I have had PAF for at least 10 years but only officially diagnosed in Nov 2021. I am on Edoxaban and Bisoprolol and also Simvastatin from much earlier.
I now am having episodes about 3 times a month lasting from 14 to 24 hours. My symptoms include slight palpiatatons, slight breathlessness and sore neck and head with an occasional rush of blood to the head. I also experience polyuria in the first couple of hours of an episode.
I have isolated alcohol and eating more than usual as triggers but even after avoiding these my 3 episodes per month persisit.
What else could be triggering my episodes? I have gone decaff on tea and coffee and taken steps to reduce stress along with 30 minutes daily walking but still no change,
I am now almost resigned to just living with my AF episodes which incidentally have never affected my daily activities. My main symptom now is being annoyed with the condition.
Does anyone have any ideas about what may be setting off my episodes?
PS Could it be congenital as my brother has it and my father almost certainly did although when he was diagnosed in 1940 he had no symptoms and they just called it an arrythmia. Apart from excluding him from military service it never affected his life for the following 40 years.
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It's a known fact that stress can keep AF attacks going and almost like fuel for them. I've had AF for 19 years and have learnt so much in that time. All mostly from this forum.
Firstly searching for triggers can be a thankless task. You could end up on a very restricted diet as a result of a series of hunches! Stress can set me off, and the last three funeral teas I've attended it has kicked off!! I tried to think what I'd eaten that was unusual. I think a heavy carbs meal doesn't help and gave up alcohol but never has anything been obvious.
As Jean said, it might be advantageous to seek a referral to an EP while things seem manageable so that future options can be discussed. 24 hour episodes for me would not be liveable with on a regular basis.
Thank you but I am concerned that all an EP would do is recommend an ablation which I really don't believe is warranted. My cardiologist has reassured me that my risks are so well managed that an ablation would be more of a risk.
As for 24 hours being intolerable that is just not the case for me. The first 2 hours are slightly uncomfortable but thereafter are barely noticable. The only way I know I am in Afib is my Kardia monitor and initial polyuria.
Then 7 or 8 hours sleep followed again by a few hours with no symptoms but still showing as Afib on my Kardia and Fitbit.
As Jean says contrary to my initial observation of being unlucky and am in fact blessed that it is so benign.
This AF is a conundrum and on the positive side apart from a couple of blips, I too am even more fortunate . I don't know how I have the nerve to suggest an EP as I've never seen one in all my13 yrs of AF!!
EPs are really the best people to discuss options with,the experts. In my experience, ablation isn't pushed at all ( uk) medication and lifestyle definitely first .Also,you are not obliged to accept an ablation if offered.
Agree, I'd be trying to avoid going into an even more annoying level of AF!
What’s your resting heart rate? And your lowest heart rate? If you haven’t already got a fitness watch you can buy a very helpful (whisper it) Chinese one quite cheaply. Mine tells me my resting heart rate, my average heart rate, my minimum hr, my max hr and how long I have been in various ‘exercise’ modes during the day. As these are (I think) based on my age it looks as though I do plenty of exercise although I don’t deliberately do any! I’m asking because an episode of lower than normal (60 bpm) can allow AF to jump in, and as we age the lows and highs tend to get slightly more extreme.
My RHR is 44bpm jumping to 49 after an Afib episode. Before commencing Bisoprolol in Nov 2021 it was 50bpm rising to 56 after an Afib episode.
This is measured on a Fitbit charge 5 which is consistent with a manual pulse reading, an oximeter and Kardio Mobile.
My cardiologist is aware of this and suggested I skip my morning Bisoprolol if my daily Fitbit RHR fell to about 44bpm. There was no suggestion of reducing the 2.5 mg dose as it was important to keep the high bpm rate down.
You don’t have a high bpm, though you don’t say what it rises to during an AF episode! What’s the point of taking bisoprolol?
