Having been diagnosed only 12 days ago I found myself back in A & E in the early hours of this morning! I reckon this attack started about half an hour before I woke as I'm sure I sort of new I had it. Woke up at 4 am to full blown AF. Tried breathing exercises, reading, walking around but by 6am realised it wasn't going so hubby took me to hospital. ECG obviously confirmed it. Now what I don't understand is that for the last 12 days have been on 5mg Bisoprolol, which make me feel very strange anyway, doctor has said to take a further 2.5mg each evening and then another 2.5mg when I get an attack. He then went on to tell me that these tablets can take a few weeks to really get into the system and start working. It seems a very high dose to be taking so early and but I was so desperate to get a possible solution to the unbearable feeling of rapid heart beat palpitations that I just agreed. I didn't think bisoprolol stopped AF and does it really take a while to start taking effect. He also said that I shouldn't let if go on for more than an hour - 2 at the most before I head back to A&E even though I'm on apixiban as well. Some people on here seem to suffer it for hours and let it take its natural course. If it starts happening every week I'm going to be spending a lot of time at the hospital. (5 hours this morning). I know we can all experience it very differently but for those of you who also have the thumping continuous fluctuating heart beat where it feels the heart is trying to escape I don't know how you manage. I am now on constant alert and I know that is not going to help. Any comments greatly appreciated
Confused. Any advice appreciated! - Atrial Fibrillati...
Confused. Any advice appreciated!
" He also said that I shouldn't let if go on for more than an hour - 2 at the most before I head back to A&E even though I'm on apixiban as well. Some people on here seem to suffer it for hours and let it take its natural course."
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None of us here are doctors, nor know your medical history, so stick to your doctor's plan until you get a better plan 
That said, in general, I've seen and used much better plans. And you are correct, bisoprolol (a beta blocker) is a very weak anti-arrythmic and not very good at preventing a afib episode. What it does is control your rate, however that can come at the expense of unwanted side effects. Some of us use an alternative drug called Diltiazem, which serves the same function, but may be tolerated a lot better.
The plan I initially used, was a rate control plan. In my case, I took "x" amount of Diltiazem at the onset of an afib episode and continued taking it as prescribed, until my rate came down around 100bpm. At that rate, I felt comfortable enough to go about my daily business until I naturally converted. If I didn't convert in 3-4 days, my instructions were to call my doctor who would then arrange for a cardioversion. This kept me out of the A&E for about 30 years, a place you really don't want to visit unless absolutely necessary (Many use a beta blocker like bisoprolol instead of or in conjunction with Diltiazem, but I never tolerated beta blockers very well)
My newer plan is a rhythm control plan, but there a number of variations here and often requires prior testing.
The best person to help you with these plans is an electrophysiologst (ep) or at least, a well versed cardiologist.
Now it may well be, that there is something unique to your medical history that requires a trip to the A&E after being in afib for only 1-2 hours. But if not, find/demand a better way of handling the situation. The idea is to control afib, not let afib control your life.
Jim
I think it is just our local hospital's policy. My AF seems pretty standard. Blood tests always fine, low blood pressure (even before bisoprolol) etc. Awaiting an EKG and cardiologist appt but not till July. Will research Diltiazem. I need to be able to deal with the afib episodes so that I can as you say get back control of my life. Many thanks for your comments and advice.
I too ended up in A&E this week on the advice of my gp. I have to be honest, I got the impression they couldn’t understand why I went there as my pulse was between 90-120. This last bout lasted a full 72 hours. The longest ever and my real reason for A&E. They just upped my bisoporol to 5mg and sent me on my way.
I get the feeling that’s all they were ever going to do.
I’m seeing a guy privately tomorrow , friday. (it shouldn’t have to be this way!!!) He wants to do an ablation. Don’t know if that’s the right thing to do or whether he is doing it as he makes money. Big decision to make.
Interestingly I think that is what would have happened to me. When I was eventually called in to see doctor and he started calmly talking to me asking questions etc. I felt my heart start to settle and by the time he said to take another 2.5mg of Bisoprolol the episode was nearly over! Had to hang around for more blood results as they forgot to check thyroid, but was told when done just go home and to take this extra dose if it didn’t settle. He even joked and said he would write himself up as a prescription 🤣
AF is not an accident nor an emergency it is a chronic condition and you need to see a doctor who can put you on a proper treatment plan. This will be either a cardiolgist or an electrophysiologist who is a cardiolgist with special interest in arrhythmias. If your GP is not helping then you need to ask for a referral to a specialist.
