Last week I was in ER for several hours and diagnosed with Afib. I'd like to share my story in order to receive any advice or encouragement going forward. (I'm 68). I have chronic sinusitis and that morning I woke up early with sinus headache and heavy post nasal drip causing nausea. I'd never had it that bad. I took a Sinutab and eventually made myself vomit because pnd was so bad. Stomach felt better but suddenly I sensed my heart going pretty wild. I went into ER an hour later and was all hooked up & told I had Afib and they were going to 'jumpstart' my heart rhythm after a few hours. Just before they were to 'zap' me my heart corrected itself. I was sent home with Apixaban and Bisoprolol and a referral to an arrythmia clinic (haven't received that appointment yet) My blood pressure can sometimes be high but usually sits about 135/84. It became quite high in ER.
30 years ago I was diagnosed with mitral valve prolapse due to a very slow heartbeat (now resting average is about 60-65) but 10 years later I was told it wasn't in fact mvp just an 'irregularity', but I didn't need further testing or treatment.
I was pretty anxious getting home from ER last week (I have always suffered from anxiety) and slept very poorly for the next few nights - a vicious circle because I read that poor sleep can be a trigger for Afib. I've been taking melatonin and trying 'good sleep habits', that seems to have helped a bit. Last night I actually got 6 hours decent sleep. Also trying meditation and tai chi to calm myself. Current issue though is that I also have silent reflux (LPR) and suddenly a day ago it started acting up. It hasn't bothered me much for years - last summer I had a bout that was relieved by 14 day course of Nexium. No real problems since, until yesterday. I'm also starting to really feel what I think might be frequent 'skipped beats' but not absolutely sure because the LPR really affects my throat and gives me irregular sensations there.
I can't get in to see my GP to discuss all this for another week. I'll be alone for a week while my husband's away and I'm just anxious wondering if something serious might happen in the meantime. I guess I'm just getting used to the whole thing. I've never been on any prescription meds so its a bit overwhelming. I do eat well and walk alot every day.
Thanks so much for listening.
Written by
zbmlm5
To view profiles and participate in discussions please or .
Welcome! I'm going to assume based on your usage of the word "ER" (They say "A&E" in the UK); the fact they offered to cardiovert you right away; and the time of your post, that you're from the US, like I am.
It's possible that the episode and/or the meds you were given, have triggered your LPR -- so another course of Nexium might be in order, if your doctor agrees.
Hopefully, if things calm down in a week or so, they will let you off the bisoprolol and reevaluate you for the Apixaban, based on your risk factors.
Beta blockers, like bisoprolol have their place, but they can also sometimes cause more problems than they solve. Personally, I could never tolerate them and did just fine without beta blockers for the 40 plus years I had afib.
When you do see the doctor, you might ask for a referral to an electrophysiologist (ep), who are the afib experts. They may then offer an catheter ablation, which is now a first line treatment in the US. But personally, I think it's much too early in your journey to go that route. You've only had one short self-terminating episode.
That said, an ep can also be useful with the afib meds, should you need them, where your GP may be limited. And of course, should you end up needing an ablation later on, you will have already established a relationship.
Meanwhile try and take it easy and not stress too much. Sometimes it's just an isolated incident, but even if not, afib is not that hard to treat these days.
You may get some advice to read as much as you can about afib, and depending on your personality that may suit you. However, at this early stage , it might just add stress because a lot of of what you're gonna read about may never end up affecting you.
And likewise, while this place is a terrific resource, we tend to attract the hard to fix cases, because the easy to fix ones, don't need as much support. Hopefully -- like the majority of afibbers-- you will be in the easy to fix group and things will work out fine.
I very much appreciate your response James. Yes, by ER I mean Emergency (A&E). I'm actually Canadian. The clinic I'm being referred to is actually staffed by electrophysiologists so it sounds like I'm fortunate.
I definitely overthink and over-research everything so I appreciate your advice there.
One question: with my heart rate back down to normal, and on the meds, is it unusual to still have frequent palpitations in the form of 'skipped beats'.
Where I definitely take the most hope and reassurance from your response is your 40 years with Afib - thank you! You may have given me a chance at a good night's sleep tonight with that!
