I’m a 50 yr old male with good health/resting heartbeat / blood pressure just been diagnosed with para afib. Active swimmer, non smoker, no alcohol, not overweight. All scans of heart show plumbing in good health.
I’ve had 6 episodes since 01 December, 4 ran their course ( lasted 10 hours before settling naturally), 2 were stopped with Flecinide. I think the trigger has been starting a new hugely stressful job and I’ve also recently been diagnosed with mild sleep apnea.
My surgeon has recommended an ablation saying they are 80-90% successful and I will be drug free but reading stories here this seems like it may not be the true story.
I have a few questions if I may:
- can extreme stress cause afib? And if stress removed and lifestyle changes are made, can afib be cured? Does anyone have an experience of this scenario
- given my age / good health is it better to have an ablation quickly (to stem the progression of afib) or should I stay on meds as long as possible and try to get it under control with meds/lifestyle changes, with surgery as last resort.
- can sleep apnea be the cause? My sleep study shows signs I’m stopping breathing during the night, oxygen saturation was as low as 87% at one point.
- is the surgery routine? Or are there different patient outcomes depending on the surgeon / tech used, and hospital.
- any advice about long term management. I’m off work and unsure how best to proceed, it’s all very new and unknown.
Thank you all very much
Written by
helpeachother1234
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I speak as someone who first had AF in around 1990 and unusually has had 7 ablations.
Question 1
Yes stress can trigger AF. In fact after my last ablation 7 years ago stress has been my only AF trigger and only twice in the past 3 years.
Question 2
The general consensus is if you do agree to an ablation “the sooner the better”
Question 3
Sleep Apnea can cause AF.
Question 4
Certainly in “Centers of Excellence” ablations are routine. However there are clearly differences in approach and success and you are best to make sure you have a EP (Electrophysiologist who specialises in arrhythmia) who can demonstrate how successful they have been in ablations.
The vast majority of patients won’t seek out forums such as this and by default our forum tells the tales of problems. Therefore you should not be downhearted by reading the stories here.
Worth noting that success is measured in improved quality of life rather than a cure. Sometimes more than one ablation is necessary.
Managing AF is an individual matter as we are all different my best advice is to try snd avoid stress, avoid alcohol (if it is a trigger for you) and do your best to put it to the back of your mind as much as you can
Hope that all helps. Also read the information pages on this forum as they sre very helpful.
Pete has written a great reply particularly Q2! I had three ablatiaons form 2005 to 2008 and no AFsince so something of a fan. If you do decide to go that route we have some good fact sheets on preparing for and recovering from ablation which were written by patients so have all the things doctors don't tell you.
Remember that on forums such as this sucess stories are harder to find than failures. Those people are off enjoying their lives rather than wasting time here. As one of the very early members of AF Association and a volunteer I lurk here to try and help others since none pf this existed when I started my journey.
Thanks Bob, how amazing you have stayed around to help others and share what you have learnt. I’m sure the good karma is coming your way! I think when I read about people needing 2 or 3+ ablations in my mind that equates to failure, but I see now it’s hard to zap all the misfiring cells in one go and that it’s also a long term condition so needs ongoing management. I have an EP at Brompton in London but I can’t see how many ablations he’s done or what the outcomes were - is there a register somewhere? And re the fact sheet , I read it earlier today, it’s brilliant! All the details that you can’t find on the mainstream websites which all say the same thing pretty much
Give him my love please. I have to go up there to the pacemaker clinic on 6th march (I live in Devon) but won't see him. . I'm still on his books"just in case" and out of loyalty declined to move my PM care to local hospital even though its a day out and shed load of wonga to get from North Devon to London.
I’m also 50 (female) with no underlying issues and was diagnosed 5 years ago when I went into persistent AF with episode lasting over 3 months. Had been having issues for couple years previous but nothing was ever captured so GP told me it was hormonal. Stress is my biggest nemesis! Had ablation and made lifestyle changes to diet and lost 2.5 stone to healthy BMI yet still was getting AF but more so increased ectopics and bigeminy, gave up work for 3 months, felt better, returned to work for 6 months, went downhill, off again for further 10 months, felt different person even though still had intermittent episodes of ectopics and only one 14 hour AF episode so returned to work part time late last year into different role with much less stress and felt benefit massively. No AF so far since August and ectopic episodes every few weeks for an hour or so. So reducing stress is a game changer for me. Whether it stays like that my EP doesn’t know but it’s a start at keeping AF at bay for a while. Hope things work out for you.