If I take my bpm above 150bpm during exercise I can easily trigger an episode when I stop exercising and return to a resting bpm. Otherwise, sudden adrenaline kicks might start an episode in my case (stress-related).
Provided that your heart rate is well controlled and remains under 100 during an event, and you are anaticoagulated for stroke prevention just ignore it and enjoy your life. It sounds like your AF burden is mercifully low so keep doing what you are doing. As my EP once told me, looking for triggers is the way to madness and that won't help your AF!
Thank you Bob for your wise words and those of your EP.
I do have one question on the best way to measure my HR during an AF episode as it is irregular.
I have a Kardiamobile (single lead), a Fitbit Charge 5 watch, an oximeter and a BP cuff monitor.
Do I use the average for the Kardia over the 30 seconds and ignore the odd peaks? The Fitbit does give an average but I am unsure of its accuracy during an AF episode.
The oximeter can vary by quita large amounts but again I fear it is less reliable during AF.
Finally the BP monitor feels more reliable but once again it is only a single average figure over the measurement duration.
I find when in afib my felt pulse bears no relation to what the Kardia says. Even though it is jumping around it never seems as high as the Kardia readings- between 130- 150bpm. Is that because there are "quivery" beats that I am not detecting with my fingers?
Strangely I find if I take for 15 secs x 4, I need to knock off about 4 bpm.Compared with immediately counting for 60 secs ( that's in sinus though) In AF for me it's by guess and by a god if over 130!!
You take the Kardia average rate. Ignore everything else as none of they are accurate during AF - in fact I would say put the lot in a deep drawer and take out once a month. If your HR doesn’t go much above 100 on that measurement I would question whether you need Bisoprolol at all but not for me to say. I couldn’t cope with RHR below 55, brain fogged up.
Buffafly, many thanks for all of your advice, but I guess you are not suggesting I put my Fitbit watch in a deep drawer as you had earlier suggested getting a fitness watch.
Not really, just a way of saying don’t obsess over the numbers if you feel ok. You’ve already got the relevant info from your fitness watch so it could ‘go in the drawer’ unless you are using it to tell the time or actually monitor your exercise ☺️
AF runs in my family, specifically on my mother's side. Both my mother and grandmother had it, and we suspect my great-grandmother likely did as well. My brother also has AF, and of course, so do I. What’s unusual is that, as a family, we all experience and present with AF very differently. While it can be an inherited condition, I believe all lifestyle factors, along with how the mind copes and processes the condition, may influence how each of us presents with it so uniquely, despite the shared genetic link.
l think we can go around in circles trying to find the reason for an AF episode. At times l think it’s something l have eaten, or eaten too much, but that doesn’t always happen. Stress and anxiety make my numbers go up and has, at times, provoked an attack, but again, not always. I have had AF for 6 years and l have come to the conclusion that it has a mind of its own, or it’s a combination of different factors that are too difficult to piece together, at least for me. Fortunately my burden is not high, so l think it’s good advice just to enjoy life rather than waste your day trying to find your cure. That doesn’t mean not to look after yourself and not take note of others experiences and tips. It all helps to deal with it. Everything in moderation and stress free if possible.
Spot on. I have the same pattern - or rather lack of pattern! Luckily my afib does not bother me that much - apart from the frequent trips to the loo in the first few hours . The only thing that worries me is my heartrate . I know when I go into afib as I feel it and if asleep it wakes me up . I take a Kardia reading and it is usually between 130-150bpm. I take extra Nebivolol and try to ignore it. I mainly succeed as I don't feel as if my heart is beating fast when resting. But sometimes I take another reading later on and the heart Nebivolol isn't bringing the heartrate down. I ask myself if the act of taking the reading is actually putting the heartrate up as I do feel anxious about it and if I would be better not knowing.