Many people here would spend their entire lives in A and E if they took the advice of the doctor you saw.
Several people have mentioned an electrophysiologist. I haven't been given the appt. yet so don't know who I will be seeing. I also have to wear a monitor for 24 hours (but not till July) so assume my follow up appt will be after EKG and monitor results. Hopefully will have more info then.
Please....do take notice of what your doctor has told you regarding revisiting A&E. We don't know your medical history and should not be advising you to vary your doctor s instructions.I do understand your constant alert. I had that for years ! If you haven't done so already then
do ask to be referred to a cardiologist. Maybe A&E have indicated this ?
In my 30 year AF history I have always been told to attend A&E for my rapid persistent AF. In the very early days I went within the 2 hour frame but latterly leave it considerably longer, more recently 3 days and was given a ticking off!!
I don't think I have any other condition that would cause concern but like a lot of people on here it seems, have hypothyroidism. Before diagnosis pretty healthy - not overweight, don't smoke, low blood pressure and eat healthily ect. It could be that I am newly diagnosed. I do take note of what you say though and mainly because at present I find it too scary will go to A&E. Thanks for your comments.
My AF episodes used to mainly come at night like yours did and woke me up ! Always extra scarey in the wee small hours. I know I used to have my middle fingers almost permanently on my wrist checking my pulse !🙄 Nowadays I would most probably have an oximeter on 24/7 😁
I do hope you get sorted soon. Meanwhile post any further worries you have on here and we will try to help you and hopefully allay your fears.
Best wishes
J
Many thanks for that and I know what you mean about finger on pulse but when I get an episode I can literally feel every beat trying to escape my chest!
So difficult when it's like that. If it happens again at night prop yourself up with pillows and try to take slow deep breaths. Try not to panic. I found it helped me to always have a hospital bag at the ready as I was almost always admitted.
My bag is also packed and ready to go!
yes that’s what mine feels like . Not nice
My paroxysmal AF episodes are like yours. Horrendous feeling of beating heart trying to escape - like a fish flapping around, extremely rapid heart beats, and episodes lasting from 6 - 12 hours (the most recent 18 hours). I was diagnosed 4 years ago and have visited A&E many times. Every time they say I was correct to come in (usually when I have been in AF for around 5 hours). I recently saw an EP privately and he said unless I feel ill (i.e. breathless, faint etc.) I might as well try and wait it out at home - it always reverts eventually with extra doses of bisoprolol. A&E wire me up and monitor me and quite frankly I would rather be at home. I am now on a waiting list for an ablation.
I sort of assume that if heart rate is high for too long they shock heart back into rythme. Since being on high dose of Bisoprolol my last episode was 90 to 120 bpm with odd spikes up to 140. First time it was 120 to 160. Hoping now they have up dose again to 7.5mg it won’t be so high.
That might change. My first episodes were like that but now although I am aware when afib starts - it wakes me up if I'm sleeping as well- the sensation is no longer fighting frogs in the chest. Part of this I think is due to being less anxious about the attacks. Anxiety can magnify the physical sensations , augment even further the raised heart rate and make you feel much more ill. I think magnesium supplementation has helped with the anxiety. I also take a hefty PIP dose of Nebivolol immediately the episode starts, extra magnesium and eat a banana. I then try to carry on as normal albeit more slowly. Going to A&E would stress me out far more than riding it out at home . I have a bad back and I try to avoid sitting in uncomfortable hospital chairs ! Breathing exercises can be very helpful too in reducing ghe intensity of symptoms.
I am on a daily dose of Nebivolol 5 mg. Yet you mention you use it as a PIP. I’m thinking of asking my doctor to lower the dosage because when I take my daily walks, I can’t go more than a mile without feeling exhausted and I used to walk at least 3 miles a day yet since I’ve been on this medication I haven’t had any episodes of a fib, so it’s a little confusing so my question are you on Nebivolol daily also or do you just use it as a PIP?
I take a very small amount daily . I am prescribed 1.25mg and my cardiologist told me to double it when having an attack. But I only actually take .65mg daily as I prefer to feel normal when not in afib rather than have no afib at all and feel crap every day of my life as I did when on higher doses of beta blockers. There is no guarantee that taking the 1.25mg every day would totally prevent the afib anyway as beta blockers are rate control drugs with a very small anti arrythmic effect. I am very sensitive to drugs and on 5mg of Bisoprolol I felt like a zombie. It was lowered to 1.25mg and then I switched to Nebivolol. Ideally I would like to not take it at all .
