Hi, up until this point I’ve have PAF which normally last 1-5hours but since Thursday night I’ve had it and it hasn’t gone away.
Ive had a mild case of diorehrea since Wednesday/thursday which I guess could be linked. Have started taking diarlite today which looks to have helped that side of things and keeping myself hydrated. Any recommendations on what i can do other than the obvious deep breathing etc? Worried as I’m going on holiday abroad on Wednesday and not sure what could be if the constant AF hasn’t gone by then.
Thanks in advance
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tom0985
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First, of courses, is to make sure that your heart rate is under control which should be under 110 at rest and ideally not too much higher moving around.
As to getting back into normal rhythm, the thinking at least in the United States, is the sooner the better so that the heart does not start to remodel and potentially weaken. I use PIP flecainide for that. But should it not work, my ep for wants me to contact him for cardioversion if I'm in a fib for more than three days.
Hi Jean, yeah I don’t feel great and more than anything it’s making me anxious particularly with holiday a few days away. Pulse when relaxing no higher than 90
A pulse between 60-100 is considered normal. Mine goes up and down between 60-90bpm at rest but I'm in constant AF. What is your normal sitting pulse rate? My normal pulse was always 62. Can you feel it thudding in your chest? When my pulse goes abnormally high now I just ignore it, but I've had AF for 19 years and I totally refuse to give it the time of day now. I'm bored with it controlling my life. All those times I thought I was dying when it struck in the middle of the night and it was all unnecessary because I'm still here! However, I know what a hateful condition it is and how it can strike fear into us.
I once asked my GP if I was out walking our steep coastal footpaths and AF struck at what stage should we call for help and he said if over 130bpm.
Do you have medication you can take to slow your heart?
Thanks Jeanie - my resting heart rate is 50-60bpm. I take bisoprolol 1.25mg daily, have taken 3.75mg today to help keep heart rate down and try to get rid of this thing.
I’ve got the thudding in chest and feel out of breath walking up stairs and generally it’s zapped the energy out of me. Is a visit to the hospital going to fix anything do you think I’m the immediate? I’m also worried that should I even be going abroad now if it doesn’t go away?
I have an appointment with cardiologist in 3 weeks time anyway.
Sorry I couldn't reply to you before Tom. I couldn't post or respond to any questions as my use of the forum was accidentally restricted. How are you now?
No problem at all, thanks for coming back. Since the update at the bottom. I am away on holiday - AF/Flutter/ectopics seem to be here every moment but just learning to do my best to deal with it physically and mentally although it is tough
If you’re like me your pragmatic thinking goes haywire when AF strikes. Setting some conditions for decision making can help to get you thinking straight again and reduce the worry.
For example if this continues for more than 3 days I need to go and get checked out as it’s a change to my normal episodes
Or if I don’t revert to NSR two days before my holiday I need to think of cancelling.
These are just my thoughts and you and your closest can decide your own conditions. In my experience just hoping and worrying can feed the condition and we have to try and take charge again.
I had a PAF episode start in the departure lounge last year but carried on with the holiday and reverted the next morning as was my normal then.
Best wishes
PS the instantaneous heart rate on devices is pretty much useless when you’re in AF. I would ignore it and look at the average while taking an ECG if you have that. You can have 30’s to 180’s instantaneously but still average below the 100.
Are you sure they won't do it on the spot? I'm in South Africa and my PAV is largely asymptomatic. On one occasion I went for a chechk with the Cardio and after all the checks. pictures etc. he told me I was in AF, would I like a Cardioversion, or did I want to just continue with the medication.? I said since I'm here I'll have the cardioversion. I was admitted and had the procedure that PM, one zap was all that was needed.
Sorry short of breath. No not “right away” but fairly quickly . Cardio version works best the earlier you get it. (Not without anticoagulants) perhaps done for Wednesday?? You’d feel better for your holiday. Are you Uk though?
See your Dr immediately for tests to get OK to go abroad otherwise you are not covered by any travel insurance.
Rapid heart rate Diltiazem CCB Calcium Channel Blocker. Start on 120mg AM. Any BBs should separated at PM. I take 2.5mg Biscoprol for BP control.
It may be tummy bug to clear up .. flat fizzy drink, boiled water, crackers and to boiled rice to bind her. (add salt to the water which boils away).