Skipped beats (ectopics) are not uncommon after an afib episode. Hopefully they will calm down soon and that's in part why they put you on the bisoprolol, at least for short term.
Good to know your clinic is staffed by ep's and a cardioversion was offered right away. That's pretty much the way it works in the United States, but I've read here where elsewhere many may have to wait months and months for one, all the time remaining in afib.
That said, a good percent of afib episodes naturally convert within three days. That's why my ep, told me no need to call him unless I'm in afib for at least three days.
However, the difference here is that I was given medications to lower my heart rate at home while waiting to convert. And there are also drugs you can take it home that actually do the converting. And that's why you want to see an ep, because they can give you these meds along with a home plan in case you go into afib again, saving a trip to the ER.
But in the meantime, going to the ER is the right thing, just like you did , because you do not want to remain in atrial fibrillation with a high heart rate any longer than necessary.
Thanks again Jim, I do appreciate your introducing me to some of the proper afib vocab!
And, I did go to bed reassured but now here I sit awake at 4:00 after waking up with a fast HR with some skipped beats - 100-110. It's calmed down now - after 30 minutes - about 75. But my resting HR is about 60 which it was when I went to bed. This happened about a month or two ago a few times a week. I'd wake up with my heart beating really fast then it would calm down after a few minutes. I didn't realize then I guess that was my intro into afib world. None of these nighttime HR were like the 'craziness' of my heart last week when I went into ER.
My concern is that I'm on meds now. I guess I just thought nothing might happen again so soon. I realize the apixaban won't affect this but thought the bisoprolol would? Do these 'nocturnal' HR jumps mean something specific in afib? If so is there anything specific I should do when they happen other than deep breathing (and panic that I'm going to have to go back to ER)? I guess alot of my anxiety is around how do I know when I am supposed to go to hospital?
Is this just now my new normal that I have to get used to?
Hard to tell what's going on without an EKG. You could be having short episodes of afib. or it could tachycardia or even ectopic beats. That's why many of us get home EKG devices like the Kardia 6L or Apple Watch, so we can document and share the EKGs with our ep's.
Busoprolol will not necessarily prevent atrial fibrillation, but it will help control your rate in atrial fibrillation, which is what might be happening.
As to I went to go to the ER. In general, go to the emergency room with atrial fibrillation if you have chest pain, severe shortness of breath, fainting, or a very fast or slow heart rate that doesn’t improve. But sometimes, in the beginning, people get afraid regardless, and need reassurance, so definitely OK to seek help as it's better to be safe than sorry.
Not a doctor nor do I have any medical training, but what you're saying so far sounds pretty normal and nothing to be overly concerned about. Hopefully things will get sorted out better when you see an ep.
Let's kick off by saying welcome to the forum. Now then ~ Let's see if we can reassure you a little, shall we.
It's normal enough to feel overwhelmed after an A&E (or ER) visit, especially when you’re suddenly faced with new medications and told you have AFib. There isn't one person on this forum who didn't feel the same when they were told.
Not one.
The 'jump start' you speak about (I call it a spark) is a cardioversion (CV). Basically, it resets your heart to sinus (normal rhythm). Now, here's some good news for you. If your heart returns to sinus after a CV, it suggests your heart is open to a number of treatment options. Being given Apixaban and Bisoprolol is pretty standard ~ nothing to worry about.
Now anxiety! Afib and anxiety feed off each other ~ they are married to each other. You’re already doing things like meditation. Try LSD too ~ Long Slow Deep breathing (not the other sort of LSD that was popular in the 60s!). Google it.
Here's a quote for you:
Afib itself, especially when you're on Apixaban, is rarely life-threatening. It’s scary, yes, but not inherently dangerous. If something changes drastically (like chest pain, fainting, extreme breathlessness), then of course get checked, but otherwise, try to keep building trust in your body and these early days of managing Afib.
It's a pain getting to see the doctor and having to 'wait and worry'. However, you're already doing everything right. You’re listening to your body, seeking help, sticking to your meds, staying active, eating well, and looking after your mental health.
You couldn't do any more if you tried.
