More frequent A-Fib episodes

[bowie88]

I've got paroxysmal A-Fib having a few episodes per year, until recently when it has increased to four in the last 6 weeks (about one every couple of weeks) lasting between 12-24 hours). I can't put it down to specific triggers - do you think this is just the natural progression of the condition, or is there the chance I could have another long period without an episode (say 6 months or a year) which is what I'm hoping. Interested in peoples' experiences...

[Karendeena]

I am sad to say it's probably progression. This is what happened to me. My EP said that afib is like a jack-in-the-box the more it pops out the more it wants to! I didn't like what I heard but he said quite frankly to me that my episodes would likely become more frequent and last longer. I was already having episodes every 2/3 months lasting 36 hours. I went for an ablation in the end and whilst I was resistant to this initially I have had no episodes that I am aware of since

[southkorea]

I have about two a year but I have had two. Ablations.Two things trigger mine stress and very spicy food so keep a food diary and see if there is a specific food trigger. I also am very careful with alcohol and stick to a couple of drinks !

[bowie88 in reply to southkorea]

Is that a couple of drinks...a night? A week? A month?!

[southkorea in reply to bowie88]

A night!!

[secondtry]

I am a believer in doing the hard yards today (given otherwise good health) to make tomorrow easier.

I would therefore book a prompt private appointment with a trusted cardiologist and discuss drug options - 100mgs Flecainide may be the best option.

As already mentioned AF begets more AF so it needs stopping completely and a combination of drugs and lifestyle changes may work - I got 10 peaceful years out of that approach.

[Youngatheartnow in reply to secondtry]

I was the same. Flecainide held me in sinus rhythm for 13 years with only occasional episodes. Just had ablation so I can come off the drug. My trigger was definitely gastric in nature. I have reflux with a hiatus hernia. Best of luck.

[Pommerania78 in reply to Youngatheartnow]

If Flecainide works for you, why did want to go off it? Thanks.

[Youngatheartnow in reply to Pommerania78]

My cardiologist thought 13 years was a long time and suggested 70 was a good age to stop if possible.

[bowie88 in reply to secondtry]

Thanks - I'm waiting for an appt with my cardiologist (NHS) at the mo. He has mentioned amiodorone before, not sure what the difference is with Flecainide...

[secondtry in reply to bowie88]

I seem to recall from posts here that Flecainide is less toxic than amiodorone and has a longer track record.

[Amhan]

I am no expert and can only go from what has happened to me. Mine started as 2 a year then slowly progressed over the last 9 years. In April this year I had an episode that lasted 6 days and then unfortunately I have now been in constant AF since 10 October this year. Been waiting for my referral since beg October. Hoping for an appointment soon. Unfortunately flecanaide did nothing for me and I now only take bisoprolol and warfarin. Best of luck to you.

[30912]

My experience with PAF has certainly been progressive with bouts becoming more frequent over time. Two ablations pushed the frequency back to minimal for a number of years but I'm back to a crossroads where I needed medical intervention recently. This has been over a 29 year period for me from first diagnosis. Having said that though, AF is a beast with a mind of its own and could behave differently for some but I wish you well with your journey.

[Buffafly]

Do you have any kind of stressful situation going on, even mildly? Have you done a home check of your BP? If no and yes, all ok, then probably progression I think. Last year I had frequent and prolonged episodes of AF, this year two short bursts, but there were obvious reasons for both. So if as you say nothing in your life has changed then progression seems likely.

[bowie88 in reply to Buffafly]

Interesting that you mention mild stress - I suppose I often have some of that! I checked my BP and it was high (163/95) which could be indicative of stress? And my HR was 125....

[Buffafly in reply to bowie88]

Hopefully that was during an episode of AF when BP monitors don’t work accurately. If not, see your GP urgently. When not in AF you need to sit calmly for a few minutes then take three readings a few minutes apart, then work out the average - though my Omron does it for me.

[bowie88 in reply to Buffafly]

Yes the BP check was during an episode....thanks

[Decaf_Andy]

Mine progressed from occasional (mainly post-drinking or post-heavy exercise) episodes to more than one episode a week (lasting 12-36hr; it was 25% load) over a period of several years. I’m 62 and in UK. I kept diaries and looked for triggers. It seems clear that sometime it will arrive for no reason and sometimes I had no episodes for no reason. Memorably I broke from above pattern to have 3 months AF-free immediately after my first Covid jab! Being rational and understanding statistics, I draw no correlation, but I do see how it might be possible to imagine causation, especially if the AF arrived after the jab.

I chose to go onto minimum dose of Flecanide (with protective accompaniment of bisoprolol) 18 months ago and am very happy. The reason was because increasingly I would go into AF part way through a long bike ride. Whilst I can carry on (even hilly cycling) in AF, it’s no fun.

I get no unexpected side effects and would recommend. I now have AF perhaps once I every 6 weeks and I then take an extra flecanide and it disappears in 4-8 hr. Load is maybe 2%. I monitor with Apple Watch.

One remark for you: when I’m 65 I will be put on blood thinners as at that age, current UK advice is that in the absence of other risk factors that is the point where the risk of bleed vs stroke tilts in favour of taking the stroke protection medication. Are you on thinners?

[bowie88 in reply to Decaf_Andy]

Thanks Andy, yes I'm on thinners, I've been on them ever since I was diagnosed at age 62. Another vote for Flecainide there...interesting

[Vonnegut]

100 mg Flecainide taken as a pill in the pocket stopped episodes in a few hours when I was first prescribed it and now that I take it regularly it has virtually put an end to episodes and I have reduced the first dose of the day to 50mg with 100mg at night.