The lecture of EP John Mandrola’s testimonial made a huge difference when I was first diagnosed with the condition. The man knows what he’s talking about, because not only is he an experienced electrophysician, but he also experienced AF himself. I love to share his thoughts with this wonderful group of friends:
13 things to know about Atrial Fibrillation
“Here are 13 things I tell AF patients.
I am sorry that you have AF. Welcome to the club, there are many members. (Three million Americans and counting.)
I know how it feels.
Your fatigue, shortness of breath and uneasiness in the chest are most likely related to your AF.
AF may pass without treatment. Really.
Important new work suggests AF is modifiable with lifestyle measures. As in, you can help yourself.
AF isn’t immediately life-threatening, though it feels so.
Worrying about AF is like worrying about getting gray hair and wrinkles. Plus, excessive worry makes AF more likely to occur.
Emergency rooms treat all AF in the same way. One hammer — often a big one.
There is no “cure” for AF. (See #5)
The treatment of AF can be worse than the disease.
The worst (and most non-reversible) thing that can happen with AF is a stroke. For AF patients with more than one of these conditions: Age> 75, high blood pressure, diabetes, heart failure, or previous stroke, the only means of lowering stroke risk is to take an anticoagulant drug. Sorry about the skin bruises; a stroke is worse. Know your CHADS-VASc score.
The treasure of AF ablation includes eliminating AF episodes without taking medicines. But AF ablation is not like squishing a blockage or doing a stress test. It will be hard on you. It works 60-80% of the time, has to be repeated one-third of the time and has a list of very serious complications. UPDATE: Read Dr. John’s essay on ablation (March 11, 2017).
If your AF heart rate is not excessive, it’s unlikely that you will develop heart failure. Likewise, if you have none of the five risks for stroke, or you take anti-coagulant drugs, AF is unlikely to cause a stroke. In these cases, you don’t have to take an AF-rhythm drug(s) or have an ablation. You can live with AF. You might not be as good as you were, but you will continue to be
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I was diagnosed with permanent Aflutter in2006 after many cardioversions in hospital which worked each time but came back later .I was eventually cured in a couple of years later but still have proxy Afib even after an ablation in 2010. Had to make drastic lifestyle changes over the next decade . Started with food and drink and the then with work especially shifts .Eventually had to give up shift work and even my job of 40 years as it was shift work or the highway .And then the mind , after a number of years treated it like you treat a headache and got on and enjoyed life. I was able the to bring alcohol back in significant quantities without problems too. Found lager to be a kill or cure along the way . We were on holiday on a Greek island just about to go out for the evening and it kicked off so not to spoil the party I suggested a couple of swift ones before the meal and the lovely ice cold lager did the trick. Incidentally found out about the lager trick back in 2006/7 when they had tried every drug under the sun I found while on holiday going into aflutter on the first day didn’t want to spoil it for the family and thought may as well have a few drinks can’t do anymore harm and may help me sleep then surprise, surprise after a couple of pints heart rate returned to normal .Happy day!
Cold drinks are known to solve the problem for some people, indeed. In my case, with vagally triggered AF, one sip of a cold drink can start an episode, though!
In some people, the oesophagus presses tightly against the atrium, so a cold drink might also work by either chilling, or through natural peristaltic movement, pressing the atrium bringing it to return to normal rhythm.
Drinking can certainly can set of ectopic beats, as it did with me causing the arrhythmia nurse to comment when I gulped tea, so perhaps it can stop AF or AFl?
I hadn't had a breakthrough after a successful ablation until well over a year when I had a frozen yogurt. I'm sure that that is what sent me into Afib. It went away after a couple of hours but wonder what I could have done to maybe have helped it to cease sooner. Any ideas?
Thank you, I did take a 100 "pill in the pocket". I cannot take it continuously because it just about did me in before I had my ablation and my dr. had my taking it. It was terrible, hence the reason I quit taking it. Blessings to you...
All so very true. I’ve have suffered with AF since 2008 after OHS and I’m still here. I do also have a small Aneurysm and HF, and grade 4 out of 9 on the CHAD SCALE, so I was fitted with a Pacemaker a few months ago.
exactly. Depending on the kind of AF (adrenergic or vagal) the triggers can be exactly opposite. Vagal AF is triggered by a vagal nerve that is too active (relaxation, sleep, full stomach, …) while adrenergic AF can be triggered by strenuous exercise, stress, excitation, … And then there are the mixed forms, where both types of triggers can precipitate an episode. Quite complicated, and sadly enough rarely taken into account by cardiologists and EP’s.
Thanks for the great article. It pretty much conforms to understandings and treatment decisions I have made for myself after about 4 years of dealing with PAF.
