how long your AF episodes are and that will probably inform the best way to treat it. Some people advocate ablation early on, others prefer the medication route until the AF becomes more symptomatic. I only have bisoprolol for now and even then there are differing opinions. I’ve been offered flecanide but I’m not sure it’s necessary right now. There was no talk of ablation when I attended the arrhythmia clinic for my formal diagnosis several months ago. There doesn’t seem to be one definitive way of treating AF, and now that I’m diagnosed I’m discovering that we’re mostly expected to get on with it and self manage!
Plenty of people will no doubt offer lifestyle advice but it’s very individual. All I would say is manage your sleep as well as you can, practice some kind of stress management technique whether it’s breathing, meditation, mindfulness, yoga or whatever suits you, and exercise within your limits preferably doing something you enjoy. As for dietary advice, it’s what you can sustain over the long term that matters. I follow a plant based diet with emphasis on whole foods, but it’s what you enjoy and can sustain over the long term. There’s no one right way to eat but if you like experimenting and trying new things you’ll probably do very well.
Autumn Leaves Well said! How reassuring your reply is. Firstly to take the guilt away helps with the following advice you gave. I gained benefit from several videos by Dr. Sanjay Gupta Cardiologist from York Cardiology. I had suffered arrhythmia of various types since menopause for about 15 years with several episodes of very scary AF usually when on holiday overseas necessitating admission to hospital ruining several long planned holidays which affected my husband as well. While in a hospital in Tahiti (our luggage still on a boat which had left port as the ambulance took us to hospital) I had many tests and was prescribed flecainide. As we needed to return to NZ I did not want to start flecanide while flying. Subsequently I have seen several cardiologists with all the tests available and have reacted badly to all medications And as the focal points in my heart are too close to the Carotid artery I was told I can't have an ablation I just have manage it myself. I have done this. I have an Apple watch as recommended by cardiologist which is helpful at times. What has worked for me is making sure I have plenty of sleep, never letting myself get dehydrated drink more water, avoiding caffeine although for some people this makes no difference, using the 80/20 rule for healthy eating and trying to keep the extra weight off and not stressing about it if my efforts are less than ideal at times, not overcommitting myself learning to say No, regular exercise (for me the YMCA gym and Beginner Yoga with Kassandra on Utube and trying to work with my body. I must include I have attended a course on meditation and check in with this on and off but find it helpful in slowing me down. All the above have helped me, we sll need to find our own triggers and perhaps use other’s experiences as a starting point. I now only have a very rare short burst of AF and noe for the last year and the other arrhythmia problems have virtually disappeared I almost feel lime it is a miracle but know it can come back but will will ne more emotionally prepared when it does. It won't kill you just feels like it will. Good luck.
Hi and welcome - You’ve had some great answers - all of which I would second and add that IMHO ablation is far preferable to medication and frankly the earlier in the process you have it done, the higher the probability of successful outcome.
So - find out a lot more about the procedure, by going to the AFA website as Bob suggested, find out who would perform your ablation, ask their history of successful outcomes, do everything you can to lose weight and get yourself in the best condition you possibly can prior to the procedure in considering all of the Lifestyle factors - stress management, sleep quality, exercise and good nutrition (nutrition not diet is key), breathing techniques - poor breathing can exacerbate and even cause arrythmias and yes we need to relearn how to breath - something you have probably taken for granted since you were born. THEN and only then can you give yourself the best possible chance of treatment that works long term and preventing progressive AF and poor quality of life.
There are some things about our health that we have no control over but Lifestyle factors are the main thing we can control.
Sorry to be so stark about it but all the evidence points to Lifestyle first, treatment second if you want to eliminate AF from your life so do listen to your private EP who sounds as though they are giving sound advice and doing the right tests with echocardiogram and follow up blood tests.
