Weekly episodes, trigger ideas?

[Hallju]

It has been awhile for me to pop on here; however, I have perused through your library of expertise many times.

I have a pacemaker and take metoprolol for Tachy-Brady and now flecainide for aFib. I used to take flecainide (75 daily)to control my it…until it didn’t. So, in 2006, I had an ablation, which worked beautifully and eventually allowed me to go off my flecainide completely. Last year, it started back up again very randomly, so the dr started me on 100 flecainide PIP. THAT worked perfectly until the first part of 2023, when I started having weekly episodes (almost EXACTLY seven days apart) that took a couple of PIP doses to arrest it. At that point, Dr started me with 50 flecainide twice daily plus another 50 as a PIP. NOW (sorry for such a long back story), I have been having an episode on Saturday and/or Sunday. I’m back to the seven-day rotation for the past 3 weeks. The dr office said to take 100 flecainide as a PIP no more than twice along with my 50 Flecainide twice daily. They “aren’t concerned” that it is happening weekly IF I can stop it with two PIP doses.

All that to say, I AM concerned! I hate having my weekends impacted and haven’t gone to church in three weeks. I have wracked my brain to discover the weekly trigger. Any thoughts (if you made it through this lengthy post?)

[Buffafly]

Great info in the back story, really helpful. I wish I could be helpful too! But the only thing I can think of is that it’s like the notorious ‘weekend migraine’ or cold that attacks as soon as you relax 🙄 What lower limit is your pacemaker set at? I believe some people tend to go into AF when their HR goes too low, obviously with the pacemaker it can’t go very low but the AF might sneak in before the pacemaker kicks in - don’t know how quick that is but it would be interesting to get a pacemaker report to see if there’s a regular change? Just my personal little theory, hopefully someone will come along with a better idea soon.

I feel for you over the weekend, I have bouts of a chronic illness which keeps me at home for weeks sometimes and apart from your own frustration you have to explain why you’re not turning up. I have been to church while in AF but it’s not a jazzy church, I just sat all the time and was pleased to have an excuse not to sing ☺️

[Hallju in reply to Buffafly]

That’s an interesting thought about the pacemaker. I always feel woozy/drunkenish when I try to get up. That’s always the indicator that I’m heading into AF. I will have my EP check on that at my next appointment. And, you are so right about having to explain about why I’m not there. It just adds to the frustration of not being there.

[Cavalierrubie]

Sorry to hear of your plight. It does seem strange that you are having this every weekend. The only trigger l could reason with is mind and association. Every Friday that comes could be making you apprehensive and causing you anxiety and stress which probably triggers your AF. It could have been coincidental at first but now every weekend is a dread. If it is this, l hope the cycle breaks soon and you get your confidence back. Love and prayers.

[Hallju in reply to Cavalierrubie]

For sure!! I start worrying about missing out on the weekend activities and could be making myself anxious with a self-fulfilling prophecy of sorts. I’ll try to start anticipating an AF-free weekend. Thank you for your prayers. I really appreciate that!

[Cavalierrubie in reply to Hallju]

Also you will be worrying about not getting to Church and being with your church family. When it goes on for a few weeks one can get more and more amxious. Well, l do. It can be so frustrating. I always say l am unpredictable and unreliable. It’s not how we want to be. I am sure you will be ok and get over this little blip. God bless.🙏🥰

[Ppiman]

I am guessing that your symptoms aren't pleasant and that you need to try to curtail the AF? I ask because I have read many times on this forum and elsewhere that treatments are only to alleviate symptoms and do nothing for the cause, which usually remains a mystery. To get it once a week seems odd although I well recall being told by a lovely specialist many years ago that Saturday was the day when many people feel ill owing to natural reductions in cortico-steroids brought on by psychological changes triggered by the end of the working week.

My own AF, so far, is either quite mild, or, when I get fast tachycardia with it, of quite short duration (an hour or so), or it has occurred before bedtime, so it hasn't impacted my life too much and allowed me to sleep while it subsides. Mine currently responds quite well to increasing my dose of bisoprolol, which is good as I was told that I cannot take flecainide.

Steve

[Hallju in reply to Ppiman]

I wish mine would just do its thing while I’m sleeping. Unfortunately, it often wakes me up in the wee hours of the morning, and then…I start the process of medicating to try and stop it. As I’m retired now for four years, my activity during the week is pretty low, so as logical as that trigger would be…it doesn’t seem to be the case with me.

[ozziebob]

Perhaps there's an unknown mind-body interaction that has so far remained elusive to your investigative skills. 🤔

I myself seem more vulnerable to AF near the occasion of a new moon, but even knowing that, other than particularly watching my hydration (tides etc.), a resolution is as elusive as ever.

Good luck with your "research".

bob

[Cavalierrubie in reply to ozziebob]

Your post made me smile.😀 Even Sherlock Holmes would have difficulty with this one l think! The biggest unsolved mystery ever.😂

[Hallju]

We are having extremely hot temperatures for our area (high 90s to low 100s F), so I wondered if needed to stay more hydrated. I’m working on that. I taught teenagers for decades and grew up in a farming community. I’ve watched the moon phases impact both students and animals; perhaps, that is the simple answer to all of this. Thanks for that thought.

[ozziebob in reply to Hallju]

I imagine this Reply was meant to be addressed to me, but you just made a general Post. I also have to take care to find the appropriate Reply option in order to direct my words to the correct Forum member. Then that member should receive a notification of your Reply, and locate it. Otherwise it might be missed.

Just saying.

I was pleased that you took my moon suggestion seriously. Some people are more aware of the moon's influence on our psychological and physiological systems than others. Students of astrology would also agree on this.

[Hallju in reply to ozziebob]

Oops! I see that you are right about my reply. I hope I did it right this time. 🤦‍♀️

[Hallju]

I really appreciate all of your thoughts on this. Perhaps it is a combination of each of these. I am retired and spend most of my “work week” days inside our nicely air-conditioned home…until the weekend when my husband is home and we run errands, go to dinner, social events, etc. Maybe I am reacting to the opposite of Ppiman’s theory. My weekends are more stress-filled (or least more hectic) than my weekdays. You are a great bunch! Thanks for your very-helpful input of ideas. Here’s to a great weekend for all of us!

[Cavalierrubie in reply to Hallju]

Bless you and thank you. Xxxxx

[Kernowafibber]

If this is vagal and comes on overnight m, are you able to load the flecainide dose so that you can take more before bed? This worked with me for a while.

[Hallju in reply to Kernowafibber]

That’s a good thought. I need to check with my doc on that.