PAF 29 years and now ectopic/skipped beats are driving me mad

[Behappy63]

I’ve had paf for 29 years and been on soya lol then bisoprolol. When I develop and is fast. My personal best was 245 while 38 weeks pregnant. A dose of verapamil got me in to double figure but the warning was it would slow Labour. My Labour was 1 hour so hubby was grateful for the slow down lol.

anyway fast forward had an ablation 2007 which didn’t work as errant pathways too close to so node but in general I’ve been brilliant and no issues. Now it seems something has changed.

janury 2024 I decided to get fitter and swim I built up over 6 weeks from 25 mins 3 time a week to 45 mins 5 times a week. Then I noticed that when I started my swim the first 5-10 lengths were bouncy. Then I thought perhaps I’m going to far too quick so curtailed it back to zero and now every day I’m getting these weird events. But it seems my irregularities have some patterns I wake at 1:30 and the next 4/5 hours have have Tom and Jerry heart- not fast and not AF according to the Apple watch sometimes inconclusive. But I’m knackered in the morning generally once I take the bisoprolol the worst of the symptoms subside albeit they will jump back if I walk about too fast. Today I upped the bisoprolol by 2.5 to 7.5. I don’t feel it has helped as I’m have jumps during the day. So will go back to usual dose tomorrow.

The Question is how do you get a good sleep how do you ignore it?

many thanks!

[AAJJTt]

Hi,I started out 5 years ago with a heart attack (nstemi II ), this was my introduction to paroxysmal Afib (the root cause). Treatment - Flecainide; no episodes for 4+ years. Bisoprolol only for PiP.

In the early days, before treatment, ectopics were always the harbingers of an Afib episode and consequently I was/am very wary of them.

I did suffer badly from ‘ectopic storms’, which drove me ‘mad’, robbing me of sleep. Anxiety just enforced a negative feedback loop that descended into more ectopics. They were investigated by my cardiologist, the burden was actually not that high, less than 3% and he wasn’t overly concerned. It didn’t feel like that, sat up and alert at 3am, slavishly watching 5 pvcs on my Kardiamobile trace. Anxiety is definitely a catalyst and an amplifier; getting control of it, is the way forward. I turned to a course of cognitive behaviour therapy and for a period, an evening sedative. This worked for me, it broke the cycle and it all settled down.

CBT - I was always a bit sceptical about the whole area - talking therapies/mindfulness but it did help; don’t ask me how though 😀 The sessions covered how to spot unhelpful patterns of thoughts, feelings and behaviours and techniques on how to deal with them.

I still have ectopics, daily sometimes, my Afib is vagal in nature and I tend to pick up on ectopics after I’ve eaten. I still have runs of them too, Dec/Jan is always bad for me for some reason and I had a stint earlier this year. They don’t bother me the same and I know I cannot let them ‘get into my head’. I literally give myself a good talking to - “ Ok, ignore it, breathe in, carry on (or in bed rollover), my heart is not going to stop.” As I mentioned previously , it just breaks the cycle of catastrophic thinking (especially at night ) which descends into anxiety and promotes more ectopics.

A device like Kardiamobile can useful too, it detects Afib well and with a bit of research, you can detect ectopics too. I use it now occasionally, if I feel different- just as a check. ‘Ectopic Storms’ - I have a look, yes it’s telling me what I know - some PVCs, no Afib - put it away and carry on. Note - these devices can be addictive, so they need to be used wisely.

- Breathing - good too. LSD = long, slow deep. Inhale and exhale slowly (something like 6 a min) with slight pause before exhale. Filling your belly with air (diaphragm) not just raising your chest and shoulders. You need to persevere with this - 5mins, it’s not instant but just breathing calmly slows down you down, allowing you to relax.

Best.

[Behappy63 in reply to AAJJTt]

Thank you so much for this calming info. This is a great comfort. My worst episodes of Af have been 1-4 weeks of super stressful events like death near death of relatives moving home work etc etc. I also think my ectopics are of a vagal nature too. And generally happen in the morning. ( circa 2am -9 ) are the peak times. CBT is a great call I will look into it. I do feel that I’m anxious- and I’m usually pretty chilled- I notice my shoulders are high walking around the shops almost as if I’m on high alert. Anyway have been doing the breathing and it does help and I do drop back iff to sleep. Anyway thanks again much appreciated. Keep well!