I am going to talk to my dr about lowering mine because I do feel like I am dragging and I don’t like that feeling. I do have to admit I have not had an episode of AFib lately. Thank you for clarifying
Sorry to sound ignorant but what is PIP? Am encourage to read that your symptoms didn't feel so scary as time went on. Really hope that is what will happen with me. I have seen several people mention magnesium so will look into that. Eat bananas daily anyway. Thanks for helpful comments
Pill in Pocket. A dose that you take when having an attack to help reduce the heart rate. Some people who have a low resting heart rate naturally when in NSR (Normal Sinus Rythm ) find that taking a beta blocker daily lowers their heart rate so much that they feel awful - some have described it like wading through treacle. But in afib the heart rate can be much higher so it needs to be lowered to feel more comfortable.
Brilliant, thank you very much.
Well done for all the healthy lifestyle things you’ve already nailed! Even if it doesn’t feel like it now, they will be an advantage in any medical conditions, including PAF.
You’re probably right that the advice about going to A&E might be because you’re newly diagnosed, and when you see a cardiologist or EP it’s a good idea to ask them to recommend what to do in an event. Do you know how fast your heartbeat is when you’re in AF? They might have said from the ecg?
Like Jalia, I’ve always had a very rapid rate when in PAF, and my EP has advised me when to go to A&E at different rates (first I take extra Bisoprolol to try to bring the rate down, but it’s never enough). I always leave going for a lot longer than recommended, and always get told off for leaving it!
It’s tough when it’s new, but it gets easier understanding and dealing with it all. Do keep us posted Jx
Many thanks for that and yes I’m sure it will get easier. Having gone public with friends, family and neighbours it’s amazing how many people have it, but majority don’t seem to have the awful sensation of it and vaguely feel it so take pulse and some are asymptomatic.
I've only been to A&E once with it, when a doddery old locum doctor freaked out at a heart rate in the surgery of 130bpm. He couldn't even print out a letter for me to take. Had to write it by hand. Fortunately I never saw him again and I've never been to A&E for Afib again either. I have Afib all the time now, I'd have to live there, and frankly there is more to life than constantly being in and out of A&E. I'd just try chilling out a bit and waiting to see the cardiologist in July. I'd not be back and forth all the time. But that's me. I tend not to do as I'm told if I think it's daft. I'm not advising you to be like me. Just to know that you can make your own mind up. These people are not gods. And they know f-all about hypothyroidism, that's another one to bite you on the butt. They fear T3 hormone will tip you into Afib immediately, not understanding that the heart and brain have the most T3 receptors in the body and need that hormone in large amounts. They have no idea, in my experience, that too little T3 is just as likely to give you Afib as a very high amount.
Hi & Welcome - sure you would rather not be her but you will find this forum very supportive and helpful.
There are mixed views as to whether or not to attend A&E - if you have regular AF 2-3 times week as I was having you would spend your life there and after waiting for 8 hours one day to be seen I gave up going however - there are certain times you should always go - chest pain, if your HR stay high and for everyone that’s really different - my tolerance was if it stayed 180+ for more than 48 hours, if you have syncope (fainting) and if you feel very unwell. AF is rarely treated in A&E on my experience so you do need to see specialist outpatient clinic - unfortunately there is always a wait. July is not that long to wait but I know it will feel like it is to you.
Beta blockers come with their own problems and I couldn’t tolerate them at all and made me feel really ill all of the time so I felt that finding other ways to keep my HR down helped ie: Rest, hydration & electrolytes, breathing techniques and distraction - I would self convert eventually so then it was a matter of avoiding any known triggers and looking at Lifestyle - sleep, stress management, nutrition, exercise and breathing techniques.
May I suggest you visit the AFA main website and read everything you can on managing AF and various treatments so at least when you do see a specialist you will be well informed and know which questions to ask.
The alternative is to go privately for a consultation which many of us have done and then transfer onto NHS list. The time spent with talking to the specialist for the peace of mind it brings alone is well worth the money but be warned - tests can ruck up the expense.
Hope you feel better soon.
We're away in France for 3 weeks in June and the French health system is great so will if need be go to A&E there but hoping, like you I will find techniques to manage it. Hadn't thought about increasing electrolytes.
Hydration is so important! Keep water to hand at all times.