You wrote:
I'll be alone for a week while my husband's away and I'm just anxious wondering if something serious might happen
Nah ~ don't be daft! Nothing's going to happen to you. That's a 'Paul's Promise' and I never make those on the forum unless I know I'm right. I'll make you another Paul's Promise, too.
AFib isn't half as bad as you think it will be now.
Enjoy your day, and please try to stop worrying so much🙂👊
Thanks so much for all this advice Paul. I'm reading it now because ... (I'm pasting here my response to Jim just to save time in the middle of the night):
"I did go to bed reassured but now here I sit awake at 4:00 after waking up with a fast HR with some skipped beats - 100-110. It's calmed down now - after 30 minutes - about 75. But my resting HR is about 60 which it was when I went to bed. This happened about a month or two ago a few times a week. I'd wake up with my heart beating really fast then it would calm down after a few minutes. I didn't realize then I guess that was my intro into afib world. None of these nighttime HR were like the 'craziness' of my heart last week when I went into ER.
My concern is that I'm on meds now. I guess I just thought nothing might happen again so soon. I realize the apixaban won't affect this but thought the bisoprolol would? Do these 'nocturnal' HR jumps mean something specific in afib? If so is there anything specific I should do when they happen other than deep breathing (and panic that I'm going to have to go back to ER)? I guess a lot of my anxiety is around how do I know when I am supposed to go to hospital?"
Is this just now my new normal that I have to get used to?
Paul, I'd love your thoughts too on what's happening with these rapid nocturnal beats. Again thanks, especially for your 'Paul promises'. Calling me 'daft' is actually very reassuring!!
"I did go to bed reassured but now here I sit awake at 4:00 after waking up with a fast HR with some skipped beats - 100-110. It's calmed down now - after 30 minutes - about 75
Hmmmm? Imperfect perfect! 75 bpm (Beats per minutes) is fine. Between 60 - 100 bpm is ok. 110 bpm? A little high, but I wouldn't be too concerned if it's just for a short period. I don't think you have too much with this one*****
I realize the apixaban won't affect this but thought the bisoprolol would?
Bis (Bisoprolol) can be very effective. It can take a few weeks to 'kick in'. I would guess you are on a small starter dose of between 1.5mg to 2.5mg a day. If it continues, speak to your medic, who may increase the dose. It's often trial and error with meds until you find the right mix.
Rgds Paul
*****PS. Please note I'm not a doctor and my post is only meant as something to discuss with your GP ~ it's not medical advice. Ask him/her to refer you to a cardiologist, too.
Thanks again Paul. Yes, I'm only on 1.25mg Bis. A lot of 'skipped beats' happening at the moment & reflux really acting up. Just trying to chill out - not so easy.
I do appreciate that you're not a dr and not offering advice in that sphere, but I do appreciate that the info and opinions you offer provide emotional reassurance.
The skipped beats are called ectopics. Everyone gets them from time to time ~ You don't have to be an Afibber to have a missed beat.
I always state that I am not a doctor when giving advice that might be 'medical' in any way. People tend to sometimes follow what they read online. Most forum members are not medically qualified, so they speak from their personal experience. It's important to let your doctor have the final say about any medical matter. The one thing I do try and offer is emotional reassurance to newbies. I was in your position years ago and know how I felt when I was first told.
Scared!
I can say 'hand on heart' (pun🤣) that Afib has its ups and downs, but hasn't affected my life in any way whatsoever. There are far more sinister illnesses to have. A friend of mine died from cancer in her early 50s ~ it kind of puts it into perspective (RIP Tracy).
Your doctor may 'up' your dose of Bis. I suggest taking it at night after food, if they do, as this slows down how quickly it's absorbed by the body. and lets you sleep off any 'zombie' like effects. When I was on 5 mg of Bis, that's how I felt ~ like I was from zombie world! Others manage 10 mg (max dose) without a problem. We are all different with regards to our reactions to meds and Afib. The only common denominator is that we were all like you are right now, very worried when we were diagnosed.
Wow, the support I'm getting here is bringing tears to my eyes. Thank you Paul!
