paroxysmal atrial fibrillation converted back to sinus rhythm

[Dizzy3]

Hi, I had a really awful Afib attack that resulted in a fast heart beat the other night. The morning after I took my medication and about an hour later my heart reverted back to sinus rhythm but for a few seconds I nearly passed out and remained very dizzy for the rest of the morning. It almost felt like my heart stopped for a few seconds and was very scary. Is this normal for someone going back into sinus rhythm? It's never been as intense as this before.

[BobD Volunteer]

Often reported, usually due to a short pause in heart beat.

[jeanjeannie50]

It can be normal for some to feel a little odd as they revert back to sinus rhythm, but I don't think feeling dizzy for the rest of the morning is normal. Having said that I can remember feeling really dizzy for several hours after getting out of bed some mornings and my GP called it vertigo but I knew it wasn't. I now think that going from lying in bed to getting up needs to be done slowly. I sit on the side of the bed and take a pill that's due. Have never had any more of those attacks since doing that.

Chrystal's that become misaligned in our ears and cause dizziness because of movement, can be encouraged to move back to where they belong by some exercises that are on shown on YouTube.

Jean

[Paulbounce]

Hi Dizzy.

No, it's not abnormal so try not to worry too much. It sounds like you have PAF when it can hit you like that. You are back in sinus - spot on. If you do faint though call 999. I always carry a mobile in my pocket just in case. I have never needed to use it yet.

You'll be fine Dizzy I feel.

Paul

[secondtry]

I would keep a diary of events before and after an AF episode (if your memory for such things dislike mine 😆) and then if it happens again you have got some info for your medic, better info better result.

[bean_counter27]

According to Dr AFib.....

"The third way in which you can pass out is actually not because of atrial fibrillation, but because atrial fibrillation stops.

This is called a conversion pause. In this example, if a patient has episodes of AFib that come and go, but when the AFib actually stops, your natural heartbeat may take several seconds to start kicking in. It’s like your natural heartbeat is just also just so tired from being in atrial fibrillation, it takes several seconds for it to start kicking in again, and start having a natural heartbeat. This can lead to pauses that can last three, four, five seconds, sometimes longer, before the natural heartbeat starts kicking in again. This is the most common reason that I have seen people passing out from atrial fibrillation, its this actual pauses that happen when the AFib stops, and your natural heartbeats is too slow to kick back in again."

I would report any significant symptoms like these to my doctor for investigation. If nothing else, being investigated and actual issue confirmed/identified should either give you peace of mind if it occurs again or if need be, action taken to prevent it happening again.

[President2012]

that could be a pause in your heart beating when converting back to normal sinus. This can cause a strange rush in your head and a feeling you are going to faint. It could cause an actual faint (syncope). I would advise reporting this to your cardiologist or EP. Take care and best wishes.

[Bruce11]

Hi Dizzy3,

If you are worried about falling from fainting and want some piece of mind, I would highly recommend getting a smart watch with fall detection if you have an iPhone the Apple watch series 4 onwards has the feature as well as ECG, you can buy refurbished ones off eBay fairly cheaply. If you don't have an iPhone there are other devices you can purchase, a quick Google search will bring up some results for your area.

FYI here are the features of the Apple watch: support.apple.com/en-asia/1...

[Vonnegut]

If you get Flecainide to take when an episode starts as a “pill in the pocket” it should stop it in a couple of hours and you wouldn’t have to wait until the morning to take medication!

[Dizzy3 in reply to Vonnegut]

I take regular flecainide 100mg twice a day. They have not advised me to take any extra if I experience AF. Maybe I should discuss this with the arrhythmia specialist

[Vonnegut in reply to Dizzy3]

It has only happened to me once well over a year ago when I must have been infected with covid with no other symptoms but a positive test and it was fine to take another 100mg as a PIP as the maximum daily dose is 300mg so I didn’t exceed it and it ended the episode in a few hours.

[Racquet]

Yes! Now I look forward to those awful few seconds. That signals right atrium AV node taking back control. Don’t fear it; wait for it!

[Della71]

Yes, I have always converted back on my own. My last episode lasted 6 days when most have lasted only minutes or even seconds. I was scheduled for a cardioversion but it wasn’t necessary even after 6 days. Some episodes are far more intense then others. I have had episodes when my heart rate went to 300. It’s a very erratic condition without any hard and fast rules.

[Cavalierrubie]

My friend’s son passed out with his AF. It does affect some of us like that. It must be scary for you when it happens, so hope others put your mind at rest.

[Auriculaire]

Yes - I have had feelings of dizziness when going back into NSR. They have not been very strong or lasted more than 2/3 seconds. I only seem to get them if I am standing up or walking about.

[Ppiman]

Your doctor would ask how the dizziness presented itself - when and what symptoms (spinning, woozy, etc). Also, whether it came on when you stood up or similar. If this latter, I’d guess it’s either caused by a temporary low blood pressure or from your heart still recovering from the AF episode. Fast AF can reduce the efficiency of the heart, I believe, and that can take a while to recover.

Have you spoken to the surgery, yet? if so, what did they advise ?

Steve

[Dizzy3 in reply to Ppiman]

yes I spoke to arrhythmia nurse who said it’s a pause before going back into sinus rhythm. Still scary though

[Ppiman in reply to Dizzy3]

Having read around this a little, it seems it isn't so very uncommon but, if it does come more common, it would be worth having further investigations done.

Steve

[ClareGott]

I used to see a blinding white light and almost pass out every time I went back into sinus rhythm

[Saltcoatslass04 in reply to ClareGott]

I have just read your post about 'the white light ' and have to thank you as I have have lots of episodes like those and couldn't understand what was happening. There has been times I thought there was someone shining a flash light into my house.

It all makes sense now (well sort of)

As 'Racquet ' mentioned for those few nasty seconds the feeling of relief that your episode is over.

Don't think I will ever get used to the horrors of PAF. but this site has helped me and I imagine many others to under better what is going on .

Thankyou

[Dizzy3 in reply to ClareGott]

hi sorry for the delay in responding I don’t seem to get notifications anymore for some reason. I spoke with my arrhythmia nurse and she said it’s normal for some people to experience a pause before going back into sinus rhythm.. but it’s still very scary 😟

[KootenayTrails]

Yes happened often to me. Darn scary. Per my EP Team here in Canada, was the main reason I was flown to a Cardiology Hospital for angiogram (to rule out blockages as cause of fainting/dizzyness) and was triaged up the one year ablation waiting list, to 3 months, so quickly. Need for pacemaker ruled out for now. Not one AF/ectopic/dizzy episode since ablation May 31st and resting HR higher (55’ish rather than 48-50). Agree you need to report all these occurences so they can triage you appropriately. Best of luck.

[Desertflowerchild]

I understand it is called a conversion pause.