Something that NO DOCTOR anywhere asks is, WHAT DO YOU NORMALLY EAT? It is a massive pet peeve of mine. The majority of our health issues comes from what we put into our mouths. So, my personal recommendation (and that of hundreds of medical doctors that is increasing day by day) is to stop eating sugar. Stop all carbs especially white rice (it depletes vitamin B1 and is now recognised as one of the main vitamin deficiencies in the western world and in heavy rice consuming countries). Stop eating wheat products (gluten). Give it a go and see how you feel. I did and God almighty, I have been asking myself why the heck I didn't give this a go a decade ago when I was suffering so much and could've avoided the mess my body and health are in now. Be warned that all drugs, especially for the heart, have serious side effects (Verapamil caused me hiatus hernia for example and delayed gastric emptying) so your goal should be to try to live in such a manner that you don't require these dangerous drugs. That said, anything you do, please keep your GP and your Cardiologist in the loop. As I am just a random dude on the internet (but I found out what has cured me and nothing, absolutely nothing doctors from four continents have been able to help me with absolutely anything... not kidding)
Are you saying that cutting out sugar, carbs, wheat etc has stopped your AF? I eat very little sugar anyway, no white rice but do have a slice of wholemeal bread each day for lunch. Very little potato and a good quality multi vitamin on alternate days. My diet can improve slightly but I do try and eat healthy organic food where possible and nothing has changed for many years. Would be interested if there is anything else you do/eat that ha.s solved your AF. Many thanks for input.
If you cut out all carbs your thyroid will struggle even more than it already is. We hypos need some carbs. I don't mean a face full of chocolate (like I'm doing right now) but we do need a sensible level of carbs each day.
Over on the thyroid group, we recommend people don't take multivitamin tablets. Even the "good quality" ones use the cheapest ingredients and are full of things you won't need and not enough of the things you do need. Much better to test first and then supplement any that are low in range. We hypos need top of the range Active B12, Ferritin 90-100, decent level of Folate, Vitamin D over 100 and we need magnesium and iron levels to be good. We mostly won't need iodine. We should be taking a good Vitamin B complex if we are supplementing B12, to keep the B's balanced.
Many thanks for that. Have just been investigating the link between low magnesium and AF and it makes for very interesting reading. Looking at the list of deficiency symptoms I can tick most of the boxes apart from high blood pressure. Several people on here say their AF symptoms improve with increased magnesium in their diet.
Nutrition is primary to good health but without testing and expertise you can be shooting in the dark. I was very lucky in that one of the GPs in our previous practice was also Lifestyle trained doctor so they were able to put through a lot of tests you would normally not get on the NHS but as they often prescribed nutrition rather than drugs it was tolerated. Few and far between I’m afraid but if you can find a good nutritionist who works from testing - that was the best.
Sugar and dairy are the two most likely causes of dietary illness - I cut them out totally for just over 12 months and felt much better for it. I now have a very little, very occasionally and I can now tolerate. Stick to whole grains and carbs with high fibre content but avoid shop bought cereals altogether. I tend to stick to Rye bread, preferably sourdough.
I did the Zoe study and found that I can tolerate some carbs and feel better for having them but find it difficult to clear lipids from blood so have amended my diet accordingly. I learned so much from that study about what is and is not right for me. Nutrition is individual - you can sometimes work out what is good for you yourself but you will never know if your micronutrients are out of range without testing.
They do, but it doesn't do anything for me. I need it for other reasons, but when I first developed AF I was literally awash with magnesium in the hope it would cure or help it. I bathed in it, rubbed it on my skin and swallowed it. My AF is obviously not magnesium related.
I did try it years ago for ectopic beat palpitations and must admit don't think it helped but as the AF is not supposed to be related (according to docs) thought I might try it again. Anything that might help! Sorry it didn't work for you.
It not only stopped it, but it stopped the palptitations and those DREADED strings of ectopics that seemed to start off my AF episodes. The medical industry has finally accepted sugar is evil, right? Well, what do you think carbs are? SUGAR. That is it. Rice gets converted into sugar almost immediately in the intestines.
Rice also causes Vitamin B1 depletion. Check out youtube about TTFD (a special type of Vitamin B1 developed by Japanese medical scientists) which has been amazing for me. For the first time in years I slept every single night 8 hours the very first week I started taking it. And NO heart issues at all.
I wish doctors would know more about all these nutritional issues, but as my GP recently said, "Jesus, we don't get taught any of this at medical school". At least she listens and is learning along with me...
Hope it goes well, take care!
Private appointment with a cardiologist pronto...assuming you can find the funds around £300.
Read as much beforehand here and elsewhere as you can, take a list off written questions and with an unnecessary apology don't leave until you have run through them all and written the answers down.
I could not agree more with this reply.
