Mental health and arrhythmia

[Crossworder]

I feel bad posting here, so many people with difficulties. I'm struggling a bit to cope with anxiety and symptoms of my arrithmia feel a bit alone and not sure where to turn. Think I have some form of atrial tachycardia which I had an ablation for a few years ago which just gave me different symptoms. At the moment I'm getting long episodes of quite erratic HR where I get skipped beats/extra beats and very slow rates at times (40 -60), at others jumpy and fast rhythms (90-130). This makes me feel unwell and distracted. Saw consultant who suggested I try various doses of flecainide again and a beta blocker. None of these seem to really help, I can't tell if making things worse. I'm waiting weeks for result of 24hour monitor. Its got to the point I feel constantly stressed and unable to go out or concentrate on work or anything most days and pretty much want to stay in bed because of the chaotic rhythms. I worry a lot about what's causing this to be bad and Im a bit pessimistic as to whether I can get any sort of life back and would be interested to hear others experiences or suggestions.

[Barry883]

I’m really sorry to hear you're feeling this way. It's completely understandable to feel overwhelmed and alone when dealing with health issues, especially ones that affect your daily life so much.

Firstly, you're not alone. Many people face similar challenges, and it's okay to reach out for support. Anxiety and arrhythmia can create a vicious cycle where each one exacerbates the other.

Here are a few tips that might help:

Follow Up with Your Doctor: It’s great that you’re seeing a consultant. Make sure to communicate all your symptoms clearly, even if it feels repetitive. Sometimes, a detailed diary of your symptoms and how you’re feeling can help your doctor get a better understanding.

Medication Management: Flecainide and beta blockers can be tricky. Keep a log of your medication, doses, and how you feel each day. This information can be invaluable for your doctor to adjust your treatment plan.

Lifestyle Adjustments: Small lifestyle changes can sometimes make a big difference. Avoid caffeine and alcohol, and try to eat a balanced diet. Regular, gentle exercise like walking or yoga might help regulate your heart rate and reduce anxiety.

Mindfulness and Relaxation Techniques: Techniques like deep breathing, meditation, and progressive muscle relaxation can help manage anxiety and might even help with your heart symptoms. Apps like Headspace or Calm can be a good starting point.

Support Networks: Consider joining a support group, either in person or online. Sometimes just talking to others who understand what you’re going through can be a huge relief.

Mental Health Support: If anxiety is a big part of what you’re dealing with, it might be worth speaking to a therapist who specializes in health-related anxiety. Cognitive-behavioral therapy (CBT) can be very effective.

Be Kind to Yourself: It’s okay to rest and take things slow. Listen to your body and give yourself permission to have those quiet days.

[stemac123]

Hello Crossworder, I have near same problem, short story, I had 3 ablations over 11 years ago for AF and flutter, all failed, but my af did stop, over the years I got alot of ectopic beats I got used to them, then in January one night it started every beat "ectopic" and it went on and on, went to the doctors and was referred to a cardiologist, "still not seen one" had a 3 day monitor that shows my ectopic beats, no AF thank god, over the last 2 weeks my heart rhythm seem to have got worse, I've had to call in sick from work, my heart is fluttering most of the time and goes into a slow beat, the only break I get is if I go out and walk and it goes back to a normal beat, but when I sit and start to relax it start again for hours and hours, I get lightheaded and feel horrible, am actually writing this and it's happening, my appointment to the cardiologist is end of next month, feel it's far to long away, I can understand what you're going through so your not alone

[Crossworder in reply to stemac123]

Sorry to hear. Solidarity. I hope we both find a solution soon.

[AAJJTt]

Hi, ectopics are tough. I totally understand where you are coming from.

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

In the early days, before treatment, ectopics were always the harbingers of an Afib episode and my constant nemesis since. I 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 though! 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 also vagal in nature too and I tend to pick up on ectopics after I’ve eaten. I still have runs of them as well, the beginning of the year is bad for me for some reason, I had a stint in Han/Feb. However, they just 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.

- 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.

At the moment, life is normal. I am currently in a good period of stability and I honestly feel that I don’t have any limitations - I regularly run, climb, cycle and travel but ectopics are ever present to some degree.

I try to keep to the mantra - calm down, they are doing me no harm but sometimes it still gets a head of me. Very recently, I had an in clinic cardiology appointment and something just tripped. While doing the ECG my heart was bouncing around like ‘a rock in a tumble dryer’. I wasn’t unduly concerned, I’m glad they got the trace too but it was really my own doing. Got a grip and an hour later and my heart was back to normal NSR - 55bpm.

I actually ate just a few hours ago and I am in that rest/digest cycle, watching the Euros. A few bumps and lumps how crept in, but so what. If I chill and relax, and don’t fixate on it, they will filter away. Don’t get me wrong, it took me a while to get here. The mind is powerful, but it is well worth investing some time on the ‘mental’ side of these conditions.

If you are concerned, I would get another opinion from your GP or cardiologist.

Best

[Crossworder in reply to AAJJTt]

Lots of great advice, thank you very much. Great to know I'm not alone. Funny you mention food - big trigger for me. "rock in a tumble dryer" is a perfect description of what I'm going through most days