Hello Bailey2004, thanks for sharing your experiences! I’m overwhelmed by the responses here, totally. It sounds like you’ve had an up and down journey but now found a better balance to life which I guess is good for the afib, and lots of other things too! All the best :))
hi Bailey, it sounds like you are doing an amazing job getting healthier and reducing your stress levels. 4 of my episodes happened on Sunday nights (before work…) so I definitely need to make a change there as well. Good luck and here’s to keeping positive and as Pete said, not worrying about it too much! I’ve started to mediate again and do breath work and that is great for calming down at the end of the day instead of a glass of wine !
I was diagnosed in 2018 and had an ablation in 21. Before the ablation I too was scared and confused which made my Af much worse. I find stress is the thing that really sets it off, along with viruses. After my ablation I've had a year and a half free of Af and have just had a few bouts since Octobe, but these came with an unnamed lurgy. I am very glad I had my ablation and have learned how to manage stress most of the time with mindfulness etc. I also lost 2 stones and watch my diet carefully, cutting out caffeine and alcohol which are usual triggers. Keeping your stress levels down is really imorportant and I hope you will find ways to manage it. Al lost all of us on here have been where you are now and have learned to live with it. Best wishes.
Thank you Bassets, it seems like I’m going to have to reinvent myself as I’ve worked full throttle all my life but clearly the body won’t take those kind of stress levels anymore. Good job with the meditation, I’m doing that and breath work which is also great for unwinding (and avoiding the need!)
Hi - like you, I was diagnosed with Afib in my mid 50's (almost a year ago to the day). I get the scared and confused bit. My firm belief is that I overdid a cycling ride - steep hills thinking I was 21 !
My father-in-law went through an ablation so having a basic understanding decided that was my route rather than medication. Cryo-ablation at the Spire Cardiff went smoothly but I did need a cardioversion two months later to get the rate / rhythm sorted. Pleased to say I'm Afib free, back exercising but at a more moderate level and completely off medication. If you decide this is the route for you, then definitely sooner the better.
Thanks Guy, I had another episode in the night (5am last night..first one since I was shifted from pill in pocket to every day meds) which is a bit worrying. Seems like I will go the ablation route. Reassuring to read that you’ve had a positive outcome and back exercising - just stay clear of those steep hill climb!. All the best
Hi helpeachother- welcome to the forum. I’m one of the timewasters who has had a successful ablation but still hangs around the forum! I was just so grateful for all the support I got here - from those first scary days, through dealing with the AF symptoms to the ablation and beyond. Wishing you luck with forthcoming consultation. I believe the vast majority of ablations to be successful (otherwise they wouldn’t be offered). Of course there are risks with any procedure but there are also risks if you let AF take its course. And I hated the symptoms of persistent AF so for me it was a bit of a no brainer!
from what Bob has said sounds like your in good hands. I’ve not had ablation but have my AF well controlled with low dose drugs of metoprolol and Flecanide. My heart is structurally sound and I’m one of those who’s waiting for ablation accuracy to improve. It’s on the near horizon with real time live MRI guided catheters in Trials as we speak. I’d say still 2-3 years before this becomes the new way to go
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Lots of good advice here. I have permanent AF which might blow your mind, but actually I'm asymptomatic, hence you will read about people having it but not being aware. I will add that when diagnosed the first consideration is omg my heart's giving out, but it's not. There is no cure but the way forward is to live with it ( whilst not giving in). Find your triggers - could be stress, booze, caffeine, etc and avoid or manage them.On Ablations and Cardioversions, etc. I was too late to the party on this. I'd had it too long, but while you have the attention of the Drs get what you can. Many on here have had failed and redone procedures but carry on to success. Then the next thing coming at you in later life is the risk of stroke, which is mitigated by medicine. IMHO the NHS sees AF as more of a stroke issue than a heart issue.
Many people have AF, Elton John, Xand Van Tuleken (who's quite young), Joe Biden (ok, so he's on the Dole now but he had a heavy job despite the AF).
stress is a big trigger as is alcohol and pickled and spicy food. Ablation is ok . I have had two and the recovery is quick. In my experience ablation reduces the number of episodes and their length but does not completely get rid of them. Consequently it is advisable to stay on blood thinners. Good luck!!!
There is no cure for AF unfortunately. You can have as little or many episodes ranging from 1 or 2 a year or daily. It almost always progresses so best ablated whilst paroxysmal as it's easier to treat at that stage Sleep apnoea can be a cause so if that is treated it's likely the AF will improve.
Thank you, yes I saw a sleep specialist yesterday and it seems they are linked, so it needs addressing as well. He said you stop breathing, O2 Sat drops, body creates adrenaline to make you take a breath, heart is out under strain.
You sound like my husband - are you sure it's not you?
