Hi everyone, I am looking for advice.I have paroxysmal afib with episodes coming roughly every 4 months (I've never yet discovered the trigger and my EP says I probably never will). Anyway, I am extremely symptomatic with heart rate jumping between 80 ish to 150 ish lasting around 30 hours before reverting to NSR. I take 40mg sotalol 3 times daily and 5mg apixaban twice daily
I am due to go on a boat on the Norfolk Broads on June 20th for a week. I know we will be eating out most evenings but would like you opinions and thoughts what I should do to try and avoid afib kicking off during the holiday and spoiling it for me and our friends. I am also anxious because we won't have access to a car and maybe away moored up somewhere overnight. I know I can't let afib control my life but I'm scared.
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Karendeena
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Well done for not letting AF rule you. Stay well hydrated, avoid alcohol (of coure), avoid stress and please enjoy yourself. Try not to eat too late in the evenings either.
Thanks Bob, I don't touch alcohol these days so one tick, I probably get more stress at home with my 95 year old mum. I will watch what/when I eat, as I think that's what started my last episode when staying in a hotel in Norfolk back March, wasn't particularly late starting but late finishing and it was a three course. Went into fast afib around 9.30pm and stayed with me for 30 hours. I am determined not to let this get me 😜
I understand your anxiety . It is important to stay well hydrated at all times. Avoid alcohol . Try not to overeat particularly late at night. I consider this last advice to be particularly important.
I realise that having a few drinks and meals out is an important part of a holiday to most but I'm sure you realise that in your situation you have to exercise caution. Bearing all this in mind, try to relax and enjoy your holiday , putting AF as far out of your mind as you can.
I hope you have a wonderful time. ( I've holidayed all over the world and only been caught out once with a highly symptomatic AF episode and had to ride it out on the high seas!)
Thanks Jalia, fortunately all of us prefer to eat around 6.30pm so providing we can find somewhere suitable (no doubt where we stop for the night) we should be ok on that one. One is really spooky, is that my episodes seem to know it's 4 months and then they come like clockwork, either that or I am willing it to happen 🥺
Not so much now since my 4th ablation in July 2021. Its made a big improvement. I had a 2 night admission about 6 months ago with fast AF and had yet another DCCV. So really only one episode of any consequence in 22 months.
Hi Karendeena, good luck with the holiday. I'm a firm believer that anxiety plays a big part in triggering AF. Like you, I used to have regular attacks, monthly. I began to wonder if it was something to do with the moon! As a month came around I would start to worry and look out for every little symptom and I'm sure that I could talk myself into an episode. I kept a diary of my episodes and very often I would have a second episode a day or so after the first, because I was stressed out by the first episode and living in fear of a second. I realised that a physical trigger was going to bed too soon after eating and those episodes started to dwindle and I was left with the stress related episodes. There are lots of breathing and meditation exercises that I now use when I notice I am getting anxious and they take the heat out of the problem. I had a cyro ablation at the end of April and am now trying to keep up the good habits to give me the best chance of a good prognosis.
avoid big meals and caffeine, it may not be a trigger but it is a stimulant and probably best avoided. Not necessarily before your holidays, but has your EP ever mentioned trying a rate drug such as Flecainide as a PiP?
Hi Flapjack, I only drink decaf and never touch alcohol these days. Unfortunately I was taken off Flecainide as I had more episodes on it (not sure why). My EP put me on Sotalol, not sure how effective or whether I would get more episodes if I didn't take it. I get scared because when I do go into afib my heart takes off like a rocket although it does slow down in the last 24 hours. My EP also told me to take an extra sotalol if I go into afib, but he did make a point of only taking one extra
HiI was on Sotalol and my episodes lasted about 12 to 16 hours. I was then changed to Flecainide and Bisoprolol. My episodes while just as frequent only lasted 2 to 5 hours max . Might be worth having a chat with your Dr - unless of course you are unable to tolerate Flec ? Flapjacks idea of Flec as a pill in the pocket otherwise is a good one.
Have a great holiday and hope you have lovely weather!
Hope all goes well, have a lovely time. We hired a boat on the Broads for a day a couple of years ago and it was very relaxing, mind you, the sun was shining which is fairly important 😉👍🤞🙏
Food is a trigger for me and over the years I have pretty much got on top of what will trigger AF and what will not. So far I'm over 12 months free of it, maybe 15 or 18 now. Time escapes me. So, based on that, eat as early as socially possible and eat light, I mean light meals, nothing that sits heavily in your gut after digestion. Also try and study any ingredients that maybe listed on a menu. If possible definately avoid anything with Gluten in it ..... even down to gravies and sauces. Try and avoid stuff with Wheat or Oats in it either as a food item or as ingredients.