I, like you, always try to think about what others have gone through in order to put things in perspective (my s-i-l died of ALS a couple years ago - that really puts things in perspective). But still, as a friend says, 'your story is your story to feel'. I do look forward to the day that I get used to this and get a grip on it, and am able to then encourage others.
I'm only on 1.25mg of Bis right now which I've been told is a very low dose. My GP is away today so unfortunately I can't even ask about an increase until after the long Easter weekend. I imagine my pharmacist (who is terrific) couldn't endorse that?
Hello again. I had another challenging night. Please bear with me with the following nighttime details; I have questions about them.
Woke up at 2am, hr 100-110. I sat up and did deep breathing, hr down to high 70's after about 25 mins. Amazingly I fell back to sleep after a few minutes. Woke up again at 4:45, hr 100. I decided to see what happens if I just lie there, breathing normally. Gradually hr went back to 60s after about an hour. Again, amazingly, I fell back to sleep and woke about 7:45, hr 90. Now, after being up for 1/2 hour, hr back to normal 60s.
After my first waking I became pretty stressed and thought I've got to go back to ER simply to see if my meds could be upped (right now 1.25 bisoprolol). Because its Easter long w/e & I'm away several days next week I can't see my GP until next Fri. I figure ERs the only way to go.
After second waking I started to think - maybe I can just keep doing what I'm doing and make it to next Friday if things don't get worse, without worrying about upping meds.
My biggest concerns: sleep and the fact that poor sleep could be a trigger for a big afib event like my intial one. How do I keep going, night after night with these wakings? Am I getting any high quality sleep at all? And, the bigger question: wow - is this my life now - sleep actually brings on high HRs and frequent wakings? I've not read anything about these nocturnal wakings. Does anyone else have this experience?
I know the heart rate numbers from last night aren't terrible, but because my resting rate is in low 60s, I'm assuming mine being going up to 100 and beyond is more significant than the same increase in someone's who's resting rate is 90?
Hi, the first thing that struck me reading your story is that you need to consult trusted Alternative Practitioners - Naturopath, Nutrionist etc to avoid more Big Pharma medication and seek more effective solutions.
Yes, it is expensive and you have to believe it worthwhile as improvements are not instant but the aim is to improve your body permanently not just put another 'sticking plaster' over the last one.
it appears in some like me that drugs like sinutab which have Pseudoephedrine or similar can set off the heart, i stay well clear of them now. They are known to kick off AF in some.
Thanks for mentioning this. My dr wanted me to go on nasal sprays when I first was diagnosed with LPR. I did for a few weeks but then decided I didn't want them and haven't used them since. I do have a combo of LPR, sinusitis and allergies so these symptoms at the moment along with afib are making life a little uncomfortable!
Hi and welcome to - some great advice above and I would emphasise Secondtry’s point that the fewer pharmaceuticals you can take, the better. If you can avoid Beta Blocker altogether, great. If you HR is normal and only raised when in AF ask about PIP - Pill in the Pocket, at best Beta Blockers can make you feel sluggish and sometimes increase rather than decrease anxiety. There are also other types of rate control drugs
Lifestyle does play a huge role in AF and the heart/stomach connection is very important which is why a consult with a nutritionist (not a dietician) may help you as if you can get the GERD under control without meds you may very well find it will help both your heart and anxiety. This is what helped me and you may already be doing some of these but I can’t emphasise how important they are and what a difference if you can practice them.
Stop eating all white carbohydrates, especially for breakfast
Sip hot water after a meal or whenever you feel nauseous, avoid antacids if you can and especially PPI’s.
Have smaller meals and don’t eat anything 3 hours prior to bed
Probiotics are very important but best way to increase your gut biome is to eat leafy vegetables, fermented foods such as yogurt, kefir, cheese, sauerkraut, sourdough bread etc.
Breathing through your nose is also incredibly important and I just read yet another study emphasising this. I had dreadful Nasal Drip for about 2 years and my GP prescribed a very mild steroid nasal spray which helped and alongside practising regular breathing exercises from Buteko. I tape my mouth up during sleep which forces me to breath through my nose, not my mouth - also great for anxiety..