Many things can cause AF including all those mentioned by Autumn Leaves and add to that poor oral health, family history of AF, Thyroid dysfunction, diabetes, infections, surgeries - the list is endless however body weight and no exercise, poor sleep, anxiety and stressful events, poor nutrition are way up on the list of causes.
AF will change your life - but sometimes it can do so for the better so think of this as a wake up call to really look at how you can improve your health and well being.
When one person tells you something you can ignore it but when more than 3 people all say the same thing you might benefit from listening, I have found that so true throughout my life.
Lots of good advice about lifestyle changes which I echo however I want to focus on some of the things you have said regarding your private consultation. It’s one thing having a private consultation, but quite another having an ablation undertaken privately, assuming that is an option you are considering. Like BobD, if the circumstances are right, I too am pro ablation having had 2 and been in NSR since 2016 but I think it’s fair to say that I would be more wary of an EP’s recommendation to proceed with an ablation than I would if it was being performed under the NHS. In my case, I consulted an EP privately who mistakenly assumed that any ongoing treatment would also be performed by him privately. When he suggested I could have it done at a private clinic the following weekend, I asked him if he had noted that the referral letter from my then Cardiologist made it clear that any ongoing treatment was to be done under the NHS. He remained adamant that it was the right route for me to take and was happy for me to be added to his rather long waiting list. That in itself is a good indicator that there is a belief that a patient will benefit from the treatment.
The other thing I would suggest you check is related to your thyroid function as an under and arguably, an over active thyroid is often a contributory cause which can be overlooked………hope this helps.
I found my EP worked both in NHS & privately and had absolutely no difficulty in switching me to either service - dependant upon which was best for me. If you choose an EP consultant who works in both I don’t think there will be any problem. I much preferred the private clinic though simply because their equipment was more up to date and staff had more time to care.
Agree, mine was the same but if someone is referred privately to an EP, it’s not always easy to know if their motivation is entirely in the interests of the patient. Whereas, if they accept you as a NHS patient with all the criteria that imposes, you can be more confident that you are doing the right thing.
Hello, I really empathise with your situation as when I was diagnosed with AF at the age of 52 I was also told emphatically that it was due to my BMI . I did go on to lose 38 pounds which was incredibly hard but I still went back into persistent AF . Sadly due to severe stress with family illness I gained 28 pounds back and the EP was extremely rude to me after my second ablation which was so upsetting as I had just lost my Dad and my Mum was palliative in an awful hospital .
Since then I have had the good fortune to have a cardioversion performed by an amazing arrhythmia nurse who has been nothing but helpful with advising me on weight management in a non judgmental way . High BMI IS a factor in AF but it is not the sole factor as many others have said . As for the ablation question , it really depends on how badly the AF affects you . For me I can barely function when in AF and my exercise tolerance is drastically reduced , I get awful symptoms such as chest pain , immense fatigue , etc . However others don’t really feel it . Also the beta blockers have negative side effects for me whereas others tolerate them well.
hi guys. Thank you all for your replies. Wake up call seems to be the common reply.
As much as I hate the private doc being right, your replies have made me understand the lifestyle change is an absolute must I’m disabled which doesn’t help Prior to my knees packing in (I was a tennis player) I was reasonably fit I was a police officer so this was a must I was retired on medical grounds because my knees were shot I’ve had one replaced but even after being put on blood thinners I still got blood clots This time the clots went through my heart the consultant really didn’t know why I was still here!!!!
Since my retirement, and with a dodgy knee, I walk the pooches at least 3 times a week for an hour My food intake is both good and bad I eat really healthy foods but also really unhealthy foods, it looks so simple in black and white to quit the unhealthy foods but it really isn’t . I’ve had a lifetime of trying to lose weight but like many before, I lose a bit then put it back on. I guess if I wanna stay around a while it’s HAS to be done
I started in af on Sunday evening (14th May). I went to A&E yesterday as a result of my gp’s advise.
My pulse was only up to about 120 (it’s been 200 in the past with af so beta blockers helping). When I was there my pulse remained under 100 so they sent me on my way telling me to double up the bisoporol.
