I’ve seen a cardiologist for the first time properly today.
He prescribed me flecanide in case I have another AFiB episode. He said that porxysmol is generally bought on by alchohol, stress, Illness or infection, is that right - and why it’s at the stage it’s not classed as risky as the other stages . Basically saying nothing to worry about yet
I’ve read how many people have moved to the stage quite quickly 🤔is that right?
My heart is structurally fine thankfully.
Paroxysmal AF (that which comes and goes ) can have many triggers though inflamation for anybody and binge drinking in younger people are common causes. Endurance sports and flying fast jets (high g work) also produce more than the average case of AF.
In my view any AF should be tken seriously and stroke risk assessed with the usual Chads2vasc2 forumula. Stroke does not erspect age regaradless of young or old. Sounds like an old school cardiologist rather than an expert in arrhythmias like an electrophysiologist.
I thought that Bob, I’ve read his profile and your right not sure he’s he ha much arrhythmia experience. 🤔
Hi Bob
Just had another read - Interventional cardiology consultant - this is what’s on his profile.
Interventional cardiologists do stents and things, he’s a plumber you need an electrician .
I was so unimpressed with the cardiologist I saw in hospital with my first episode, I saw another one privately 3 days later who agreed I shouldn’t have been put on drugs after a first episode .
I have had three episodes roughly two years apart . Mine don’t seem to be affected by stress or illness . My first one was a prescribed inflammatory . My second was on New Year’s Day after a festive period of too much chocolate and sugar generally, topped off with a Chinese takeaway then trying to exercise it off the next day.. 3rd one about two years later was panting up and down some very steep hills on holiday in Yorkshire . I am on a very long waiting list for an ablation
There is a pool of triggers the trick is to try and find which ones affect you, if you are lucky. For many people AF happens regardless, but still I stick rigidly to my own guidelines of no alcohol , caffeine , chocolate or indeed sugar full stop , processed food . No exercise that is going to push my heart rate right up . You have to decide what is best for you.
Currently I take Edoxaban . I also supplement with fish oil, which many say don’t take with anti coagulants but I ve taken it for decades, magnesium and Vit D
It’s all very frightening and confusing especially at the beginning I know
Hmm.I'm concerned here. 'Another' AF episode?.suggests quite low burden,and so query onto a stonking medication in that case.
Id strongly suggest you would be advised to see an Electrophysiologist .
Some ,not all ,Cardiologists are pretty vague about AF and other arrythmia. Yours sounds like an old school type!
Where do you live? UK?
HiCardiologist or EP? Remember, you can always ask fir second opinion. Glenfield is not too far from you,or UCHW( Coventry)
See how you feel,go with your gut feeling xx
My dad had his surgery at 57 at glenfield and they did an amazing job, he’s now 70 in April 🙏I could see if they would accept me xx
Normally you can choose,I'm in Mansfield and choose Glenfield over City..Paid private at the Park for a zio monitor and to see Dr Chitkara.Cuts out alot of Red tape,try and ask for a Echo.Ive had an ablation my results from the zio monitor where bad,svt,missing beats 82 episodes in 12 days.NSR since November procedure.Its scary but things can get better,I'm 53 and male
I’ll try this, really appreciate it - I moved from kingsmill as I’m really not a fan.
The heart nurse was good at King's Mill, a lady called Solley.Dont mess around with it your only young,.The Park was good money spent.If you want to talk about it I'm available for a chat,it was a bit of a firestorm for me but all good now.The people on this forum are amazing
My Afib they believe was from pulmonary embolism blood clots on my lungs.I was very fit at the time,
drsaagarmahida.co.uk I went on a top doctor list and there were hardly any electrophysiologist - this man sounds really good x
From what the cardiologist said, I think you know more about atrial fibrillation than he does. Best to pose those questions to a more sophisticated electrophysiologist.
Jim
I think I may pay privately to speak to an Electrophysiologist. I still don’t feel satisfied yet again. I know about cardiac remodelling - and I know it can progress quickly, not always.
Hi Wishcld,
I think you need to do that too. A cardiologist is totally different to an EP unfortunately. I have seen both and it was only the EP who really looked at my AF.
Hi Wishcld
Paroxysmal AF is defined as occuring up to 7 days. If it occurs more frequently up to a year it becomes classified as persistent.From my studies about 30 % go on to persistent from recurring PAF. Persistent AF and long standing persistent which is defined as AF for more than one year are less responsive to conversion to SR. That is why many individuals with PAF are advised to have cardiac ablation to forestall progression to persistent AF, often associated with irreversible anatomical changes in the heart due to ongoing chronic inflammation.The problem with that approach is as I mentioned only 30% progress to persistent AF and secondly cardiac ablations may not be successful and require repeats. Cardiac ablations are described as low risk unless you experience a life threatening consequence. As a physician with a history of asymptomatic longstanding persistent AF that I converted to SR now for 20 months, I will continue my low risk protocol if I can avoid cardiac ablations, meds, and electrical cardioversions, all of which have considerable recurrence rates of AF. I am not advocating against those interventions for AF individuals who have serious cardiac issues but I do think my protocol , which has been successful for me, may have a place for PAF individuals with supervision by their professional health provider. My problem is getting the medical profession to take a relook at careful scientific administration of oral supplements because Mg treatment in the words of one cardiac editorial questions is it “ myth or magic” due to inconsistent results with Mg administered intravenously. They are missing underappreciated observations that made my conversion possible.