If l get anxious when l have an AF attack my HR can go 130/150. If l relax, do deep breathing and ignore it, l can jog along 70/80. So, anxiety with it, does make a big difference. It can also prolong the attack. The same applies with my blood pressure. I have low blood pressure, but with AF it can spike to 130/50. Rate control is important to not put a strain on the heart. At least, not for prolonged periods. It can be difficult to get control and takes a lot of practice to calm down. Deep breathing is beneficial, but it’s my thoughts that need to be diverted. I talk to myself and tell myself it’s ok, had it before, it will pass, l am not going to die etc.,….. and then do something to occupy my mind. Coming on here and chatting is good therapy for me. It’s something to make me concentrate on, other than myself. The mind is very powerful. I always say only you know how you feel. Listen to your body and cope with it in the way that is unique to yourself. We all have our own battle going on. 🥰
Strangely my BP is usually about 115/70 with a heart rate of about 45bpm but during AF it drops. Last time it dropped to 70/50 with a heart rate of 59.
It just goes to prove how diverse and difficult this all is, not just for us but the medical profession as well. I am sure there is not another physical condition that comes anywhere near with its many tangents and complexities. The more l learn, the more l think there is a miracle needed to fathom it all out don’t you? We live in hope. X
I'm usually 45 bpm with bp 120/80. My oximeter beeps as a warning of low bpm. Just checked after tea and toast....52 bpm and no beeping which is quite novel for me.
The trouble is that when lying in bed reading and distracted I don't feel anxious at all. But my Kardia will not work in the bedroom . It will only work in the dining room where there are no other electrical devices. So I have to get up and go to the dining room to do a reading. Although we live on one floor it's still activity. Perhaps if I sat there and read for 10mins I could get a more accurate reading! My attacks generally last between 9-12 hours though often I don't feel the conversion. Only if I have been walking around when it goes back to NSR.
I have been searching for the triggers for the last 4 years, my EP says it's like looking for a needle in a haystack and I would probably never find a trigger because AF will come just because it can and like a jack in the box the more it pops out and you put the lid on, the more it wants to pop out.
Yes - I'm not sure I'd go that far. But, yes - a curse it is. It rules my life in a way, even though I suspect most people who know me would never guess.
After 29 years of PAF, you would think that I would have given up trying to find a cause but only recently have I resigned myself to the fact that the beast in my chest will go for a gallop no matter when or what is thrown at it or starved of. I try and get on with life nevertheless with a sensible diet and minimal alcohol. Sorry if it sounds defeatist and I wish you well in your quest.
My hunch is it is not usually one habit that triggers AF but instead a build up of poor lifestyle choices plus an inherited physical or mental (more prone to stress) issue.
Spot on regarding lifestyle choices - over indulging, being lethargic, worrying incessantly about this or that... As with so much else, we, essentially (and in our quiet moments do know it...) bring these ills on ourselves to a large degree: blood pressure, diabetes, AF, arthritis - the list is long.
Hi Joy. Not sure I follow your good LDL comment but the full results are as follows.
On simvastatin: Total cholesterol 4.4, LDL 2.7, HDL 1.3, TG 1.0
Before statins: Total cholerserol 6.8, LDL 4.8, HDL 1.3, TG 1.6
I am less sure about the triglycerides as the old level was a fasting sample and the latest one is not. So I am not sure we are comparing like with like.
I understand that some people's psychology causes them to feel sure that there must be a trigger, and to gain much-needed comfort from the knowledge - but why should there be such a thing as a "trigger"? The largest study looking into this showed that few sufferers could discover one. I certainly cannot. I can say that physical movement, bloating, and so forth can seem to cause ectopic beats to occur at times, and these maybe can then lead to AF, but not repeatably so. A few people here can pinpoint a trigger, it seems, but they seem to be in the minority.
