Longer episode than usual

[50568789]

Paroxysmal AF, on waiting list for ablation. Episodes have been roughly every 4 to 6 weeks, symptomatic, tight throat, shortness of breath, more rhythm issue than rate, which goes from normal 50 to 80/90. Usually lasts 2 to 3 days, then reverts to sinus.It had been a good 8 weeks since last episode and I was wondering what the delay was (didn't think I'd been a particularly good boy). Then last week on it came, probably due to a bit of effort gardening. But this time it's gone into a fifth day, can't shake it off, although it seems a lot milder than normal.

It's not causing much anxiety but am a bit suspicious of it being outside usual parameters. My default is to ride it out until it reverts, thinking it's just a blip, but interested in your good comments and advice.

[Hidden]

Tightness in the throat may suggest angina. Coupled with breathlessness, I would ring 111 for advice.

[50568789 in reply to Hidden]

Thanks, but angina has been ruled out previously, and the breathlessness is a fairly standard effect of AF (mine at least).

[mjames1 in reply to 50568789]

With your ablation coming up so soon, you are not going to go into permanent, however, all the more reason to contact your electrophysiologist now to see whether they want to convert prior to the ablation.

Jim

[mjames1]

I would give your ep a heads up now and schedule a cardioversion for a few days out. You can cancel if you convert naturally, but they probably won't want you in afib for too many days. At least my ep didn't, in the months prior to my ablation.

Moving forward, if your ablation isn't for several months, maybe time to ask for a daily anti-arrhythmic, or at least something like PIP Flecainide in case of future events. Hopefully, this will be a one off in terms of late conversion, but it could also be the beginning of a new trend.

Jim

[50568789 in reply to mjames1]

Thanks, Jim. That's my concern, am I going into permanent? Ablation is now only a few weeks away. Will see how to breakdown the walls of the NHS.

[CDreamer]

Please know that AF is progressive so having longer than usual episodes is not unusual the longer you have AF. That certainly happened to me.

The pain in the throat I can’t help you with if Angina has been ruled out. Could it be acid reflux? Tension build up in the body can cause a tight throat but if you are breathless I wonder if you are mouth breathing? Is the breathlessness also at rest or only on exercise?

AF is such so unpredictable and just when you think you got it taped, it goes and does something entirely different 🙆‍♂️

[50568789 in reply to CDreamer]

I've read somewhere that the tightness is to do with the vagal nerve, it's definitely an AF thing. I've had chats with others on this forum about it (will have to look back just to check my memory is right). Breathlessness is only on exertion (climbing stairs, walking uphill).

[Buffafly in reply to 50568789]

Cardiologist told me it is caused by ‘lack of capacity’ which I took to mean that my circulatory system couldn’t cope with the irregularity of supply. Affects both slow and fast AF if very irregular.

[Ppiman]

I can guess what your doctor would say if he were like mine (a good GP, though); but I guess all is well except you are becoming more "AFy". Persistent AF is on the horizon or nearer for many of us, I expect. Each time I have an episode, I wonder if it will stop.

I would, however, as I am sure you will be doing, phone your friendly GP for a chat.

I get similar symptoms to those you describe, but often with a higher rate varying from 85-160. The tight throat feeling is, I think, common enough and I have that, too; it might well be because your throat and heart are anatomically pressed tightly close together. When it occurs, and I get it occasionally, AF angina pain is caused by the temporarily reduced blood flow to the heart muscle in people where the arrhythmic atria affects the ventricular output a little.

Steve

[pip_pip]

When I have episode I get a tightness in the throat between the neck and upper chest, where the rib cage ends. I've always been told "you would do if your heart is going at speed". ! However I was given a GTN spray which was very useful at times.

Phil

[50568789 in reply to pip_pip]

When I was being first diagnosed the cardiologist gave me a GTN spray. First time I used it, it seemed to do the trick. Second time, not so good. The cardiologist said it was just a fluke the first time, if it was AF it wouldn't work, only for angina.

[OzJames]

are you on anticoagulants? My cardiologist said as soon as I go into AF start them and continue for 30 days after going back into sinus. I also start Flecainide and Metropolol which keep HR low and rhythm even until cardioversion. The only time I don’t take them is when episodes are really short like an hour. I’ve been advised that a clot can start forming after 24 hours. If my episodes go more than a few days then I’m in for a cardioversion. Up to 2022 I would self revert with short sprints within 30 minutes.

[50568789 in reply to OzJames]

Yes, have been on rivaroxaban for some time. As my AF episodes started to be more frequent, I asked about flecainide as a PIP but they didn't want to get me started on more meds and put me on list for ablation, while I was still young (ha ha).

[OzJames in reply to 50568789]

well I think todays 60’s and 70’s are more like 40-50 yr olds! Anyway my Cardio says that if we control rate and rhythm there is less chance of causing stress and damage to heart. Example when I went in for ECG after being on Flecainide and metoprolol for a week the technician said I was in sinus. I walked into the cardio’s room and he looked at the printout and said I was in AF and said almost looks like sinus with subtle difference showing the AF. From that day I understood what he meant by rate and rhythm control. I had the cardioversion a few days after that. He also did a TOE scan down my throat to ensure a clot had not started to form prior to the CV

[Pommerania78]

Do you take medicine like Flecainide and Beta Blockers? Thanks.

[50568789]

Atenolol as a beta blocker, plus rivaroxaban, plus various blood pressure meds, statin, lansaprazole, insulin. I do rattle a bit.