For anyone listening hug your heart and for others who need a hug.
Hugheart
Hello from Oz,
I have had paroxysmal AF for nearly 15 yrs, I’m now 84. I have taken Flecainide 50mg in an evening throughout. I have only had two or three episodes where I have not responded to an extra tablet (pill in the pocket). I lead a normal life, walk the dog, clean the house, do the garden. Like you I don’t have underlying heart problems, so enjoy life and don’t worry. I do take Apixaban to lessen the risk of stroke.
Thanks for sharing that……. It’s reassuring x
who knows what brings it on. I’m on flecanide ..still get episodes..…just learn to live with them and don’t worry about them. Lucky you..I’ve never seen a cardiologist lol..only phone calls.
Dehydration is another factor, get to learn your triggers .
Watch the York cardiologist on you tube..very reassuring and talks in a lovely relaxing and easy to understand way.
I was seeing a rhythm nurse who rushed me so I moved hospital x but now I’m thinking he doesn’t know enough lol - especially the progression x
Well…it won’t go away that’s for sure. There is no real cure…just meds..an ablation but don’t think even that is a permanent fix. Just make sure you have anticoagulants to minimise the risk of a stroke but above all…DONT. wORRY x
mine started when i was 35 i'm now 67.. been paroxysmal all that time. Its just got a bit more regular the last 3 years maybe once or twice a year and prior to that on average once every 4 or 5 years. I believe my good Mediterranean diet and regular exercise has helped stay out of it and of course maybe luck. My big triggers have always been too much alcohol, caffeine then followed by exercise immediately after eg... running up the stairs or chasing a mate.... anything steroidal can kick it off and when i break out with cold sores(HSV) and thats a viral thing and inflammation in the body, AF does not like that.
I’m glad you got through as I’m 43 and thinking can I get through this. Have you stopped drinking then.
Firstly - I think it’s a really good idea to cut out all alcohol YES, but also sugar, artificial sweeteners and ultra processed foods - all of which create inflammation in the body = irritation to the heart muscle = arrythmias. Just see if it makes a difference because you are young and believe me that it doesn’t get easier as you age.
I would always advocate Lifestyle Adaptations first - try supplements such as magnesium and anti inflammatory (avoid the drugs such as ibuprofen as they can cause AF) before other treatment plans such as drugs and ablations - all of which do have affects in the long term. What is disturbing is that so few doctors advocate Lifestyle but one EP who does is Dr John Day who wrote a book called The AFib Cure. What he says in it that Lifestyle changes may not always work for everyone but they will certainly help keep you fit and well and if, as and when you need to take meds or have ablation - more likely to have a good outcome ie: no more AF.
If you are a good weight, sleep well and other than AF fit and healthy then it is time to see a specialist and talk about best treatment plan for you.
Best wishes
My AF was similar to what you have experienced at the start. I agree with comments made on seeing an EP.
I have just undertaken my second abalation. After my first abalation I was AF free for 9 months but it came back.
My cardiologist will not take me off blood thinners due the risk of stroke.
Mine came following a virus and after an echocardiogram showed my heart was structurally sound I was eventually prescribed Flecainide by an EP I saw privately after what my surgery prescribed proved wrong for me after only three days! At first I took 100mg as a pill in the pocket (PIP) but now that I take it regularly I am virtually AF free and have reduced the first dose of the day. But I was well into my 70s before this started and you are so much younger so that’s sad. The EP told me that unless an episode was with a very fast heart rate and continued for long, I would not be at risk of stroke and guess it’s the same for you. When I took it as a PiP it stopped episodes in a few hours and thus I have been fine without anticoagulants. Try not to worry and just rest if you do get the odd episode, having taken the Flecainide. Welcome to this helpful club!
Thanks for that. I have good and bad days worrying how my life might end up…… I exercise and everything now.
Well, don’t overdo it!
I feel like a mirror image to you. Mine was exactly the same. I had an ablation in July 24 as HR with af was in the 200BPM. So far all is ok. Still get ectopics but have not had PAF or AF since the end of the blanking period. I’m on Edoxaban for coagulation and have Flecanide PIP as a just in case. I walk the dog daily. Still scared to push to full exercise. I have not had alchohol since February last year and have decaffeinated drinks. I don’t eat bread and try very hard to stay away from sugary things. So far so good. I wish you luck.
