AF - Sudden Increase To Every Night

[Barny12]

I occasionally get a very slight twinge or spasm in my heart during some mild exertion - a gentle bike ride or lifting the hoover for example. This often kicks off an AF bout the following night.

I had the twinge thing on a ride a couple of weeks ago which caused an 11 hour bout of AF, and since then I've had an hour of afib every night. I normally get afib around every two months for an hour or so, so this is a very sudden and worrying progression.

Currently taking Bisoprolol 1.25mg daily and Flecainide 150mg as pill in pocket.

I spoke to my arrhythmia nurse who has suggested a 48 hour monitor to see what is happening - but this will only pick up the AF not the why or how of the sudden increase or what is happening re the twinges/spasms.

Any ideas?

[BobD Volunteer]

AF is always a progressive condition. The more you have the more you will get. Goes with the territory ! Mabe ask your arrhythmia nurse about a maintainance dose of flecainide?

[Barny12 in reply to BobD]

Thanks for the reply.

Is a sudden jump from once every 8 weeks to every single night a normal progression?

[BobD Volunteer in reply to Barny12]

AF does exactly what it wants to so there is no "normal". It is very much a mongrel condition.

[Aegean56 in reply to BobD]

Indeed !

[JayDJ]

Try looking at what you might have changed in your drinking/eating routine over the past few weeks ie have you changed or added something to your diet? I know that if I have certain foods and in particular foods that contain gluten then I'm in for it maybe some 5/6 hours down the line when - I'm trying to sleep.

[mjames1]

The 48 hour monitor is an excellent idea, however a 7-14 day patch would be better, if available. The nurse not only wants to more scientifically track frequency and duration, but to also make sure it's afib and not another tachy-arrhymia like flutter or SVT. If the frequency of episodes persist, they may want to try daily Flecainide to help prevent the episodes from occurring in the first place. Did you discuss the "twinge" in detail with the nurse? They may or may not want to do additional testing such as a physical exam, echo, stress test etc.

Jim

[Barny12 in reply to mjames1]

Thanks for the reply. I told her about the twinge/spasm but she didn't ask for any more details...

I think you're right re the echo/physical exam so I'll definitely mention it again.

[mjames1 in reply to Barny12]

Another thought is that if you feel the "twinge" while wearing your 48 hour monitor, write down the exact time and they should be able to sync it up with the ekg recording to see if any changes. Also, if you get a home device like the Kardia, you could generate an ekg for your doctor's review any time you feel that twinge, assuming it lasts more than 20-30 seconds.

Jim

[Barny12 in reply to mjames1]

Good idea. Not sure about the Kardia, though as the twinge only lasts about one or two seconds.

[Buffafly]

As you know what brings on the ‘twinge’ make sure you do lots of those things while you have the monitor! And the log it if you manage to bring it on.

[Ppiman]

Are you worried that some physical changes have occurred which an ECG might not pick up? That's always my fear. As Bob says, the cellular changes that lead to AF are generally deemed to be progressive. In my own experience - so far, at least - these "flares" do mysteriously eventually die down and I return to a relatively quiet phase (not that, I suspect, most non-sufferers would consider things remotely "quiet").

Steve

[Barny12 in reply to Ppiman]

Yep, exactly. The brief twinges/spasms which occur occasionally feel as though the heart is being touched or pinched. Possibly a gastrocardiac thing where the diaphragm nudges the heart?

en.wikipedia.org/wiki/Roemh...

I suspect the ecg will just pick up PACs and afib and we'll be none the wiser.

[Ppiman in reply to Barny12]

I wonder whether an exercise ECG might convey more? With regards to heart sensations like “pinching”, I’ve read that the heart itself has no sensory nerve supply that could signify such things as its being pressed against. I was told that it can respond to pressure by producing ectopic beats, though, and they can be felt indirectly and also have the potential to trigger AF.

Yesterday, I had many of the same kind of odd and worrying little symptoms you describe and the thought went through my mind that there’s so much we’re never going to find out about as, essentially, no one has the time or interest. What adds to the load is that sympathy is hard to come by as there’s nothing obvious going on from the outside. Such is life.

Steve

[secondtry]

Hot weather?? Ask trusted cardiologist to start daily Flec at 100gms (low dose)??

[Barny12 in reply to secondtry]

Thanks for replying.

The hot weather is a possibility...the chance of speaking to a cardiologist any time soon less so 🙄

[secondtry in reply to Barny12]

If funds allow, go private - appt usually within a couple of weeks, cost circa £250.

[Barny12]

That's not a bad idea. Thanks.

[JeanetteH]

Over 50 per cent of adults have a hiatus hernia and my gastro probs do seemto cause AF.Bending over would cause reflux.Mine is very near apex of heart.I eat smaller meals and avoid certain foods.But i take Omeprasole twice a day after being diagnosed.

[Barny12 in reply to JeanetteH]

Interesting. I don't think mine is a hernia as I had an endoscopy last year for other gut issues, but I agree that HH could well affect the heart.

[KootenayTrails]

My Afibs (prior to May 31st ablation, came every 10 days, then within 2 months came every 2nd day or daily) also often were preceded by a twinge/spasm type feeling. Confirmed by Kardia, event monitor (wore x7days) and ecg to be ectopic, specifically bigeminies. Found them quite distressing. None since ablation thankfully!

[Barny12 in reply to KootenayTrails]

Very interesting. Thanks.