longest bout of AF , am I doing the right thing?

[Kjsp]

Hi everybody,

Before I begin , I wish everybody a merry Xmas and a happy healthy new year!!

My Xmas present has come early this year with my longest bout of AF ever! 40 hours and still going . I have an ablation booked for 18th January at St Bart’s , it will be my 3rd.

A brief outline is I have had a AF since 2016 , when it was discovered after a TIA. As a fit gym bunny and marathon runner it was a shock but I have curtailed my activities over the years , but still try to keep fit. The first 2 ablations improved my condition and up until early this year were 2 to 3 a month which I could terminate with PIP flecanide and metropolol . However over the last 4 months my episodes have rapidly increased and now are happening every couple of days and lasting a lot longer . I have a resting heart rate of 37 to 40 so beater blockers unless in AF are a no no for me. . With this episode the PIP strategy is obviously not working , but I have continued to take 100g Flec and 25g Metropolo to keep myself at a reasonable rate 80 to 115. This may not seem high to others but given my resting heart rate this is bearable. Obviously with Xmas on the doorstep and all my family expected anytime this afternoon I feel comfortable enough to weather this storm . I’m just concerned I’m doing permanent damage but can’t see what my other options are as ablation is imminent. Just wanted some words of wisdom and opinions from any of you lovely people. Thankyou for listening xx

[BobD Volunteer]

Your rate is not particularly high since "normal" is 60 to 100. Unless you have any chest pain or fainting feelings I think you are doing OK and the last thing you want at this time is A and E. Drink plenty of water and rest as much as possible.

[Kjsp in reply to BobD]

Thanks Bob , my sentiments exactly , A and E to be avoided.

[Jalia]

I would agree with Bob. I went into AF on Christmas Eve a few years back and ' weathered' the Day at about 140/50 from memory. I presented at A&E on Boxing day evening , still going strong and was dc cardioverted.

Happy Christmas! Hope all goes well for you.

[Hidden]

Totally agree with Bob, the 18th Jan is not far away and there should be a few pleasant distractions between now and then. You couldn’t be in better hands as you will know if Barts have been looking after you so far. Avoid A&E if possible if for no other reason than there are a lot of bug’s flying around at the moment. The last thing you want it is to catch something that might prevent or delay the procedure……good luck and enjoy the holidays.

[Thomas45]

You say that beta blockers are a "no no" and then tell us you take metropolol which is a beta blocker. I would go along with Bob"s advice.

[Gumbie_Cat in reply to Thomas45]

I had to be more careful with beta-blockers while in paroxysmal AFib, as my heart rate would plummet when going back to sinus rhythm. Could only take a tiny dose. Now that AFib is permanent, I take a moderate dose daily.

I believe that Kjsp can take them alongside the Flecainide while in AFib, but not while in sinus rhythm, as it would lower the HR too much.

[Thomas45 in reply to Gumbie_Cat]

I merely stated that Kjsp had stated that beta blockers were a "no no" yet she was taking one. I was never prescribed beta blockers while on Flecainide as I have chronic asthma. I have been in permanent AF for 7-8 years.It was after my heart rate had risen over 190bpm during an operation to remove my appendix, that a well-meaning hospital doctor, status not known, prescribed Bisoprolol. For the first 7 weeks, it appeared to have no effect, then on Christmas Eve, about five years ago I had the first of many painful rashes. They occured everywhere apart from my face. They'd last for about 2 hours in one area, then go and appear elsewhere.

While being weaned off Bisoprolol I had the 2nd side effect, exacerbation of asthma. It came on very suddenly. I'd parked outside a pharmacy to collect repeat medication when very suddenly I was gasping for breath and had chest pains. An ambulance was called and I spent three days in hospital. The GP practice which run my local medical centre, and a few others have their own researcher who found that if you've had reactions from one beta blocker, you'll get very similar reactions from other beta blockers, so I was taken off all beta blockers.

My sole medication is an anticoagulant, Warfarin being my choice. I have my own INR meter so can check it at any time. Today I will be eating quite a bit if vitamin K, Brussel sprouts, broccoli, peas, etc. My main meal will be a casserole of vegetables, currently cooking in the slow cooker.

[Gumbie_Cat in reply to Thomas45]

Yes, I believe they’re not good with asthma. I just meant that the OP said ‘a no-no unless in AF’ - due to low HR in usual rhythm presumably. This was similar to how I used to be.

[Singwell in reply to Thomas45]

She's taking metropol as PiP with the Flecainide is what I understood. Common strategy time avoid triggering atrial flutter.

[Thomas45 in reply to Singwell]

I was merely stating that she says that beta blockers are a no no, and then tells us she's taking one.

[wilsond]

In my non medical experience, you ate not especially high rate. I went through 2 x5 weeks of AF,and no damage. Your ablation is en route.Weather the storm, try to distract yourself, not easy of course,but helps.

Best regards

[Singwell]

I concur with what others have said. You have a strategy, keep using it and aim for others to help out more this Christmas. No booze alas, and maybe avoid too much high sugar content. I used to find glucose lows would set mine off.

[Vonnegut]

100mg of Flecainide taken twice daily has virtually put an end to AF episodes for me though I’m an old woman of nearly 80! Hope you find something that works for you as that would be the best present for the new year and the years to come!

[execz1]

Merry Xmas to you and all the readers of this post . I am sorry to read about your Xmas afib experience.

Since you already have two ablations and you have such lengthy episodes, I would highly recommend a Wolf minimaze consultation. I join all the others to urge you to ignore the episode and enjoy the holidays with your family and friends.

[FSsimmer]

Hi, I wish you well and feel your concerns. I was a 'runner' prior to developing Afib almost 3 years ago.

My resting rate was about 45-50 bpm and I did at least 5-10k non stop runs each week. I now continue at the gym but do brisk walks....I am almost 70 though.

That said from the night I went to A&E feeling rough and was diagnosed with Afib I have never been out of it!!.. My ablation ( I have had one and am listed for cardioversion ) lasted one week in NSR, then back into Afib. Your resting rate is not high, so I would not be too concerned.

Have a chat with you EP/Cardiologist...I worry the other way, as my RHR is now about 80 bpm at rest...Afib is controlled either by sorting out the heart rate or the rhythm. It often takes a while to get you on track....Remember also that Afib is progressive, but that does NOT mean you cannot live an active and productive life with it...Take care

[Kjsp]

Thank-you to everyone who took the time to reply or comment! It’s now morning of the 27th and pleased to say back in NSR. That was a long bumpy 6 days! I’m sure there’s more to come.

Wishing you all

A happy healthy new year 🥳