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Time between Afib trigger & episode

MrBinks profile image
13 Replies

Hi all,

I've very recently been diagnosed with Afib (thanks, Apple Watch for highlighting the problem I'd never heard of) and have been to the GP/hospital since February to get a proper diagnosis. So far all my results are showing normal (blood pressure, Echo, blood tests, that sort of thing). ECG did manage to catch it twice to confirm.

I'm currently waiting for an appointment for the cardiologist. Wait time here in the UK is currently.... 52 weeks. Wow.

Oh, I'm a 44 year old male. Probably drank a bit too much, and am carrying some timber but not hugely so. I keep myself healthy with plenty of walking and last year I began interval training on the exercise bike and lifting weights.

Since recognising what I have, I have cut out caffeine completely, reduced fatty foods, and cut my alcohol intake by 90% and started taking bioprolol.

I'm still having episodes, and I can't help but feel they're random. So after the long winded bio my question really boils down to this: How long between what could be described as a trigger event and an afib episode is acceptable?

If, say, I had 2 beers and a glass of wine on Saturday night would it be fair to assume that an afib episode on Monday be attributed to that? Or is it more normal for an episode to appear straight away?

Thanks in advance.

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MrBinks
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13 Replies
Teresa156 profile image
Teresa156

Hi MrBinks,

Welcome to the forum, the club that nobody wants to join, we say 😊

Sorry you’ve found out that you have this and at a younger age too.

Unfortunately Afib can be a progressive condition and can definitely be random in the early days. You may go a long time between episodes, but it will usually always be lurking in the background. Many things can trigger it, most of us having to make lifestyle changes, which are mostly better for us, including dietary changes. Unfortunately and sadly this includes giving up alcohol. Alcohol is known as a trigger for a lot of Afibbers.

Large meals, late meals and too many carbs can also contribute. Triggers are often just that - and would trigger an episode quite quickly.

Who gave you the echo etc at your hospital, was it cardiology? Was it the hospital who officially diagnosed you? Did they fit you up with a monitor to wear for a few days? I wonder if the 52 weeks is the follow up, as it sounds like you have already seen a cardiologist?

p.s you can have normal blood tests, echo and ECGs with Afib, especially paroxysmal Afib, as in your case, which means it comes and goes.

MrBinks profile image
MrBinks in reply to Teresa156

Thanks for the reply.

I was given an echo by a technician at the cardiology department, but I'm yet to sit down with a specialist. I've had a "24 hour heart monitor" fitted, which was really only 12 hours before they wanted it back, and I didn't feel any bumps that day, so will assume that will be inconclusive.

I said 90% on the alcohol thing, but realistically it's a bit higher than that. I know that I definitely need to stay away from spirits, but hoping I can still have a beer every now and then. If not, so be it.

It definitely seems to me that if I have an episode it is often 24+ hours after I've done something naughty, or exercised harder.

Teresa156 profile image
Teresa156 in reply to MrBinks

Hi,

So the Cardiology Unit haven’t actually seen your Afib ‘in action’ on an ECG - it’s just your GP has seen your applewatch ECGs?

Triggers usually are fairly quick, not a day or so later…

Do you get them during the night?

It sounds like you haven’t ‘officially’ been diagnosed by the Cardiology unit because your ECG didn’t catch it? Is that correct?

If you haven’t been officially diagnosed by cardiology, because they haven’t caught your ECG, this is why I think, you’ve been put in a 52 week wait. Ideally, if you can, next time you get an episode, go to A&E. it’s not going to be pleasant going there I know, but they will hook you up to their ECG machines and you’ll get an official diagnosis. I’m afraid this sounds like what is missing.

In the meantime, we can drive ourselves mad working out the triggers for afib. We can get them anytime and cannot always pinpoint what caused them.

Once you have an official diagnosis, you should get put into the system to see a cardiologist sooner than 52 weeks.

I would suggest seeing one one privately, but as you haven’t been officially diagnosed, this wouldn’t be best for you at the moment.

MrBinks profile image
MrBinks in reply to Teresa156

Oh no, it HAS been caught on an ECG - which is why I've been put on bisoprolol. I think because of my relatively "young" age, I get the feeling I'm less of a concern to them (which isn't a great feeling!)

Teresa156 profile image
Teresa156

ah, so you have had the diagnosis - apologies.

Well, in that case….I’m really shocked they’ve put you on such a long wait. It shouldn’t be a year before you see a specialist about it. It won’t be your age sadly. It’ll be something in their system. It is usually months, but not a year. They probably think because you’re on Bisoprolol you are sorted. A cardiologist or EP should see you really.

