ongoing AF not responding to drug

[Midnight2022]

I am 78 and have had AF episodes for 10 years and always managed to control them by taking sotalol when they occurred usually at night. However this Thursday I woke with AF and as of now Sunday it has refused to revert to normal rhythm in spite of taking double dose of sotolol. I was examined in A and E at local hospital to check for heart attack but sent home with urgent referral to cardiologist. My resting pulse is around 95 and a soon as I get up my blood pressure drops 20 points and I feel permanently exhausted and dizzy. I’m terrified this will go on and on. I live alone. Does anyone have any advice? Should I just try to carry on normal activity in spite of dizziness? Celia

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Hello

What a lovely name you have Celia

I do not know much about AF but living on your own with what you have described and how you are feeling must feel quite stressful

As you are going dizzy I would just potter around for now and make sure you are near somewhere you can sit down quick if you have one of these episodes

If it really gets unmanageable and you are not managing even though you are waiting for an urgent referral I would go to the Hospital again

I understand your fear but once you get seen I am sure there will be something they can do so you will not have to keep feeling this way they are fantastic now with medications and treatments

I hope those that do get AF when they see your post will be able to give you some better advice than I have been able to but please let us know how you get on x

[jeanjeannie50]

Hi Celia

Are you drinking enough water?

Once when in hospital my blood pressure dropped low and I was told to drink more water, it soon brought my rate up again, Give it a try and see if it cures the dizziness too. Low blood pressure can certainly cause dizziness

A heart rate between 60-100 is considered normal as we age

I've had AF for 18 years

Jean.

[Millbrook]

Hi. My husband was diagnosed with Afib in 2021 when he was 64. He was given 100 mg flecanide 2x a day. And beta blocker. It was reasonably well controlled except for some breakthroughs which an additional flecanide could stop.

In January started to have episodes which would last for days and eventually developed from paroxysmal to persistent and would not convert to sinus rhythm . During such episodes blood pressure dropped -he stopped 2 of his blood pressure meds-and he would feel light headed and dizzy, a fall risk. His blood pressure was 88/63 and heart rate 115. Heart rate would go up higher at slightest exertion and would feel exhausted. He was given digoxin for a few days which brought heart rate down a little while pulse field ablation was scheduled and done 3 weeks ago to fix the atrial flutter and afib. My husband says he can function normally without having to think about afib. It certainly changes your quality of life. 🙏🏻

We are so glad we went for ablation inspite of the fears. A good doctor is not only good at his work but manages your fears.

I would advise you to do the following:-

1. Follow up with your cardio asap to check if you need a procedure and go to A&E if necessary

2. Be careful each time you get up or move because of the low blood pressure that results because of your afib. No abrupt movements and move slowly. Sit down and do not move if you are dizzy.

3. Do not resume normal activities like driving as you do not know when you may get dizzy and be a risk to yourself.

4. Get a friend to help you get organised so you can limit your activities till you get fixed.

I know you probably feel terrible as did my husband but all will be ok once it gets fixed.

Take care

[Karykowj1 in reply to Millbrook]

Hi Millbrook, I am a fit 57 male and was diagnosed with paroxysmal AF while going for my weekly jog back in Nov 2022. I get weekly episodes so have booked a pulsed field ablation at the Royal Papworth Hospital Cambridge UK early May 2023. I note your husband had pulsed field ablation done could you give some more details as I am nervous about having it done. Did you get it done privately or on the NHS? Which hospital? Was it done under general anaesthetic or sedation? Did your husband stay overnight or did he go home the say day? How was the overall procedure. Looking forward to hearing from you. Many thanks

[Millbrook in reply to Karykowj1]

Hi. I am surprised to hear that you were diagnosed in Nov 2022 and already scheduled for ablation May 2023. I understood that most people had to wait awhile.

Whilst most people would take medication to control the afib it is now advisable that ablation is done as soon as possible before the structure of the heart gets altered or damaged. Our cardiologist advised ablation since he moved from paroxysmal to persistent.

We are very blessed to have pulse field ablation as the private hospital we went to just purchased the new machine.

Pulse field ablation was done under GA and it took 1 hour of prep and 3 hours actual procedure as EP fixed atrial flutter followed by the afib- both ventricles-

The EP also did mapping so there is a reference as to where was ablated.

According to our cardio PFA cuts time by half and avoids the complications of old and is now his preferred treatment.

My husband stayed 1 night . He felt abit of chest discomfort, headache and jaw ache. Best is he did not have anymore afib and he is so relieved he is back to normal.

It is understandable to be nervous as we all were. But it should be ok. Wishing you a smooth and successful procedure.

api.heartrhythmalliance.org...

The above article was very helpful to us

[Karykowj1 in reply to Millbrook]

Hi, thanks for your prompt reply it has really helped. AF has had a massive impact on my life in a bad way hence why I wanted to get back to normal asap. Pulsed field ablation seems to be the way to get there. Which hospital did your husband go to and now that your husband is back to normal is he still on the same medication he was on prior to pulsed field ablation? Is he still on blood thinners such as apixaban?

[Millbrook in reply to Karykowj1]

Hi. We are from Singapore so definitely a different hospital from you. Immediately after the procedure we stopped the flecanide.

He is still on rivaroxaban and concor. He will be monitored and meds will be adjusted accordingly.

[MummaSoap]

Hi Celia

I’m sorry to hear that you’re not feeling well at the moment and I can hear how frightened you are.

I hope that I’m not treading old ground for you (if I am I apologise) but here are some natural ways that might help to bring you out of Afib although I would like to stress that I’m not a medical professional:

- splashing or submerging your face with very cold water can help to stimulate your vagus nerve and reduce your heart rate

- the valsalva technique (holding your nose, closing your mouth and trying to gently pop your ears) against helps to stimulate your vagus nerve and slow your heart rate

- concentrate on your breathing and really focusing on your diaphragm as you slowly breathe in and out

It’s ok to feel scared, especially given that you live alone; I would be too. Just be sensible and if you feel at any point like things are getting worse then don’t hesitate to call 111 or in an emergency 999.

Is there anyone that you could ask to come and stay with you for a week or two to give a bit of physical support?

Let us know how you get on and keep talking.

Best wishes

Soap

[Deejay62]

Hi Celia I’m sorry to hear you’re now struggling with Afib symptoms. I have been living with permanent Afib a good few years now. Whenever I feel dizzy or faint, as i sometimes do, I sit down, finding the nearest seat I can find. Mine is due to the stage of heart failure I’m in. To be honest I suffered with supra ventricular tachycardia (SVT) for years, which I found worse to live with due to the constant feeling of my racing heart and when it switched back wanting to pass out. I think this as helped me to withstand Afib’s crazy beats. I hope you’re able to be seen to quickly, because living alone is scary. Like someone else suggested maybe you can ask someone to stay with you for a while, or even contact age concern, they can arrange for you to have an alarm fitted with a pendant on your wrist or around your neck in case you need help. My mum as one of those. I hope you get a speedy appointment with the cardiologist.

[Midnight2022 in reply to Deejay62]

Thank you for your reassurance. I do have an alarm which I wear all the time. My brother has come up from Devon to be with me this week. very kind of him as he has had to postpone his work there as an electrician.My main aim now is to get to see a cardiologist asap. Try to get some control on this condition. Its all been a bit of a shock to be honest. Thanks for your support.