Today (Wednesday) im still in af. This is the longest ever. I feel the nhs were little or no help.
I’m at the private doc on Friday. I hope to god this bloody awful condition goes before then. If I’m in AF and my pulse is ok, is that ok? Is it all about keeping the pulse low? AF is making me really tired.
It is horrible and most of us will have been in your situation at one time or another and are able to ride it out at home but some who find it difficult and want the reassurance of medical monitoring. There are times when you should go to A&E - chest pain, HR which isn’t controlled for more than 48 hours, syncope (fainting) and feeling very unwell. If you are being treated in outpatients however my experience was that the most you get is monitoring.
Rest - ensure you are well hydrated and take an electrolyte drink of some sort and do some long, slow deep breaths and stay really calm. Distract yourself - read, watch a film get lost in something you enjoy. The more you focus on how you feel the worse it will feel.
I’ve just come out of af after 72 hours. The longest by far. My pulse during this never went above 130 but kept just below 100 most of the rest of the time. It’s never lasted this long before, this is what scared me, plus I rang a gp for advice and they said get to A&E. It’s all just so new to me. It’s been so scary for me not knowing what to expect.
AF is rarely a serious threat of itself especially if you go back into sinus rhythm without interventions. While the Bisopropol will help considerably, the risk comes from the potential for blood clots in the atrium which are then passed on to the brain or other organs causing a stroke. So I hope your medications include an effective anticoagulant such as apixaban or similar.
Ablation can be very effective in those not in permanent or persistent AF, though it is possibly wrong to regard it as a 'cure', as AF can still occur later. AF tends to be a progressive problem and most people with episodes get steadily worse. So there can be a choice between effective drug control of rate and/or rhythm and there is no evidence that life expectancy is any better with that or with an effective ablation. As Dr Gupta says, these things are far more to do with overall life styles.
My tip would be don't be daunted by the steep learning curve it is necessary as the answer to stopping your AF will be very individual to you and the routes your medics favour.
IMHO most people just don't realise the extent of lifestyle choices they can alter, make a start and you will find you do more and more - it's a journey not a destination - if it gets tough remind yourself you very probably will be avoiding many other chronic issues in later life apart from stopping AF.
I think an ablation is a useful procedure if your symptoms are sufficiently disturbing, otherwise it is a choice.
Various factors seem to pre-dispose AF, or at least sit alongside it, including being overweight, having a lethargic lifestyle, excessive alcohol, extreme duration sports, illicit drug intake, obstructive sleep apnoea, hypertension, hypothyroidism - there might be more.
If a doctor told me that I needed to lose weight or, god forbid, stop drinking (argh!), I would accept their judgment, but a healthy lifestyle is clearly something we all need to attend to.
It’s so hard getting to grips with this condition, I feel for you. We’re all in similar boats, or have been.
Everyone has given such great advice, and you’ve had a taste of the multiple lifestyle factors that we find affects AF in our own lives (everyone is different, so some triggers will be trial and error for each of us). I’d just add as I didn’t notice it said here, that dehydration can be a real trigger for AF. (Whatever size we are.)
For me, remembering to breathe properly and remembering to keep hydrated are two basic things that make a huge difference.
Do ask anything, and do let us know how you get on. Jx
Being overweight does not cause AF - what nonsense. My husband is seriously overnight and does not have AF. I lost over a stone soon after having developed AF - not because I was overweight - .y AF didn't go. That said, I'm sure others here will have encouraged you to make lifestyle changes, as these are known to help with AF. You don't seem to be getting quality advice as yet. Having ablation is only one option available to you. Read all you can about AF - how to help yourself, choose options and about different medications used. The AFib Cure is a good book and the York Cardiologist you channel is a good source of information too. And maybe use your health insurance to source a top recommended electrophysiologist that you can go and see.