Do hope you can beat it otherwise Dr may advise to postpone your overseas travel.
Later eat a banana a day for magnesian and potassium. Sardines, 2 brazil nuts and beef liver for selimium.
Take care.
Apparently most AF that comes and goes needs attention before it gets into persistent - cardioversion, ablation or anti-arrhymic meds like Flecainide but diliazem works like one. But caution any structural damage prohibits the above and any lower ventricle abnormality prohibits diltiazem.
To prove what you can have you must have an ECHO or CT SCAN of your heart.
During this period you may loose weight which is usually a helpful state.
Get it checked by GP or a&e before you go. At least go with peace of mind. I have had cardio versions when my doesn't slow down. But I get fast AF which you need checked.
update as of 2 hours ago it has calmed down however it appears I have been left with an ectopic beat every 4-5 beats but Apple Watch says sinus Rythmn. Resting heart rate around 70. Hope the ectopics go and then in theory back to normal. Would it still be wise to go to A&E or contact cardiologist?
personally I would go to A&E if you are still in afib/tachycardia. If they have availability they may do a cardioversion if you tell them about your holiday. However they won’t if your heart rate isn’t over 110
However they could give you flecainide through a cannula or even flecainide tablets combined with higher dose of bisoprolol.
You do need to check with your EP, cardiologist or GP if you are fit enough to go on holiday because of your insurance.
I do hope you manage to get away and you have a wonderful and healthy time
Hey, aFib has stopped but got an extra beat every 4-5. Do you think it’s still worth a visit? Think maybe a telephone appointment with my cardiologist tomorrow would be beneficial?
If anything I have found A&E aren’t too crowded on a Sunday so to put your mind at rest I would still pop there if you can. You can always still phone your cardiologist on Monday for a second opinion.
It sounds like you’ve been left after your afib with ectopic beats, but still worth a check especially as your holiday is so close.
If it is very hot where you are going don’t forget to keep well hydrated if you do manage to get away
You could go to A and E and ask for advice. They might simply increase your heart medication in the first instance. Whilst you would be unlikely to see a consultant, A and E can often confer with one for advice on medication. Tip: if you do decide to go, today (Sunday) is a good day. Nurses at A and E have told me that contrary to what people often think, weekends are not particularly busy. Monday is their busiest day.
Thank you for the advice, appreciate it. Afib has stopped but it has left me with an extra beat every 4-5 beats. Do you think a visit would still be beneficial?
I’m not medically qualified but, particularly as you are going on holiday shortly, I would say it’s important to go. They will give you a troponin test to check there has not been injury to the heart and also advise on what to do (particularly with regard to medication ) if it happens again on holiday. As mentioned, you probably won’t see a cardiologist, but they can confer with these experts for information. They could authorise an increase in dosage if they think it’s necessary. It’s always a pain going to A and E but sometimes it’s necessary.
My thoughts are for what it’s worth is that the diarrhoea caused dehydration which in turn triggered the AF.
Sounds like you are returning to normal rhythm now, probably helped by the diarlite replacing the electrolytes lost and rehydrating. Keep your fluid intake up and hopefully you will be back to normal.
I assume that you have declared AF on your travel insurance.
Last month I took a long haul flight (11hrs each way) while in persistent AF. It was paroxysmal for years, but it became persistent after I caught Covid 18 months ago. I'm waiting for an ablation now.
I went on the trip because my mother is in failing health and I did not want to wait until after my ablation. I was nervous about the trip because I'd never travelled while in AF and was concerned about needing emergency care.
My cardiologist cleared me to travel despite being in AF 24/7. I take drugs every day including anticoagulant (CHADS score of 1, but I'm in persistent AF so I take the anticoag). I declared all this to Saga and they issued me with an expensive but necessary travel policy. They were the cheapest I found. Among other things, they wanted to know if I get breathless while lying in bed (no), how far can I walk, and how many 'unplanned' hospital trips did I make in the last 12 months (just one, which wasn't to do with AF: my experience of going to A&E with AF in the UK is that they don't actually do anything to resolve it, just put me under observation, so unless I feel extremely unwell, heart rate >130, on verge of blacking out, etc., I no longer bother to call 999). )(I'm not slagging off the NHS. They have been doing a heroic job under nearly impossible circumstances.)
