During Af

[lacolyn]

Today I think I had an Af episode. I have paroxysmal Af, and have had 3 severe attacks in the past 12 or so years, each requiring evacuation to hospital for 24/48 hours, once by helicopter, oooh! I don't tend to usually get significant episode outside the big ones. My last was horrible, about 2am I awoke bathed in sweat, totally distressed, and barely able to speak. I received a quick shock on arrival at the hospital and recovered fairly quickly. Unfortunately this happened in California and cost 18000 Dollars, and I was insured btw! Anyway all that's background. My suspected attack today put me in mind of the California experience with the distress, sweats and other aspects but less severe. I was alone and didn't know what to do. It actually started with a migraine aura, then I slept a bit and then the afib began. After a while I took a Flecanaide tablet, felt awful but rode it out, sleeping for a while. It's evening now and I'm feeling improved. What I'm asking is, is this 'normal' for a 'normal' attack? What actions do you take?

[BobD Volunteer]

Sounds qute normal and sounds like you did the right thing though maybe not leave it so long before taking the flecainide. What instructions have you had from your cardiologist?

You should know that AF is normally a progressive condition so this may be more frequent as time goes by so perhaps a good opportunity to make an appointment to see your specialist again.

[lacolyn in reply to BobD]

Thank you Bob. It's not set easy to go down that route here in Sussex but I'll certainly try, it's surprising what you can do when you try. I'm now wondering however if the episode was combined with migraine. I'm more used to how I react to those and yesterday was definitely similar. I also know that the effects last about 3 days and I seem to be still absorbed in it today, but less. I shall persevere with the GP to get in touch with a specialist. Thanks again. Sounds absurd but there's a part of me that hesitates to contact them as I don't want it to affect my right to insurance.

[CDreamer in reply to lacolyn]

There is a link between migraine with aura and AF. Migraine and aura is also associated with hole in the atria septum - hole in the heart - which about 20% of the population have, often unknowingly. Mine was only discovered during an ablation to fix the AF as they have to punch a hole in the atria septum to get to the left atria.

I would agree with Bob about pushing to get to see an EP - there are some excellent EP’s in Sussex (which is also where I live these days) but I agree that getting to see one is just horrendous - even privately! Having said that once you do I have had excellent reports from new friends about the prompt and efficient treatment received at both Brighton Cardiac and Haywards Heath Princess Royal - once on their list!

If you do suffer another episode ensure you keep well hydrated and good idea to have an electrolyte drink of some sort in store as that can also help. Take the Flec (presumably you use as a PIP?) within the first hour of AF but not if you have recently eaten as it can make you feel very nauseous if taken on a full stomach.

Hope some of that helps. Where are you in Sussex?

[CDreamer in reply to lacolyn]

PS - it shouldn’t affect your ‘right’ to insurance. I have had AF now for some 15+ years and another much more serious condition for nearly 10 and have never been refused insurance. We have travelled widely and the most unusual place I have ever had AF is whilst whale watching in a fjord in Iceland - triggered by running for the boat! I have never been refused insurance but have had a % increase for the medical conditions.

You should check DVLA rules re: AF - forever changing - but mostly unless you have been told by a doctor you must not drive it’s just a matter of online reporting. More than half the people I know now have AF but that is an age thing.

[BobD Volunteer in reply to lacolyn]

Insurance shuld not be an issue, but if you conceal that you have a condition like AF then you may find claims refused, especially travel insurance. As CDreamer has said check with DVLA though latest info is that no need to report unless it is distracting or incapacitating.. I had a pacemaker fitted last year and reported to DVLA as required and also car insurance and neither affected just "condition noted".

[secondtry]

Can you recall what may have triggered your 3 episodes in 12 years?

I have vagally mediated PAF and have had two episodes in 10 years, one started by gulping a cold drink and the other by revisiting a place where I had too much stress. So I don't do either of those anymore 😁.

I would book a private appointment with a cardiologist to discuss.

[sdgb]

hi it sounds very similar to how I am when I have an episode, unfortunately I cannot tolerate any meds like Flec and they actually make me more ill.

I try and ride the wave as awful as it is, but if I’m feeling really ill I go to A&E. I usual revert to normal after a 1-10 hours my cardiologist says if it lasts 12 or more or I feel really unwell go to A&E.

I had an ablation in 2010 but AF started again 2 years ago, certain foods and dehydration are my main triggers.

I’m fortunate that my cardiologist has a policy once a patient of his always and I can email his secretary and send Applewatch ECG printouts ( his suggestion ) if I’m concerned and they always respond (this is on the NHS)

Go to the GP and demand to be referred, my GP told me to go to A&E for every event! Which is crazy but I hope you get sorted out

I find that box breathing through the nose, 4 seconds in, hold for 4,out for 4, etc really helps to calm during what is a scary time

[lacolyn]

Many thanks for comments so far. So helpful.

[Vonnegut]

We are all different - I was advised to get a Kardia which is a clever little gadget which with an app on your smart phone ( that’s how I was introduced to one of those too!) you can check what your heart is up to and so take your 100 mg of Flecainide if it’s in AF. With added Bisoprolol, if AF is very fast. I now take the Flecainide regularly and only have rare episodes which can be sorted fairly quickly with an extra pill. Do discuss your case with an EP - I saw one privately found through the AFA - so you can find something that suits you. Good luck!

[Byke]

I too have paroxysmal AF. Diagnosed three years ago. I have had three bad bouts where heart has run at 195. Each time I have gone to hospital, the second time I was on Bisoprolol, I was told not have them, pill in the pocket has not been given to me as they said I would be better on Teldium which is slow release. I have had an episode whilst on these, but I think I have found a pattern of any sudden turning around or really any sudden movement. It could be wrong but it does seem to happen then.