What seems likely is that the cells in the atrium vary over time in their ability to conduct properly. When they misbehave, then a range of stimuli can set them off. I can think of the most likely being a change in the levels of adrenaline or other hormones that directly impact the heart. This happens to us all with the most obvious being emotional or physical stress, but so much else can also cause this, such as hunger and even eating - many bodily processes in fact. I find any kind of confrontation sets my palpitations off within seconds. It's so weird. Others seem to have there troubles when there's drop in these same hormones, so for them, resting, digesting, sleeping and so forth can be their sensitive times.
Spot on Steve! I always want to find the cause for everything, even going back to the Big Bang. Sometimes though you have to accept that we humans are not as clever as we think we are.
The last time my brother opened a book was when his teacher threatened him with a detention if he didn't, I should think, and yet he thinks he knows it all. The expert on covid, vaccines, vapour trails, the Great Reset... 😜😂
Sounds like your bro has done lots of reading since that threat, dear sole.
You know that a woman's intuition is far better than MAN who does not have any.
Recalling one,I stood there watching our tow rope break (it's true) when I had already rung for the tow truck to come. He arrived when dear hubby had left, and attached a wire rope to pull the car out backwards using a power driven mechanism. The house was Fremaos, woody pine, and slotted together on top of each board, with the outside wall also the inside wall, making any repair of the wall impossible without taking the roof off. The slope down to that wall was in my imaginings. So this towing out with our piece of rope was dangerous to say the least.
Intuition should be respected.
Perhaps your bro had 'women's intuition'.
Food for thought.
Metoprolol I had already experienced and did not want it.
Medical should listen to patients.
I agree as it was suggested that stopping statins could be the first line of subtracting a med especially that it is an add on as to a top important med.
If it made him happy, Joy, it wouldn’t hurt. He’s become a cynic believing in what is generally called “far right wing” fantasies of the world gone wrong. His reading is limited to sound-bites and his knowledge of the world courtesy of YouTube (and now, he told me yesterday, TikTok).
So I know it was my thyroid which caused mine and then undiagnosed caused the Embolic Stroke.
But what I don't get is that over 3 x24hr Heart monitors when changes in meds needed to prove a drop in rapid heart beat Day, my Night Heart Rate goes down to 47avg bpm from 186 Day H/Rate on Metoprolol, 156 Bisoprolol and finally controlling me Diltiazem a CCB.
I guess I'm saying why is Day H.Rate differ so much than Night. Even at rest. I couldm't exert myself on Metoprolol. I didn't want it and told dr who was an Endocrinologist, from Stroke.
Even the Diltiazem 120mg CD doesn't bring my 47avg bpm lower. I take the CCB AM.
Maybe take a break from the Statins? They have lots of unwanted side effects and as you seem to have been on them before you noticed your AF maybe they are the culprit.
I think perhaps you need to update the use of cholesterol within your body and why reducing it is not advisable. There are a lot of good research articles on the topic now.
I read a medical magazine saying that cholesterol levels cannot be measured.
My Chemist who is also studying natural meds doesn't like them.
As I take thyroxin I could only take Avorstatin 20mg. You need to stop them to have the antiviral for cOVID.
It disturbs the bodies maintain on sugar so many become prediabets to diabetics.
Their manufacturers pay heaps to countries to get patients hooked on them.
An anti-coagulant to prevent clots and strokes YES.
But statin pill popping is not a must to have.
My run in September 2019 was Stroke, Rapid & Persistent AF & diagnosed with a carotid arteries scan Thyroid Cancer. There was a shadow on my thyroid. But the Carotid Arteries were squeaky Clean. But it was Thyroid problem which caused the AF and that AF caused the Stroke.
Statins would not have saved me from Stroke but the Anti-Co.agulant may have. But I was on no meds except B12 for deficiency.
Reducing your total cholesterol is my having more antioxidants such as avocados, garlic, ginger etc but medical use statins as an anti-inflammatory but in fact there are lots of foods we can have.
Read all about what medical earns for each patient who has been persuaded to take statins.
My Dad joining up in WWII was classed as an early diabetic 1 at aged 25 and I certainly don't ever want diabetes.