I wore compression socks on the flight, shunned alcohol, drank lots of water, got up frequently to stretch and walk around, brought extra drugs in case I ended up being away longer than expected. Managed to stay out of A&E while I was abroad, though I had a couple of episodes of fast AF (my heart rate hit 120 but it didn't stay there, fortunately).
I survived. I'm 60 and otherwise in good health apart from AF.
I've been on a learning curve for the past 18 months and I agree with Jean above: if your heart rate is still normal when you're in AF, and you feel all right, don't let this condition restrict you too much. Within reason.
In my case, I’ve noticed a definite link between my bowels and afib. I have a hunch that when you intestinal issue resolved, your afib will convert to NSR.
I was in a similar situation. In my case I’d not been in AF for 5 years then boom 4 days before heading to Bali for 2 weeks. I started the Metoprolol and Flecainide I’d been told to take if I went into AF as well as Apixiban.
I went to cardiologist the next day and found my AF was well controlled on drugs around 70-75. He did stress echo to ensure heart was sound and then said go on holidays and if not back in sinus cardioversion would be performed. I spent approx 3 weeks in AF.
It’s stressful but I really focused on breathing properly through my nose, controlled breaths. As others have said control the rate so you don’t overwork the heart and in my case the fkecanide helped with the rhythm and to such an extent when I returned from holidays the cardiologist assistant that did the ECG said I was in sinus only to be told I wasn’t by the cardiologist. Such a subtle difference. So for some people Flecainide can do the trick even if it didn’t convert me after 3 weeks
Thanks for this and it’s comforting to read. I am in A&E now waiting for ECG and Bloods to be taken. I just really hope I’m going to be allowed on holiday
Without the drugs yes could feel the bumps. Practice nasal breathing this can help relax you. With the drugs I could hardly feel the AF I had to really be still to feel the odd miss on my pulse I often felt it fine for 15-30 seconds then a little extra or missed beat. Basically really well controlled by the drugs. After that CV I aside from the first month I went10 months with no drugs and no AF so anything possible
Just to let you know when I was taking Bisoprolol I felt like you do, short of breath couldn’t walk up 4 steps. I put up with it for 6 weeks, told Cardio I couldn’t tolerate it any longer. He changed my meds . Talk to your Doc.It could be the meds. Good luck
What symptoms have you got?. How is it effecting your normal activities and can you get advice from your cardiology team..As said already look at your heartrate as that needs control. As for being in Afib continuously for 2 days don't panic. I was in it for 3 years continuously!!. Many people are. You need advice from your cardiologist/Dr about this. As for your holidays then you need to mention that as well, I presume you have taken out insurance ?
Seek a medical opinion before you go away. Good people offering tips and tricks for dealing with AF is one thing, but it’s not a substitute for medical advice after a dramatic change in your AF history. You may need a review with your medical professional soon.
Thank you - update on progress for all interested….
Bloods fine at A&E. was put on a saline drip with no benefit that a last resort of drip of magnesium which just pushed me to SR in the last drops. On way home went back in to AF (I could feel the Ectopics coming)
Got an appointment with cardiologist yesterday - did echocardiogram which confirmed heart still fine. 2 hours before appointment went in to so it rhythm and pretty much other than a few shaky ectopics have been there since….hoping it continues. Cardiologist said go and enjoy your holiday, every chance it will come back but as long as rate is controlled, don’t worry about it and let it ruin your holiday. Been referred for abalation.
Thanks everyone for your comments - it really has helped. I’m hoping being on holiday has its own benefits on the AF also but we shall see
Brilliant news! Wise words from your cardiologist. Ectopics are annoying but preferable to AF. Enjoy your holiday and I hope you stay in NSR throughout. Good news about the ablation too. 👍
I find that I’ve had ectopics after an AF episode but I’ve found them oddly reassuring on those occasions. At other times I’m truly fed up with ectopics as they’ve been quite a constant at times. Agree the thought of an ablation or any procedure like that is quite a scary prospect, but the cardiologist must reckon you’re a suitable candidate from the echocardiogram and ECG. Enjoy your holiday and let’s hope no more scary AF.
Don’t worry about having an ablation, I found it a very positive experience. Go enjoy your holiday and when you return one of us can point you to the information sheets, just ask.
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