My best defense is to keep the weight down and avoid getting a build-up of stomach gas and bloating. I have celiac disease and issues with gluten and other gas-producing foods, which I try to negotiate around daily.
I too have coeliac disease and have found my AFib kicks off every time I'm away from home. I'm house sitting for a friend right now and have been quite unwell. I've come to the conclusion that any time I eat away from home I am gluten exposed via cross contamination and the resultant inflammatory response kicks off my AFib.
I feel that. however much they may assure me that they have the 'gluten free' thing covered, it's too difficult for the average commercial kitchen to avoid cross contamination. It's very frustrating! I'm used to having my coeliac disease be triggered but the addition of AFib over the past couple of years is making travelling at all very problematic.
I have had the same experiences, as well as often having problems when friends or family assure me they have made a gluten-free meal. Here in the US, restaurants advertise gluten free, but when you get there you read the "fine print" on the menu that says they can't guarantee it. My issue makes me feel like a rain cloud at the Sunday picnic!
I have taken simple turkey/ham and cheese sandwiches on trips and eaten them in the cafe while my family ordered from the menu. I think a new industry could emerge from preparing and selling "travel-food" bags or boxes of non-spoil , gluten-free items for those with food allergies and restrictions. I no longer do more than day trips. When you put together the fact that your digestive issues will not only bring discomfort, but also Afib episodes, travel becomes perilous. I have never met a medical professional who thought or cared much about that syndrome, but it must plague many of us.
thanks for posting… I too have found the cold thing can work to flip me back into sinus, mind you it’s a cold swimming pool, maybe I should try the pint trick first!
I’m trying a new approach besides the mind body and soul things I’ve started taking a very low dose of Flecainide about 20mg twice daily since my last cardioversion start of February along with a low dose of metoprolol 10mg twice daily.
I also listen to John Mandrola on Medscape. His researched viewpoint on the state of medical evidence is always a highlight. He also relates to those with AF and I quote his experience with AF below:
"The arrhythmia passed as mysteriously as it arose and now an arrhythmia doctor stands educated and certainly more empathetic. Sometimes life can make one a better doctor."
After the stroke caused by Thyroid cancer which caused AF
I was left day on Metoprolol which I said no to, but ignored with Heart Rate 185!
1 year 4 months I asked for Heart Specialised, ECHO, ECG, 24 hr Monitor. M.. caused pauses at night when my H/R avg is 47. It caused breathlessness with any exertion, fatigue, walk interrupted by 'couldn't go further'.
Changed to Bisoprolol, then up to 10mg, H/Rate Day 156. Night without pauses @ 47 avg Night.
No one was listening so the Locum suggested a Private Heart Specialist.
Introducing CCB Calcium Channel Blocker Diltiazem which was balanced down to 120mg AM for control H/Rate
and
BB Bisoprolol 2.5mg PM for control of BP.
Bingo success.
A lesson ask immediately for Heart Specialist after Stroke or high H/Rate at rest over 100.
No ablation, no cardiversion or no anti arrhymnic meds for me also I can't because I now have an abnormal heart structure. I have no longer rapid but persistent AF. AF controlled and no symptoms except walking and exertion - take it easy.
yes totally agree ... first lesson is ask for referral to cardiologist ... second is to drink a large glass of ice cold water ...
My dear GP evidently thought I was just an anxious old lady, after 8 months of not figuring out what the night time 'palpitations' were, he had little evidence to go on. I subsequently learned I have 'vagal type' of PAF, always at night, or early morning, when pulse is low, and ambulances slow .. so when I asked GP for referral to private cardio he gave me a sad look and said 'you'll be going down a rabbit hole' I told him that i need to know what's this earthquake in my chest is all about, if it's not cardio maybe it's squirrels in there ..
Private cardio suggested implanting a sensor or getting Kardia, on the second appointment he glanced at my Kardia ECGs and diagnosed paroxysmal AF. Immediately put on Edoxaban (and Verapamil which I couldn't tolerate) after a spell in hospital I now have Flecainide PIP.
My nhs cardio is brilliant, listens and answers questions .. he said the vagal type AF is generally less likely to be 'progressive' but no guarantees of course. According to him 60% of patients with AF are progressive. I am in awe of those who have the courage and patience to deal with persistent or permanent AF and keep smiling ...
Apparently drinking cold water and splashing ice cold water on the face can return AF to normal, I think it has to do with the vagus nerve. The first thing I do when in AF, is drink a large glass of very cold water, and then sit down to deep slow (yogic belly) breathing - if that doesn't work (after 30 mins) I reach for Flecainide ..
I love that nhs website describes AF as 'uncomfortable' ... I would call it terrifying. Maybe they're just listening to asymptomatics?
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