In that case - and if you can afford it, your best bet would be to arrange an appointment with a private cardiologist or EP/Electrophysiologist. They usually all work for the NHS too and you’ll get seen quicker of course - and they should put you back on the NHS list for a proper follow up. Unfortunately a lot of us have to di this. This would be my suggestion. It costs around £200 for a consultation. A cardiologist/EP can also prescribe you something perhaps to help stop episodes quicker.

In the meantime, try and really limit alcohol or stop altogether and see if it helps your episodes. Avoid artificial sweeteners too, they can often trigger afib for some.

If not, it might be worth seeing your GP, asking for a chase/up quicker referral.

LowT profile image
LowT

are you capturing AFib episodes on your  WATCH? Do that and print out examples of them to take to doctors.

Create a sort of diary to get some idea of frequency and duration and precipitating events.

Until you get to cardiologist try magnesium citrate pills three times a day. That can stabilize cardiac irritability.

Sustained episodes are of greater concern.

Do you have sleep apnea?

Cavalierrubie profile image
Cavalierrubie

l had all the relevant tests before l was seen by a Cardiologist. I think they like all the tests in for diagnosis and treatment, if any. Alcohol is a well known trigger for AF,,sadly, but l can get away with a glass of wine now and again. Life style changes (sacrifices!). are needed, but we are all different in that area and you have to find your own way by trial and error. Stress is another big issue for it to raise its ugly head. There is a lot to take in, at first, but it does get easier, the more you are in control of yourself the better. Take care.

Buzby62 profile image
Buzby62

I never had much success identifying individual triggers, it’s more a case of multiple things all lining up to fill the AF trigger bucket. Distinguishing between triggers and coincidences is another minefield. If you are susceptible to AF then you will get AF and maybe not identify a trigger in my experience.

Alcohol is definitely not good for AF but for me it was not a trigger in itself but the hangover could be if overindulgence happened the day before but even then there may have been other factors helping to fill the bucket. Some find just a sip of alcohol can trigger them.

We’re all different and have to learn our unique version of AF, reading and learning as much as you can is my advice. I keep an update on my bio (click on my badge)

Link to Patient Resources heartrhythmalliance.org/afa...

I would start with the AF fact file

Best wishes

BenHall1 profile image
BenHall1

My social drinking was more than that, 2 beers and two or three glasses of red wine too ........... never ever activated my AF, even back in the day when my AF was very active.

Following a recent private Cardiac Consultant visit I hardly drink at all .......... in my 14 year long experience AF has a mind of its own and will have its wicked way just whenever it feels so inclined.

For me food was the trigger ........ and if I eat too much (forbidden food ) even today it might give me - at a minimum - some serious palpitations, but no full blown AF. Forget talking to a GP about food and AF triggers, they know damn all ........ best consult a Nutritionist.

So, to your final Q ............. more likely to be food thats kicked things off. Also suggest you read up on the Vagal Nerve ( if you haven't already done so ) ....... an information superhighway in the central nervous system connecting the brain - heart AND the gut. That's not to say booze won't but in my personal view not with the time lag you report.

John

Tellingfibs profile image
Tellingfibs

I usually have a glass of wine in the evening, and on special occasions have had two. This routine has developed after a fair bit of experimenting. When first diagnosed 6 years ago, I was drinking regularly - and more than one glass a day. I stopped on diagnosis because I didn’t want it to affect my Warfarin regime. I didn’t know then that it was an Afib trigger. However, I very slowly re-introduced wine into my life, without obvious effects. A while ago I decided to give it up though, and see if my afib or palpitations changed, but they didn’t. Back with the wine indulgence. Then I had a few days when circumstances didn’t allow for my normal routine, so no wine. I had a few unpleasant episodes and frankly, my Kardia showed no normal sinus rhythm at all during this time. I thought ‘well, I’m in Afib already so im going to damn well have a glass of wine ! Lo and behold, when I used my Kardia about an hour later I was in NSR ! Probably, the wine reduced the stress, which is the only trigger I can identify for my afib, and I’m not even certain about that. However, some people can’t even sip alcohol without it triggering symptoms. And so many people have identified really obscure triggers. I can’t spend my days researching the minutiae of everything I eat - I would be a nervous wreck; but in all this, it does emerge that everyone is different. Trial and error seems to be the only way to find out what your triggers are, and how quickly they become evident. Good luck.

Annie

DianeEM profile image
DianeEM

Hello Mr Binks, I found that most times the trigger was straight away, with the exception of stress which was always two days later.

Truth is it's a rogue condition with a mind of its own.

I personally would call the consultants secretary, politely explain your concerns and see if you can be bumped up the list.

Best wishes

Diane

needlestone profile image
needlestone

My triggers, artificial sweeteners aspartame and sucralose along with gluten/ wheat happen almost immediately. Also, high stress moments cause problems and immediately.

MrBinks profile image
MrBinks

Thank you for the replies everyone, this has been interesting reading and food for thought.

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