Good advice. I put my list of questions in my lap and doctors noti ce.
Thanks for that and have already decided after I return from France end June if cardio appt isn't soon will go down private route.
I did the same even though it hurt a bit to be jumping the queue. I still have to wait on NHS list for any procedures but the EP cardiologist I saw also works in NHS and he sorted my meds in the meantime. Don’t panic and enjoy France!
A lot of people have recommend an EP so will be going down that route if NHS appt not forthcoming on return from France. Many thanks
Let us know how you get on!
See you also live in Southwest. You don't happen to know any AF meetings that happen in this area. I'm South Somerset. Many thanks
There is an online group that I think originally met up in Frome, but went online during covid. I haven’t explored it yet, but you could give AF association a call - it was them who told me about it. I visit my sisters in west Somerset frequently and I live in Devon.
Many thanks for that. Just looked them up and yes they do still hold meetngs on line via zoom (which I haven't navigated yet or understand!) I will contact them to see if they are going to hold any group sessions with people talking face to face! I'm old fashioned! Many thanks again. We also lived in Devon for a few years and my parents (now long gone) retired there in the 80s. Beautiful part of the world.
Problem is that beta blocker Bisoprolol does not suit everyone.
I am so desperate for the bisoprolol to work because the AF episodes I have had (2 within 2 weeks) are so scary. It's the only drug that has been suggested so far but very new to this so early days. Doc in A&E said that horrible side effects would wear off and the drug would become more effective the longer I'm on it, so I'm persevering and must admit side effects are getting better. I seem to be on a high dose at 5mg am and 2.5mg pm but trusting docs and hoping next episode won't be so bad!!
I think in time you will know your own body enough to decide whether to go to emergency or not. I have never gone to emergency not even my first event because I knew my doctor knows me best once I was diagnosed I just never felt that going to emergency would be useful for a fib, because it is what it is and it does what it wants to do. Know when you’re not sure it’s best to go. I actually got feelings at times similar to a heart attack and that’s not something you want to wait out. I also found that my GP does not know that much about heart issues. I start it with a Cardiologist because your electrophysiologist is usually though not always your surgeon. They do not tend to get involved with the day-to-day of a fib at least not here in the US. Within a week I did meet the EP. Because of my condition. Prior to that before I moved my other Cardiologist handled quite a bit, but when it came time to have a loop recorder implanted, and then oblations he left it to the EP. You should be dealing with a heart specialist. I don’t know about there but here in the states, they all have an EP that they work with.
I spent £180 on a private consultation with an electrophysiologist and it
missing most of your message
Sorry, fingertrouble. Just wanted to say that I found it great value as I was able to spend plenty of time asking all the questions I had and getting so much understanding of possible answers
It is all about your doctor I believe that. I was going to get a second opinion about a pacemaker. I had a list of questions I was going to ask him before I went to the second doctor. I never had the chance to ask my questions because my doctor is so good. He gave them right off the bat. I also had not realized how serious my particular condition is, and that there was no pacemaker for it that is until this past October here in the states. It is state of the art. I am Monitored 24 seven and have a hotline 24 hours as well. It has an app where if they call me to send them a transmission I can do it from anywhere on my phone. I have only used it once and had a doctor. Call me back in less than 10 minutes. My doctor believes quality of life comes first, and will not redo procedures that failed. He does not believe that there is any value to the patient only to the hospital and doctors. He pretty much straight out said it’s about the money. None of the procedures they do on us are permanent or cures right from the start. He refused to do another ablation on me because of scarring and temporary and the fact that 1 mm off would mean it would not work anyway. The only other ablation I had was my AV node. When we finished our conversation I canceled my other appointment. There was no need for it I believe God holds the hands of my doctor, I trust him as much as I trust any human. If you looked him up, you would be surprised because to meet him. He is so humble and sweet. Best of luck with everything.
It's bad luck for you that bisoprolol hasn't helped as it can definitely be a highly effective, safe and widely used first-line treatment. It's all that I needed in two separate ER visits (5mg). Recently, I've started taking 1.25mg each day following an increase in AF incidence.and this is working well.
The drug takes about an hour to work and achieve its effect, perhaps a little longer. This makes it less useful as a "pill in the pocket" for emergency use if the AF is very symptomatic. For me, so far, it is proving ideal as even when my last episode took my pulse to near 200bpm, I managed to cope well until, thankfully, the bisoprolol worked its magic and brought it down.