I just wanted to share my husband's experience which might provide some insights for you. Two years ago, at a similar age and level of fitness, he encountered his first AFib episode. Like you, he also has a highly stressful job and was suffering from sleep apnea - similar age to you.
Fortunately, we had private medical insurance, and he was able to undergo an ablation just six weeks after his initial episode. Previously a social drinker, he chose to eliminate alcohol entirely from his lifestyle. I'm pleased to report that, so far, he hasn't had another AFib episode. So yes, I would suggest if you can treat it now then go for it.
From this experience, we've learned how crucial it is to manage stress and address sleep-related issues. It sounds like you're already making some lifestyle adjustments and considering your medical options, which is great.
Do you think that reducing stress and improving your sleep could help you as well as well as the procudure? Your situation sounds strikingly similar to what my husband went through so yes!
Welcome to the group.....though it's not one you'd choose lol! I wasn't suitable for the catheter ablation so was referred by my nhs EP to a nhs cardiothoraisic surgeon for minimally invasive maze op. (Mini maze) and clippage of LAAFlap. This waa keyhole. Afib free since.
Also has a very high sucess rate of over 90% if intermittent (comes and goes) 86% if persistant. Not widely available but is available on the nhs - just letting you know it's out there when considering all your options.
You’ve had many replies. Sleep apnoea is said to go hand in hand with AF. An early ablation is said to offer more chance of success than leaving the AF active for years; the “trigger” might have been stress but the cause is likely to be genetic or chronic changes in the electrical conductivity in the atrium. Triggers aren’t easy (perhaps, in fact impossible) to fully ascertain, and most people seem to have fairly random episodes with no obvious cause (or, at least, the heart sensitivity goes in phases).
Atrial arrhythmias are most always “safe” even very long term if the rate can be controlled. It is the symptoms some suffer that brings the need for treatments including ablation. If you can reduce the anxiety the arrhythmia naturally brings in its wake, your symptoms might well diminish significantly and life return nearer to normality.
I would suggest focusing on your sleep apnea and looking at diet. I was 48 when I had my first episode and subsequent one 8 months later. I keep my calcium intake to less than 100 percent daily(I have always loved milk and some anecdotal evidence around calcium being a trigger). It has been 4 years since an episode. Everybody is different but my doc pressured me to have ablation and I’m glad I held off. If you decide to go ablation route make sure to find a doc that does pulse field ablation.
Ha ha I hope that you don't have PLUMBING in your heart!
Metopolol cased my pauses so if on meds ask for a heart monitor procedure. I had 3 during 2021 when introduced to Heart Specialist no followup after Stroke!
In Sept 2019 I was diagnosed with Embollic Stroke, Rapid and Persistent AF and Day 4 during the Carotid Arteries scan (clear) I had a shadow on Thyroid. The latter I had a Thyroidectomy in Feb 2020 and it is checked yearly but recalled 2024 as I have some calcification of 2 lymphs and something 19mm x 9mm. (surgeon says possibly thymus which shrinks as not required as an adult.
My AF under control finally with CCB Diltiazem 120mg which I have had for 3 years. Bisoprolol dropped late last year.
No meds before Sept 2019 except B12 I use SOLGAR Gold Top Sublingual. I keep my level at 700-800.
Do get checked out that it is not your meds causing pauses.
Sounds like you'd do well to learn some stress relief strategies. The simplest one is just to breathe deeply. Secondly, do some muscle relaxation where you tighten muscle groups while breathing in, then relax them breathing out. Good luck! You've done a good job maintaining your health, you will figure this out too. Its a better disorder to have than other kinds of disorders that trouble people.
I was diagnosed with Atrial Fibrillation in 2015, brought on by exercise (I was a runner). I live in Canada, was a healthy female in my mid 40's, with a resting heart rate in the high 40's. I was referred to an EP right away and he suggested an ablation, because I really wanted to avoid beta blockers for life. Based on my age & health I was considered a good candidate. Had my 1st ablation, and during it my EP discovered I had Wolfe Parkinson White Sydrome (an extra electrical pathway in the heart which is genetic). This took a 2nd ablation to correct. Happy to report that I am now 56 and consider my ablations to have been a success. I had one episode of SVT 2 years ago, after a night of over indulging with alcohol (dehydration seems to be a trigger) and was able to get my heart rate back in rhythm with a vagal maneuver. I have now completely cut out alcohol, and have not had another episode since.I would get an ablation sooner than later if it were me, and make any lifestyle changes necessary to help with a better outcome.