Your condition seems a mirror of mine. I am taking notes now. What I can glean from them is: stress can cause it; artificial preservatives can cause; also when I lost weight after stroke seemed to help; other suspects... eating too fast, indigestion. Moderate exercise helps but intensive exercise doesn't. I do this because from August last year I was in permanent af and had given up but now days go by in sinus rhythm. Having said that not a huge difference when I'm in or out of af and I really feel for the people who have debilitating effects and count my blessings
I have never much believed in 'triggers'. I, too, tried abstaining from alcohol, but when I indulged there was absolutely no pattern as to whether this would cause a bout of AF. I simply gave up, and kept to a moderate consumption (with occasional over indulgence). It simply didn't seem to make any difference. Same with coffee. I have since had an ablation, and although not a 'cure', I have suffered a sufficiently less number of sessions to be satisfied it no longer affects my life decisions.
What I will say, is that I suspect stress will almost certainly encourage AF to occur. This can be trying to meet some else's schedule, being in unfamiliar situations, or simply getting too cold (or too hot?) . I now take life a lot easier, and have learned to say NO more often.
I’d say your hypothesis regarding a genetic ‘trigger’ is more likely than trying to find an environmental one. Stay on a healthy diet with minimal booze or caffeine is as far as I’d go.
Couple that with stress-reducing physical activity (e.g. walking, yoga, TaiChi) and deep breathing technique … and you’ll be ok. I also ‘grow my own’ for a cannabis tea that reduces anxiety (I call it the ‘who gives a sh#t’ drug).
That’s my routine after six ablations, a dozen cardioversions, and trying lots of rate & rhythm drug cocktails. Good luck.
It's certainly familial, you can find a list of the genes involved on the Internet. My father had it and my 4 sisters and I all have it, my son was diagnosed with it when he was only 36, but he is a canoeist and they are very prone to it (according to my Cardiologists the second largest goup he sees after the older folk are canoeists, he's one himself) My son went to Cape Town for an ablation and has had no signs since and he is54 now.
It is a process to figure out the triggers. It is like pealing on onion, layer after layer. Like JeanJeannie50 said anything chemical for me, MSG, Gluten which is very similar to MSG. My latest is Fish Oil. I had a very good source. I am currently rereading Super Gut by Dr. William Davis. In the book he advocates taking fish oil but he also says to eat fish on occasion because fish has Taurine and fish oil supplements do not. Taurine? could that be a key? Missing amino acid? So I did a search on that and lo and behold the two amino acids that can help with AF is Taurine and Arginine. a-fib.com is the website I found. Check that website out. He is a PhD and struggled with AF himself. There he explains the two amino acids that help. I found this very hopeful. I sent this info off to my Chiropractor friend who also has AF, she was very excited because she didn't know this either.
We are all different but one thing for sure, we are all body electric and when something messes with that current it shows up in the heart.
As we age we loose our ability to produce the things we need like Taurine and Arginine. I encourage everyone to check out that website.
I have found that insufficient fluid intake contributes to episodes so remember to drink more water.
I found that bisoprolol made me feel very cold. If you also experience this ask your doctor to prescribe nebivolol instead and you never know but changing the beta blocker may also reduce the number of episodes!
I was diagnosed two years ago, meds, two cardio versions, and an ablation later outside of a little anxiety I am doing well. I came to believe that there really aren’t triggers only coincidences. If it was a matter of identifying triggers and thus avoiding afib we would all be feeling peachy by fine tuning our lifestyles.
I have given up alcohol and caffeine, done the Zoe diet, exercise most days (3 slow runs, 2 weights, 1 swim, 1 yoga). Try to get a good night’s sleep.
Take magnesium and apixaban.
I haven’t had so many episodes this year 2 minor compared with 4 major) but aware that it could all go wrong at any minute. I will still have any vaccines offered but will take it easy afterwards.
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Oh for a good night's rest from incessant insomnia!
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