paroxysmal AF

[Caradomben]

Has anyone gone from paroxysmal AF to permanent AF. I haven’t had and episode for over a year but I had breast surgery last week and went into AF one day later. My pulse before was 45 resting but has gone to 90 ish but the thumping has stopped. Had anyone had this happen to them and what treatment was prescribed . I am already on 5mg apixaban 100 fkecainide twice a day and 1.25 mg bisoprolol . Waiting to see what the plan is now

[jeanjeannie50]

Yes, I went from paroxysmal AF to permanent about 4 years ago. To be honest I prefer being this way as now it's much easier to cope with and my body has got so used to it that I can just about forget I have AF. I'd had lots of cardioversions and one year when I had two and then needed a third a few weeks later, I was told I wouldn't be offered any more. My PAF attacks used to be very debilitating.

I was recently taken off of flecainide as my cardiologist said the tablets were causing more problems than helping. Feeling better than ever now and just on 1.25 Metoprolol daily. My resting heart rate now flits between 60-90bpm.

I did change my diet drastically too and for many years have not eaten or drank anything that contains artificial additives.

Jean

[mav7]

Like jean, I went from paroxysmal to permanent AF as many do. Try to relax and don't let the stress of worry be a factor.

Prior to your next evaluation, would be good to contact your doctor or nurse to possibly increase the dosage of bisoprolol to reduce your resting heart rate from the 90's.

[mjames1]

You've only been in afib a week, so that's not "permanent" afib. It's barely persistent, maybe even still paroxysmal, as before. Your breast surgery probably triggered things which is not unusual. My guess is they will either tell you to take an extra one time dose of Flecainide to convert, or if that doesn't work then cardiovert you. After that, hopefully you will do fine as before on the current meds.

Moving forward, many of us on daily Flecainide have an as needed Pill in Pocket (PIP) plan for situations like yours. For example, where you take "x" additional mg of Flecainde when an episode begins and then take "x" more an hour later, if still in afib. Ask your doctor about such a plan for any future episodes. Not unusual to have an episode here and there when on daily Flecainide. Doesn't mean it isn't working, just means it needs a boost from time to time. Think you will be just fine

Jim

[Threecats]

Hi

Rather like you I hadn’t had an AF episode in about 10 months. When I did get them they were very dramatic but, as I say, I’d been free of them for months after starting treatment for sleep apnoea. I was therefore, quite surprised when, one Saturday afternoon in early February, my ticker quietly slipped into AF and there it’s stayed ever since! As Jean says, I also find it rather easier to deal with constant AF than I did the paroxysmal variety - not something I thought I’d ever hear myself say!

All the best to you, TC

[Florence-Nightingale]

Hi Caradomben. I suffered from PAF for 3year then went into permanent AF. I have to say I feel better in permanent AF than I did inPAF due to the unpredictability of it which would really freak me out. I take Apixaban 5mgs twice a day ( which by the way is the usual dosage as far as I’m aware ) Bisoprolol 5mgs a m 3.75 pm plus meds for my BP. I am 72 yrs old and do have days of complete fatigue like most people on here would admit to having with this condition and get breathless on walking uphill but apart from that am ok. My decision was not to have an ablation but many on here have had them with varying degrees of success each to their own. I wish you well

[opal11uk]

Yes. I have and I can only put it down to the fact that I had a trauma fall a year ago necessitating total hip replacement and, as far as I know in perm P/A/F since then, I am also in heart failure so my dosage of Bisoporal has been gradually increased from 2.5 mg to 10 mg. I had not experienced P/A/F since having a Pacemaker fitted 8 years ago so it came as a bit of a shock when my symptoms of breathlessness, dizziness and a cough, after lots of misdiagnosis by the GP and Nurse Practitioners testing everything other than my heart, it came as a bit of a shock! Will know more next week when I have two appointments with Cardiology. Good luck

[DevonHubby1]

Wife went from paroxymal to persistent in March. No obvious trigger. Bisoprolol increased from 2.5 is to 7.5 mg once a day. Wife found in severely impacted her QoL. Tired breathless, heart rate all over the place. Managed to see a cardiologist who switched her to Nebivolol which has improved things but still quite life impacting. Waiting for a cardioversion now.