Focus on what you can do to help yourself right now, your priorities will be good control of your BP and your anxiety. Research nutrition and breathing, research AF and always check any OTC medications and ask the pharmacist about it and AF as many of these preparations are contraindicated for AF.
AFA have an excellent information data base, recommend you start there
AF is scary to begin with but a lot of people live a long time with AF which is considered a chronic rather than an acute condition ie: it may well come and go on it’s own.
There are many nuances, individual circumstances and different protocols between health systems but sounds as though you are in a place with good access to EPs which is fantastic!
It’s almost certain that nothing serious will happen to you. You will have had an ECG in A&E and that is what will have allowed them to feel confident that you are okay to be allowed home.
I expect the Sinutab set off your AF as the decongestant it contains can affect the heart rhythm. The top of the heart is where the issues lie and the important bottom part remains thankfully rather well separated from this. The issue with AF is the risk of embolism leading to stroke, but the apixaban has resolved that.
AF can feel much worse than it is and most people cope with their episodes, frightening as they are, especially till you get more used to them. A&E will unlikely be needed again unless you start to feel faint. If your heart rate stays high, you might ask your GP if you might take an extra bisoprolol tablet. That’s what I did and it worked well. Have you had any other investigations such as an echo scan? That will help ascertain that your heart is otherwise sound.
The only doctor I've spoken to about all this is an ER doc. I should have an appointment at the afib clinic in 3 weeks and will see my GP next week. I expect I'll get an echo etc at the clinic appt. in May.
Right now my physical issue is that the combo of reflux and afib seems to be creating more skipped beats than before, which is pretty anxiety-producing. Main emotional issue is the uncertainty and the 'do I or don't I' go to ER if I go into afib again. I am okay with staying home for a while and trying to ride it out if that's a safe thing to do. I'm just anxious about not knowing what's best, especially if I wake in the night with a racing heart. I appreciate your suggestion about asking my GP about extra bisoprolol.
I really appreciate the encouraging messages that afib isn't necessarily as bad as it first seems and that I can live a long and good quality life with the right care. (once I get a grip!)
Thanks again for your support. Already this forum is invaluable.
I get more “skipped beats” than AF. They are more troublesome, too, and more frightening for some reason, maybe it's that the unpredictable “thump”?
Those are in fact “ectopic “ beats which are usually the same basic problem as AF - electrical mis-conduction in the atrium. AF itself occurs when the skipped beats find a circular route and they then the atrium carries on chaotically pulsating.
You are not on your own. It is hard for all of us, when we first get diagnosed with AFib. I was very anxious as well. I just read up about it and found good advice from everyone on here. You just have to learn to live with it. You might be offered an ablation in the future, which lots of people have had, to relieve it. Hopefully, in the future, someone will find a guarenteed permanent cure for AFib. Best wishes.
Thank you for your encouragement. I guess I have to find the right balance between enough information and too much info and research. I suffer from 'OCD of overthinking' which can cause anxiety to loom large in my life. 😶
your anxiety is probably your biggest enemy right now. I have sick sinus syndrome on top of everything else don’t panic over it not being NSR no it’s not good but you have a short time before you see your doctor. I had tachycardia for six months straight around 200 beats a minute that is damaging. I ended up with heart failure.
talk to your doctor about your anxiety. I never thought blaming it for anything. It was my EP who took control of it because my heart and pacemaker everything was perfect. I had meds for anxiety, etc. to be used as needed. I didn’t think I needed them much he straightened me out and said I needed them more than I knew and realized he actually spoke with my GP I was put on a regular course. He was absolutely right. What a difference even as far as having flutter, etc. our head can really mess us up. That’s why I hate to see so many people on here get into stuff they shouldn’t. How many years does it take to be a doctor especially an EP? That’s why I know I don’t belong into that stuff lol my doctor already did all of the training I trust and rely on him. I don’t know if Bob has something basic about having a fib and flutter just the basics he does mention it’s benign. I have seen him tell people it doesn’t kill. Maybe not in those words a fib does what it wants to do. it’s annoying as can be. Yes it can make you feel miserable, but it goes away. If it doesn’t, your doctor will do something when we have the bouts of them. It just is what it is. sometimes we trigger them. I’m sure you’ve read all of us talking about our triggers for and especially anxiety. I had one of my kittens die this morning. She took her last two breaths in my arms later even though they tell me not to I took my oximeter out. My heart rate was 107. It’s back to normal now. It was 72 earlier, but that shows what being upset does to me.