It is what is called a "steady state" level of the drug in the body that takes a few days, I gather, but this is not relevant to its effectiveness: it just means that once daily dosing works well. Also, the body's dose response to bisoprolol is apparently not at all linear. This means that 1.25mg is not by any means a quarter as strong in effect as 5mg, thus 10mg is not twice as strong, necessarily.
The drug can be very effective at stopping arrhythmias such as AF and this is what many people presumably find as it is a first-line treatment. It does this not by a direct anti-arrhythmic effect, but, I gather, by slowing the heart rate significantly, an effect that is often sufficient to return the heart to a slower but natural rhythm.
I haven't been told to go to A&E with mine, just to wait for the bisoprolol to work, but that would depend on how I was feeling. I am hoping that if I do get another episode like the last one, it will be similar, but since taking it daily things have calmed down a good deal (either thanks to the drug, or simply the natural course of the condition, I suppose I shall never know).
Steve
I'm really hoping the bisoprolol will work for me. After 2 weeks side effects seem to be easing. Now just want the AF to be easier than last 2 episodes!!
If you can get away with a rate-lowering drug, e.g. a beta-blocker, or the somewhat similar calcium channel blockers (e.g. verapamil), then that might be best as, I gather, these are generally safer all-round than the anti-arrhythmic agents (e.g. sotalol, flecainide).
Steve
What a dreadful experience! Poor you. When the lowest dose of Bisoprolol proved too much for me after three days, I saw someone privately who suggested I got a Kardia (which meant getting a smart phone!) and after I sent him a reading of my next AF episode he sent a prescription for Flecainide to my surgery to be taken as a PIP ( pill in the pocket) when I had the odd episode, which gets heart back to normal in a few hours without need to go to A&E and only to add one of the low dose Bisoprolol if heart rate over 140 twenty minutes after taking the Flecainide. Now I take Flecainide twice a day and only get very rare episodes which can be treated with an extra pill. Of course the medication comes with side effects but all drugs do!! Hope you find what works for you soon.
As I said in a couple of other responses my bisoprolol (5mg am and 2.5mg pm) side effects after 2 weeks are getting easier. I assume they will leave me on that until I have first cardio appt in July/Aug (or go private if not forthcoming). I happen to have a Kardia machine that was given to me by hospital many years ago to diagnose ectopic beats after years of palpitations (which were very mild compared to the AF!) so might ask if I could send them readings and save myself a trip to A&E.
I used to get rapid heart beats 240 at least which thumped all over the place. Bisoprolol is a rate control so it “should” help to slow down the heart.
Bisoprolol a rate control
Flecainide a rhythm control
Thankfully at the moment I don’t get the 240 but I have started up again with about 168 and this one has been going on for about 4-5 weeks.
I did go to A&E eventually last week and they got it down to 89-93 but as my usual rate in nsr is 43-48 it is still high for me snd discharged me. I asked if it was dangerous to be going on so long with this, but didn’t get much of an answer except unless I fainted or got bad chest pains then go into A&E again
I hope you settle and feel better soon, but do remember stress and panic won’t help. Easier said than done I know too well
I suppose they can't use Flecainide unless I am a suitable candidate and bisoprolol seems to be a catch all medication. I am encouraged that several people have said the horrible sensations of AF do get easier, so I'm keeping fingers crossed that is the case for me! Thanks for your comments.
yes your body seems to almost acclimatise to the AF, it’s the tachycardia which is the horrible one and hard to wait for it to settle back down or go to A&E for treatment
Beta blockers are rate control and flecainide is rhythm control
All the best
Totally agree. Hopefully that's where bisoprolol will work it's magic!
🤞 xx
Welcome to the Forum, I can see many of the Members have already made you feel at home and offer their own shared experiences and advice.
Please feel free to visit the AF Association webpage: heartrhythmalliance.org/afa whereby you will find patient resources \ videos and information.
If you have any questions, our Patient Services Team are here to help, feel free to contact them on +44 (0)1789 867502 or via email at info@afa.org.uk
Everybody has been wonderful and it's great to not feel so alone on this journey. Many thanks
I was diagnosed with AF about 8 years or so ago after local GP took my heart rate going up to 160 dropping back to 120 a horrible feeling then a flight from a country town to a major hospital in perth by RFDS and was put on medication by cardiologist within hours of arrival. I was put on a beta pace called sotalol and a blood thinner apixaban, this brought it into check by mid morning the following day.
I had the break through of AF returning without warning on occasion lasting for 6 hour to a day and a half before reverting to normal rhythm again (sotalol medication dosage being increased slightly but always under a doctors direction until normal rhythm returned). Even saying this I have taken my self off to A&E on occasion for treatment of AF but only 4 times in the 7 years to make sure nothing else was going on that may be causing an attack of AF.