Try and think traces in food ingredients too. I once drove a bus for a school in Surrey and that school was NUT free ... it wasn't the NUTS themselves it was traces of nuts in kiddies sweets even !! One needs to think in a different dimension.
Have a great holiday ..... and chill ..... AF won't visit people who chill.
After your holiday and when you are home try and keep a food diary and see if you can establish a statistical pattern to your events relative to food eaten.
Try taking cardiovascular magnesium taurate every day ( Amazon) Avoid hot spice foods or anything which will give you indigestion. Also avoid excess alcohol . Enjoy yourself!!
enjoy! Ages ago I read some interesting study that seemed to show some af has its own internal “clock” irrespective of external triggers. When mine was more active (only one brief episode once a year since ablation - have you considered one?) they settled into every Saturday night despite (during first lockdown) me having no idea it was a Saturday or eating / drinking / doing anything different. Arrhythmia nurse called me “the Saturday girl” (girl??? old boiler). Have a great time, if it happens it happens and you will ride it out.
I've found out that aged cheese is a trigger. A couple of other people I know react as well. I think it contains tyramine which I is the culprit so I stick to mozzarellas and cream cheese.
Don’t eat 3 course meals in the evening - sorry but that was always a trigger for me. Leave at least 3 hours after eating before retiring to bed.
I’ve just returned from holiday and one of the interesting things I noted is how much earlier people, especially the over 50’s, are eating. 25 years ago we never ate before 10pm, now most of the restaurants close by 9.30pm because everyone wants to eat between 6-7pm - stick to eating early.
Plan your journey - don’t stop overnight in out of the way placeIf if you are on a barge and away from a tow path. Remember - if there is a pub in sight - there will be access.
I know what the doctors say but HR of 150 is not dangerously high, makes you feel crap, but unless with other symptoms, not immediately dangerous so first rule of AF - LSD= Long, Slow & Deep breaths to control anxiety. I had AF in a small boat whilst whale watching in a Fjord in Iceland - the retelling of which was quite amusing.
Make sure you always have mobile cover - you can check mobile coverages on line - so plan your route - then check and avoid stopping over any places that have weak coverage.
Least that is what I would do….
Have a great holiday, plan and do the stress now so you can forget you ever had AF on your hols.
I totally understand your anxiety, I’ve had afib episodes a few times on holiday including once when I was due to travel home by train from Switzerland. Sometimes I think there is nothing we can do to stop them coming but all the advice re dehydration and alcohol definitely helps. I’ve also found that it’s best not to have too big a meal late in the day. I don’t drink more than an occasional wine so my holiday events have usually been traceable to dehydration or big meals.
Last year I read an article in here about also keeping electrolytes balanced, so in the very hot days I had I occasional snacks of a few dried apricots or a salty snack as well as keeping water intake regular. . No idea if there is anything in it but I made it through the Summer without an episode.
I would add for many of us the Vagus Nerve has become over sensitive due to poor lifestyle choices; unfortunately almost everyone falls into this trap. This means that any digestion issues or stress factors can trigger an episode.
My recommendation to enjoy your holiday would be to have a firm plan that gives you confidence you have been proactive in avoiding AF eg light early evening meal preferably not meat (maybe make lunch the main meal) , avoid Chinese or Indian, no carbonated drinks especially tonic with quinine, reduce sugar and gluten by 75%.
If you get into Norwich do visit jarrold.co.uk/ for lunch.
I do know how you feel though as I once had an attack in Madeira but took a couple of extra bisoprolol and after a day it eased. Still felt as if an elephant was sitting on my chest, but it did feel better
Another time it was on the top of a mountain in Italy (I didn’t climb it - cable car!!!), but I rode it out snd it reverted after a couple of days
You can do that but it might not happen anyway if you are happily with friends. Just try to get help if you are in pain, lightheaded or fainting. Try not to think afib
Drink water regularly. I flew for the first time to Grenada with PAF & T2 diabetes carb controlled. I’d had a LONG day!! PAF kicked off when we went to bed😵💫 TOO TIRED and probably dehydrated 🙄 The plane as only giving out tiny bottles water 😳 So, I laid there and did breathing exercises, went off to sleep and woke next Morning tired but ok. Then took it easy lounging on the beach 😜
Last year for the first time I went into afib on holiday. It happened on 3 separate trips. It had been something I had been worried about but when it happened it actually was not as bad as I thought it would be. A boat trip on the Broads sounds very relaxing . Maybe instead of worrying you could tell yourself you will take all the precautions others have suggested but if it happens you will just have an even more relaxing time - sitting quietly and watching the scenery go by. Stop negative thoughts about spoiling it for others- these will induce anxiety which is bad for us fibbers. If you normally manage your afib episodes at home then you should not worry about not having access to a car either. Enjoy your holiday!