[RoyM]

I suffered PAF for many years and all the usual difficulties that comes with it. During May 2016 I went into Permenent AF and immediately felt better. I did have a cardioversion which put me in NSR for all of 11 hours I discussed with my EP the way forward. We agreed no further treatment was necessary, my QOL was good. My medication consists of Apixaban and 1.25 mg of Bisoporol daily. I have a resting heart rate between 60 and 65 BPM and normal range blood pressure. I am able to swim, walk miles and more importantly I can chase my grandchildren around without difficulty. Wo LPuld I prefer to be in NSR ....most certainly. But being in Permenent AF rather that PAF for me is far better. We are all different. Regards Roy

[Thomas45]

I went from paroxysmal to permanent several years ago, after approximately twenty two years of paroxysmal.I now take only Warfarin. I had a bad experience with Rivaroxaban. I was told to stop taking Flecainide which I'd taken for the previous 12 years. I intentionally lost weight, which means I don't have the shortness of breath that I used to have. I have other ailments but the one which affects me most is foot drop of my right foot, which affects balance. I can't carry shopping so my weekly food shop is delivered. I can get around on foot and public transport. I forget I have permanent AF, though of course keep taking the Warfarin. I have stopped eating meat, apart from fish. I eat vegetables and fruit, though not tomatoes or oranges as they give me urticaria, "thanks" to Bisoprolol which I was once prescribed. I'm 78 , and happy.

[Fibber222]

Hi Caradomben I used to have paroxsysmal Af which converted to persistent when I fainted one day. I was on Apixaban twice a day, Sotolol twice a day and Flecanide. Plus a BP tablet. However, now I tajevApixaban 5mg twice a day, bisoprolol 5mg once a day and my bp tablet. My electrophysisist took me off the flec when I converted because he said it wouldn’t be helpful anymore. I also had a pacemaker fitted as I had beeen having dizzy spells resulting in me fainting. I would be totally guided by your cardio and get checked out before doing anything yourself. Personally I can cope with persistent far better than paroxsysmal af and my cardio nurse tells me it’s unlikely to go back to paroxsysmal now. Hope all goes well for you on all fronts x

[djmnet]

I've been persistent/permanent for a few years now and it is much easier to tolerate than random/paroxysmal episodes. Resting heart rate is 75-85 for the most part, and around 130 with exercise. I take only 180 mg diltiazem to keep my heart rate in check. For the most part, I'm never aware of my afib any longer. But it doesn't sound like you've necessarily reached that point, as your surgery was the likely cause. Frankly, you should probably hope that you are becoming persistent/permanent!

[Swimsyroke]

Hi I went from paroxysmal to persistent, now permanent afib in August 2021. I was not offered any treatment and I only managed to see an EP this year. He is happy for his patients to find their own path which I did partly from his help, also from information gained from this site and one or two letters to the EP. I have tweaked my own drugs with his approval, take 30 mg of Edoxaban and 1.25 bisopropol twice a day. Whereas before I was frightened to do exercise, eat certain foods or even sit in a chair because I worried it would trigger the afib , I now can eat lots more variety of food even Indian and Chinese drink half a glass of wine, play golf, swim, do yoga etc and I never think of my afib. I have never felt better and even though I may get a bit breathless walking up an incline at 77 I think I would without the afib. So all those of you who are worrying about persistent afib it may be the best thing that happened to you for a long time. It certainly was with me.

I wish you the best of luck in your journey.

[Caradomben]

thank you everyone for your replies . It’s reassuring to hear all your stories which are similar to mine. Been discharged from Cardiology with an increase to 5mg of bisoprolol and my usual 100mgs Flecainide. Anyway .unable to have a cardioversion like I usually have due to disruption in blood thinner prior to my surgery . Just feeling exhausted now but this is to be expected . Probably take a few days to let the higher dose of blocker to kick in.?