Last September I had a cardio version done which only staying in normal rhythm for 2 hours and reverted back to AF back up to 140 and dropping down to 70 continuously. 3 weeks latter had an ablation which has worked well halving the sotalol meds apixaban staying the same but touch wood all seems to be going well.
From personal experience going to A&E helped even just to put my mind at rest to let me know I was going to be fine, if you are not able to touch base with your GP due to no appointment, a phone consult is alway a good option as well.
One thing is my husband brought me an Apple Watch that keeps a check on my heart rate and which alerts you when you are in AF and how many BPM and will also take an ECG of your heat beats which you can be sent directly to your doctor via sms or email so even though you are on a phone consult the GP has a good idea of what is going on so they can advise you, even though the apple 8 watch is an expensive item there are other smart watches on the market that are a lot more affordable and have these same features
Hi, I have had an Apple Watch Series 4 for many years and during my 2 episodes it had flashed up that it's noticed a possible AF episode. Don't know if it's relevant but ever since I've had it since Dec 2018 it shows almost daily spikes of heart rate going up to sometimes over 200bpm. As I have not felt anything out of the ordinary I chalked it up to a quirk in the watch. Does yours do anything like that? As I have a Kardia machine for my ectopic beats I used that for when I suffered anxiety related palpitations and they always came back harmless. Thanks for your comments
Yes my Apple Watch 8 records every episode on my iPhone, how long and how high, mine was going up to 160 then dropping back to 70 continuously the occurrence was worse after I had a cardioversion which only lasted into sinus rhythm for a couple of hours then went haywire, before my ablation it was multiple times a day and since having the ablation last October I have had 1 episode that lasted for a couple of hours so definitely works a friend of mine has the Garmin that records the same when she was having episodes back to her phone and she hasn’t had any since her ablation.
In my opinion the Watch I have is accurate as when I was in hospital I compared the reading on my watch with the hospital ecg machine and it was very accurate.
When I was having episodes before the ablation because they were happening so frequently I didn’t seem to notice them so much because with also having sle fatigue is a normal daily occurrence but after the ablation the fatigue factor was heaps better so when I had that 1 episode it was very noticeable.
Hope this helps
Thanks Hopey. If my watch is correct I’ve been having spikes in heart rate for over 4 years which makes me wonder how long I have had AF?? The few times I have had it “full on” it’s been Very noticeable like somebody said “frogs jumping around in the heart” and those recordings were different on my watch (and subsequently phone). When I was in hospital, like yours, my watch was in sync with the monitor. Modern technology is amazing! Each of my episodes eventually went whilst I was talking to a doctor, so yes you are correct - it’s the reassurance we need.
yes I have found that when you can calm down through reassurance from someone with medical knowledge things seem to start to calm down but not to put a downer on it mine didn’t that why the ablation but yes feels like your heart wants to jump out of your chest but hasn’t got an exit and the more you worry or think about it the worse it seems to feel.
I found my AF occurred more if I was stress, dehydrated or fatigued so even though I haven’t had an episode since Christmas touch wood, I’m very aware of my triggers and try to make sure I take steps to be kind to myself in that if I’m feeling stressed or fatigued I chill out for the day and literally do nothing, and that appears to be working for me.
If I may be so bold to ask have you yet seen a cardiologist if not take note of every time you have an episode and how long your watch has been recording this for, how long each episode lasts and how often and if you know how high your BPM go up to this will help your cardiologist make a decision on the best course of treatment for you.
Good luck and hang in there
hi, no I haven't seen anybody yet apart from docs on cardio ward and A&E. I have a heart ultra sound (EKG?) on Wednesday and then a 24 hour monitor mid July. My cardiologist appt will be sometime after that although if it doesn't follow through soon I am prepared to go private. I'm on holiday for 3 weeks in France during June and I know their medical care is great, so at least if I have a problem I know I'll be well looked after. I will (hopefully) will feel happier after the ultra sound as I believe from other people that that is the definitive test as to whether the heart itself is healthy. Haven't really discovered what my triggers are, although I am a very anxious person but don't recall any particular events on changes in lifestyle before my previous two episodes. I am as suggested by others trying to stay well hydrated and now taking magnesium supplements.