Thanks, I don't think I can have calcium channel blockers as I have low BP even when unmedicated. Yes, the 4 months is up beginning of July, so wish I could go past it just the once would give me hope that my heart doesn't have an internal clock of its own!!
I keep convincing myself that the last episode was caused by being wet through, chilled to the bone when out walking, then plunging into a hot bath, followed by a three course rich meal when staying in a hotel.
What fun! I hope you have a great time and are a-fib free. The only thing I can add to what others wrote, is to get plenty of sleep and don't overdo it -- don't throw caution to the wind, i.e. always be mindful of triggers. Have a wonderful time.
Thank you so much. I will be careful, lots of laughs I hope. I don't sleep well though, always have horrible dreams and wake frequently, I think this is the low dose steroids I am on for polymyalgia, can't wait to get off them if I can
I have and done minor traveling.Recently got a pacemaker because of pauses.Did one day trips recently by trainbus.Intend to do longer trips or I will go nowhere and have less years left so advise take your chances..meditate.Breathe..
As you’ll notice, everyone’s triggers are different. If you followed the advice of everyone on here you would end up not being able to eat or drink anything. I would look at the things that are common triggers for people and then decide if they are for you as well. Common triggers are alcohol and caffeine but they don’t have any effect on AFIB for me. My triggers are related to eating (eating too much too late, eating something cold, etc) and position (bending over forward especially after eating or lying on my left side). I’ve gone into AFIB a number of times just eating ice cream or a cold smoothie.
You sound like me. I don't touch alcohol or caffeine and haven't done since diagnosis. I think my triggers are food, especially 3 course or heavier meals in the evening. Funny you should say that about ice cream, I had just finished an iced parfait when I last had an episode
You've had a lot of good advice on here already - though I would second the advice to ask your doctor about 'pill in the pocket'. I have Flecainide for that purpose and I take 200 mgs immediately an episode begins and so far (knock on wood) it's stopped every episode within an hour.
The other advice may be easier said than done but I would suggest you need to do a mental reset around the idea that having an episode will ruin your and everybody else's holiday. Let me explain. I have had PAF for going on two years and I had very symptomatic episodes. I was really anxious about the whole situation and lived in fear of having an episode. I'm still not thrilled about it but it is what it is.
Back in March I was really stressed out as I was solely responsible for organising a sizeable party for my dad's 90th, complicated by the fact that he lives several hours away. Consequently I starting having far more episodes than normal. My daughter had come over from the US for the party and we were going to Amsterdam for a week a couple of days later. By the time the party was over I was exhausted and the night before we were due to leave I went into AF literally every time I put a mouthful of food in my mouth. We ended up in A & E late that evening and were due to leave at 8 a.m. the next morning.....but the junior doctors were on strike so they said we'd be in A & E all night. I have to tell you, I was completely ragged. My daughter wanted to cancel the trip - she was really nervous about being in a foreign country with me being unwell and/or going to pieces, which I understand! I was several hours away from home. We had nowhere to stay if we didn't go. There was no good answers.
In the end I decided to ditch the A & E and I promised her I would be okay. I said whatever happens, if I have an episode I'll deal with it. I'll be brave, I said! And somewhere in that moment I just did a complete mental reset and decided to myself that AF wasn't going to be a crisis anymore, it was just going to be something that was happening and no biggie. We had a really awesome week in Amsterdam and I didn't have a single episode. And, I have to say, I've been much less anxious about the AF since then and, also interestingly, although I can still feel it when I go into AF, the episodes have been much less symptomatic.
Having said all that, I hope you have a great holiday!
I holiday on the Norfolk broads eveey year ....there is a very good a n e at Norwich hospital...try and stay that side of the broads to be close . Also Yarmouth has a n e facilities. I found this a comfort to know and helped calm my anxiety . Try and stay in areas that have good signal as some parts of the broads the phone signal is limited .
The peace and quiet will be a tonic for you ....so try and relax and embrace it
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AF episode on holiday. Advice needed please 
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