Hi ,
I have PAF aswell and been taking flec now for approximately 10+years. My heart races occasionally and I try to deal with it, slow breathing and a kind of meditation.
We all know the list of triggers and eliminating all of them , I think, is unrealistic and would make life rather dull.
It's more about moderation now, although I try to avoid caffeine (never really bothered me anyway), sweet treats artificial sweetners.
I still eat spicy food , drink alchol etc
I live a relatively normal life.
Taking flec , if it helps you, is not a big problem, in my opinion.
Good luck 😊
People have said they can drink on flec and they are ok.
Hi Wishcld,
It’s best to give up alcohol unfortunately. Some can get away with it and drink moderately, but I still believe that it is worth eliminating it altogether as it can be a definite trigger.I used to like a nice cold Prosecco or a glass of red wine, but I haven’t had any now for nearly four years. I can drink most alcohol free wines and spirits. Some are susceptible to additives ( sulphites) in them, but not all of us and I seem to be ok. It’s trial and error still unfortunately. I’m also ok with coffee, but I do limit the amount. We still need some things in life we enjoy.
Definitely see EP (electrophysiologist) as others have suggested (electricians & plumbers have their own skills) - I fortunately went privately so saw the consultant every time & no horrendous waiting lists. If that’s not an option, look up consultants in your area (BUPA have lists online) choose your local area private hospital to see who is around & then see where they do their NHS work (if it’s not stated on Bupa site just call the listed secretary & they’ll tell you) Get Gp referral to one you feel is best qualified.
I think I’ve found a private one I can get in touch with.
Hi there yes it is a very common condition and when I first was told I have it I was very concerned to say the least...but it can be managed with treatment and many people lead normal , long and productive lives ...I found a few lifestyle changes , I.e . No more intense fitness training just moderate fitness and a few diet changes have really helped along with the flecanide I was prescribed..and as time has gone on I've been able to reduced my dose by half because of the changes...its a case of what's best for you treatment wise and the cardiologist should help you with that...to much intense excercise by the way is not good for afib and can be just as big a trigger for an episode as alcohol etc..
add indigestion and your cardiologists conclusion about triggers is absolutely spot on! I had a virus a few weeks ago and had two attacks after not having one for months. Try meditation, small meals and limit alcohol! I also think that magnesium taurate is good and also co enzyme Q 10
Sounds good what your doing.
I was diagnosed with lone paroxysmal AF in 2020, my heart being structurally sounds, they could find no reason except perhaps my over indulgence in wine and stress. I was treated with medication but my episodes became more frequent and lasted up to 36 hours. Paid to see an EP and we tried to control it but nothing worked and he said AF is like a jack in the box the more it pops out the more it wants to! It nearly always progresses. I had an ablation in March 2024 and whilst I was terrified I was told that it's best treated when paroxysmal. It was successful and I've had no episodes since 🤞
That’s good. Glad it’s going ok, for you.
Hi
Was diagnosed prior but Sept 2019 I was diagnosed STROKE - Embolic type wirh Rapid and Persistent AF and a scan for a check on my carotid arteries showed a shadow on my thyroid. This was the cause of AF which caused the stroke.
So none if what he has quoted fitted my diagnosis and explanation.
Steps are lose weight, stop neing stressed or anxious. It could be a family trait.
High Heart Rate - rapid needed to be brought under control asap. Rhythm NOT as important. ECHO to check heart for structural damage. If any Flecainade NOT for me.
Over next 2 years 3 months - no follow up Stroke or AF. No one cared. Metopolol I could not exert - sweating and breathless 186bpm avg Day. Demanded Public Heart Specialist. 24Heart Monitor reported bpm Day as above and 47avg Night with 2 swc pauses.
Changed to another BB Bisoprolol 24hr check 156 Day avg same at night mentioned above.
Both BBs did not control 100 or under H/Rate.
Needed 2 operations not Heart.
Locum Dr the best in her 80s but had AF earlier in her life directed me to go private.
Interested he introduced CCB Calcium Channel Blocker. 1/2 dose took me down from 156 to 51 in 2 hours.
We twinked it to Diltiazem 120 CD mg early morning and Biso.. for NP Night 2.5mg.
In December BP went low so no more BB Bisoprolol.
CCB Diltiazem saved me from more damage to my heart.
You should be trialled on a CCB or BB in pocket until you are persistent or permanent. But you have been put on Flec an anti-arrhymic med as he recognides that rhythm is more important if you have symptoms.
Yesm had the 2 operations stopping PRADAXA 110mg twice day for 3 x 24hrs prior ans 2 x 24hrs after.
Surgeons refuse to do operations if the h/rate is over 100.
Take care, JOY. 76. (NZ)
I’m on bisoprolol and Apixiban and been given flecanide as pill in pocket.
Cardiology appointment 
Update following Cardiology appointment
Update to ‘Waiting List’ post - cardiology appointment 
One year post ablation today!!