Many thanks for all you support.
you are quite correct, bisop does not stop AF, however it does slow the heart rate down quite a lot. I was warned to be careful when taking extra ones as it can slow the rate down too much and give you a diferent problem! AF is an extremely unpleasant sensation, I understand where you are coming from. my gp assured me that as long as I take the anticoagulants regularly, nothing is going to result from it, since this chat I admit I have found it easier to sit through. I now try to approach it the way a migraine sufferer would , try to avoid triggers as far as possible, but when you get an episode, sit it out quietly. Triggers seem to be different for every one, I find if I eat or drink alcohol to late in the evening I will inevitably get an episode in the night, but everyone is different. I would suggest keeping a dairy to help identify what starts yours off
Good advice. I already have started to make a note of what I eat and drink, but having not changed routine, hobbies, diet etc for many years I think I will find it difficult to find anything specific. With the bisoprolol having been put up to 7.5 mg I'm hoping next episode won't feel so severe and like a few people say they don't feel so bad as we become accustomed to them. Many thanks
Hi
We don't know your heart rate.
But I was never controlled until I was put on a CCB Diltiazem a calcium channel blocker by a private heart specialist.
Bisoprolol did not control my sweating, fatigue or heart rate enough and I was taking only that 10mg.
Bisoprolol is a beta blocker and for me 2.5mg controls my BP. It blocks adrenalin.
Diltiazem is a Calcium Channel Blocker and it took my H/Rate down to 51 in 2 hours!
They both help rhymn.
I think BBs help anxious folks abd CCB have a different problem and it relaxes the heart's pumping. Widens arteries etc.
Sounds like you need to have your history done by a excellent heart specialist. I needed to as Drs simply put up dosages.
You cant live with uncontrolled heart rate. I did for 2 years 3 months.
Take care Retired.
cheri JOY
Many thanks Joy. I know I will have to wait until I see cardiologist to see what they say about medication. I have an EKG on Wednesday so hopefully that will show if there are any problems with heart. I also have a 24hr monitor in July and all this has to happen before my cardio appt. As I think I have said on previous replies I am prepared to pay to get a private appt if follow up doesn't follow fairly quickly.
I was diagnosed 3 years ago and when I get an episode it's like yours, heart rate around 150bpm and goes on for around 30 hours (although it usually slows in the last 24 hours). I am on sotalol and apixaban..My EP is widely respected in his field and tells me to sit it out unless I feel particularly unwell, have chest pains or feel extremely dizzy or breathless, otherwise just try and go about your day which is incredibly difficult with a racing, thumping heart. I haven't been back to A & E and do as he says. I often think the fact that you are in A & E and hooked up to monitors makes you more anxious which makes the afib worse
I agree, it is almost impossible to just carry on, I feel very jittery during an episode, and I am definately not good company!
During my last A&E visit, after the ECG confirmed AF, they sent me back to waiting room for several hours while the blood tests were completed. During this second episode heart rate was 60 to 140 for first 3 hours and then 55 to 100 for the next 4 hours before settling down. These readings are taken from my watch so not sure how accurate they are. Don't get any pain but certainly feel wobbly which could be stress and anxiety .
Yep, A&E is definately not where you want to be! my last visit to A&E was a bit of a nightmare, I was 4 days post op after hip replacement, which was really why I went in, and they put me in a little side room on a monitor which nobody paid any attention to!. so spending the whole night on a trolley without any painkillers did not do much to releive the stress, I think since they did nothing in the way of treatment, I would have probably got through the whole thing faster if I had stayed at home, but I was worried as it was so soon after the op.
I must admit when I was having an episode I would get anxious and which in its self doesn’t help the situation but just the reassurance of medical staff puts your mind at rest that you will be ok so at least the anxiety factor decreases this has been my experience, but yes it does make it very difficult when told to just suck it up and continue with your daily chores, I have a great GP that is very understanding of my fears and would give me advise and tell me to take it easy relax don’t worry about the chores but if it got worse or had shortness of breath giddiness to take myself off to A&E or get a friend to take me there which just being told that by the GP was comforting to know I wasn’t being over the top or a bother going to the A&E.
I was told afib more uncomfortable than it is dangerous.. if ur already on blood thinners it’s best to ride it out than run to hospital on every attack.. I get them every few days for hours I just take it easy. I found I just waste my time at the hospital they don’t really do anything that I can’t do at home.
Certainly uncomfortable and very unpleasant feeling! but you're right they don't do anything in A&E apart from make you sit around for hours. I suppose it's just you're in the right place if anything does happen and as I'm so new to it all I felt safer there but am sure this will wear off as I get used to it all and get to now my body.
Another bisoprolol query
Weird AF
AF after exercise 