I don’t drink I don’t smoke I don’t get anxious nor am I stressed. It just seems to be my weight ‘maybe’. It can’t help to shed a few (or in my case a lot) pounds so I’m going to have to really try. It’s just so hard especially when I love food so much. I love to cook it and eat it 😩😩😩
Try the Zoe Programme. It's a really good way of learning with foods work for your particular gut chemistry. Costs about £400 for 3 months. A few of us tried it here and found it helpful.
If you enjoy cooking then you already have a head start in that you could experiment a bit with different recipes and ways of eating, especially if you’re retired and have more time on your hands. You only need to make one change at a time and it’s more likely to stick rather than trying to change everything all at once. One very simple tip is not to eat anything after your evening meal until your breakfast the following morning—that is, if you already have a snacking habit—having nothing but water or a herbal tea (0 kcal). It’s the little things that add up. Personally, the Zoe programme isn’t for me but I do not doubt that many people have benefited. The key points are about keeping your intake of ultra processed foods to a minimum, eating lots of plant based foods (aiming for 30 different plant foods per week ie lots of variety) and a little bit of fermented food here and there, such as live yoghurt, kefir, kimchi, sauerkraut, veiny blue cheeses etc, whatever you prefer. It’s not that hard. You don’t need to go to fancy organic shops but if you can afford to, by all means do. We all like nice things! But if you’re affected by the cost of living crisis, frozen veg is good, and Lidl has some good weekly offers that can be quite good value.
I’m only retired from my ‘real job’ (police officer). I now have my own gift shop which I love but it’s an hour each way travelling to it on top of the working day. Fortunately I only have to be there 2-3 days a week. I can make a million excuses as to why I find dieting hard 🤣🤣. Truth is I love my food. I don’t really eat bad food I just have way to much carbs. I know what I gave to do in theory but putting it j to practice is hard. Portion control is my problem.
Medications for Afib work for some people, but not all people. They may work for 2, 6, 9 months and for others 30+ years. It all depends on the individual. The medical establishments have an idea of what may trigger episodes, but they don't really know the cause and effect. And, everyone is different. And a lot of times the medications will do their job but eventually stop working.
There is danger in not addressing the Afib, and by addressing I mean stopping the episodes from coming back- whether controlled by medication or ablation. Every time the heart goes into Afib, it is getting weakened. When the hearts pumping isn't efficient, oxygen to to the heart muscle is decreased leading to weakening of the muscle. When in afib, because the blood isn't flowing as it should, sometimes blood can sit in the atria and eventually form a clot. Then it's just a matter of time for that clot to either move or break off and cause a stroke. Every time a person has an episode of afib, it is more likely that person will have another one. In the beginning the episodes occur infrequently (paroxysmal afib), but if it's not addressed it will eventually become persistent and then permanent. When considering ablation, people who address their afib when it is in the early paroxysmal stage have better outcomes and are more likely to have a successful procedure. The longer someone has been experiencing afib episodes, the less likely the ablation will be successful.
Afib is an electrical problem that can eventually lead to a physical problem with the heart. When your heart is damaged your whole body is affected: respiratory, circulatory, nervous, digestive, urinary, integumentary, skeletal, and reproductive. All your systems! You know the saying, "Get to the heart of the matter", that's because your heart is so important to the rest of your body.
ECHO will show any heart defects, ECG, stress test, blood tests, 24-monitor on your latest pill.
I moved from Beta-Loc to Bisoprolol both BBs. Former caused breathlessness and 2 x 2 sec pauses during night. Biso better but not CONTROLLED H/R. Public didn't help further. Just by putting up Biso did nothing much for my H/R rapid.
So wen private. Introduced CC B Calcium Channel Blocker. He found at rest 120 plus.
CCB Diltiazem 180 brought down 51 H/R. So changed to 120mg. AM.
BB Bisopropol 2.5mg PM.
PRADAXA 110mg x twice day. ANTI coagulant. Prevent clots hopefully.
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