I experienced a traumatic brain injury in 2015, which we believed was treated well at the time. Fast forward to my first bout of Afib in 2019: discovered that for 4 years my brain had been forgetting to tell my lungs to breathe regularly at night (central sleep apnea), which had put stress on my heart, which was exacerbated by COVID, resulting in the onset of Afib. Muddled through "managing" my afib relatively unsuccessfully until had a pulse ablation 10/1/2024 with promising results. Whereas I was having afib with increasingly regularity and much longer duration, I have had only one bout (apparently triggered by inflammation associated with having the flu) and it lasted half as long as previous bouts before the ablation. From my experience, I recommend treating the sleep apnea and having a pulse ablation sooner rather than later.
thanks for sharing your story. Can I ask, how do they treat central apnea? Did you use a SPAP machine? I’ve bought a little gizmo (a ring) that monitors O2 levels and vibrates if you drop under a certain level, which I hope will help shed some light on it. Wonderful to hear you’re in a good place now RescueRanger
I sleep with a CPAP machine attached to an oxygen machine set at 2 litres. I occasionally wear an EMAY rechargeable oximeter all night (it tracks my heart rate and oxygen level throughout the night) to see how I'm doing. Last two nights my oxygen ranged from 92-98. Prior to getting the CPAP, a sleep study revealed my oxygen was dropping dangerously low dozens of times a night. All the best to you!
I have had paroxysmal AFIB for just over 2 years now. 64 yr old male and like you have good health /resting heartbeat / blood pressure and eat very clean. Active non smoker, not overweight. Like you, also contemplating ablation but for now treating with daily Flecainide which seems to be working now that I have the correct dosage.
Triggers are unknown - my first episode came on 1.5 years AFTER I retired from a stressful corporate job so I don't believe it's stress for me unless it's a delayed reaction. Like you, my cardiologist thought the trigger was sleep apnea since about 70% of my episodes started while asleep. Sleep study confirmed mild sleep apnea and now I use a CPAP while sleeping. It took a while to master using that thing, but I'm not convinced apnea is the trigger since I still get oxygen saturation readings in the high 80's from time to time even when I score a perfect 100 on MyAir app and my average AHI is < 1/hour.
Alcohol is not a trigger for me, nor is caffeine. Agree with what pottypete1 said, managing AF is an individual matter and we are all different. My heartrate is lower than most even when I'm in AF, but I'm very symptomatic and uncomfortable when it kicks in. At this point, I'm tolerating the meds but also contemplating a pulse ablation in the next year. Good luck and keep us in the loop on what you decide to do.
Mine is also low in an attack. Are you able to stop an episode with meds? 2x 50 mg of Flecainide used to stop mine, but I has one last night and it didn’t… I did what I’m EP said and took 1x more 30 mins later, and another 1x 30min later (so 4 in total in an hour) but it still ran for 3 hours more. What would you (and others) do in that situation? Wait for it to pass naturally at home and cope as best you can, or go to A&E? My symptoms while episode is happening are really bad. What dosage are you on if I may ask?
Stop an episode with meds? I can't say for sure yet, but I hope so.
Like you, I started on 2x/day 50 mg of Flecainide which worked great for 53 days straight (a nice break for me since I averaged ~ two episodes a month prior to taking meds and some lasted several days). After that, I requested to increase the dosage to 2x/day 75 mg and my EP agreed. Since upping my dosage, 67 days straight as of today -- maybe increasing your dosage slightly is something to discuss with your EP? However, I'm not claiming victory yet but if I have another AFIB episode I'll be more inclined to move up the possibility of ablation.
Diagnosed with AF in 2018 at 51. Non- smoker, active female and not overweight. Had a Cryo-ablation in 2019. No AF since and on no meds. I have documented my AF journey on my profile.
1. Stress-maybe. Everyone handles stress differently. Besides life is hard. there is no way to avoid it. One year before my AF diagnosis, I was let go from a 29-year-old career. One year later I was still unemployed. Yes, stressful.
2. Yes, it is better to have the ablation sooner than later. My EP indicated that the ablation success rates are better the sooner the procedures is performed. Medication did not work for me. My ablation was 18 months after initial diagnosis.
3. Health, weight and activity level do not determine if one can develop sleep apnea and yes, studies show a 30 to 40% relationship with AF. My EP would not perform the ablation without a sleep study (I am in the US). He indicated that AF success rates are higher when sleep apnea is treated.
4. Yes, this procedure is now considered routine. Yes, do your homework. Follow your gut when meeting EP's. Make sure they are answering all of your questions. The technology for this procedure is state of the art.
Long term management is still taking good care of yourself. Trying to avoid all of those things that set off your AF before (for me it was caffeine, MSG, artificial sweeteners).
Is it scary, sure. Would I have the ablation again? In a second. Do I know that AF can come back? Yes, but now I know what to do and would have another ablation if it was recommended for me.
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