when my cousin bought the we didn’t know we had a small colony of are constantly trying to get ahead having them fixed. It’s an expensive battle to try to win and meanwhile inbred only have a 2% chance of surviving this baby was two months old. I’m always doing checks on them. The little ones are in a crate. I let the mother in and out she was in there at the time. I keep the little ones in because some of the bigger ones think they are toys because they are so tiny. I never thought I would be able to do something like this but someone needs to step up if you’re an animal lover how can you not right now? I am on the verge of tears just talking about it. By the way I take my anxiety med at bedtime. It’s probably pretty much worn out by now so I feel like I do.
try to make a list for the doctor. I have read in several places you can’t take melatonin all the time although I see people on here they do and have once again I would want my doctor to tell me, whether you are having problems or you’re not you always want to try to do the right thing sometimes with a fib it’s not possible I call it a nasty little bully that likes to push us around and make us feel bad when it can
take a deep breath Bob gave some great breathing advice. Do you have anything for meditation to listen to? I don’t sleep well. I wonder if it’s also an age thing I am also in a bad pattern drink water three hours later go to the bathroom get more water three more hours up then it seems like it’s time my cousin gets up for work. I swear the man does not stop talking from he opens his eyes. I am down the hallway. I can still hear him with the lol I really have to exhaust myself to sleep and even then it’s not always that many hours unless I go to the doctor every day for whatever reason a day traveling to the doctor etc. knocks me out cold almost until the next morning. I’m wondering if it’s because he made me feel better about things not worry as much so the anxiety lifted.
you are not alone not even close. Look at all of us out here how many people here a fib before they got it? I might’ve heard of it. I never paid attention right now. I’m being diagnosed. Will know more Monday about thyroid read up on that and see what a nasty thing it is. Oh my goodness it controls your entire body according to my EP the other day I told him I read the list on Mayo Clinic and I can check almost everything off that is wrong with me right now just like others. I jumped to the wrong conclusion and blamed my heart and pacemaker even though my other EP told me not to do that. I will be glad to see the doctor Monday hopefully get rolling on whatever he is going to put me on the has already been done. I don’t want more but I don’t have a choice right now my hair when I brush it makes small farm animals for out of my hair. I am not coming bald out of the scalp. It is shedding, etc. my long my shoulders once thick and what I felt was my only good feature needs to be cut on Tuesday my choice it certainly isn’t any good the way it is. I look like I get medical treatment that causes hair loss. The light at the end of the tunnel seems to be most people get it taken care of. I didn’t even know a friend of bad. She has a beautiful head of hair now I didn’t know her when she had gotten sick with it.
don’t compare yourself with others. We are sharing our stories. Some of it may sound familiar and may give you a little bit of peace in your heart. If it sounds scary don’t let it scare you. No one says you have the same stuff. It is so confusing I know do what your doctor says. If you don’t have a doctor, you have faith in and trust with all your heart. Remember, you only have one I would then look for another. My I always said that he and his team made me feel swaddled with meeting my new doctor the other day, and meeting many of the staff there also having spoken on the phone with some I feel the same way and that is the way you should feel about your doctor. They are not God they are not miracle workers but even if they do make good money, they didn’t choose to do this for money. I think they were born to do it. I teased my other EP. I told him I could picture him practicing heart procedures before he came out of the womb lol. He really is a genius on top of everything else. He even won jeopardy when he was in college yet to meet him he would never have believed it young humble, soft spoken, but he knows how to talk to you and he really knows what to do even when he doesn’t he will figure it out.
please let us know how you are doing stop scaring yourself because I know you are just like we all do or did like I said that is our enemy being anxious and scared the more of us that are on here shows how we are all surviving that’s a good thing
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
afib and blood pressure
Afib worse since Ablation
Afib stressed out :(
Paroxysmal Afib at 60
Upgraded from paroxysmal afib into persistent afib…. Deep joy!
