Is there any hope with afib?

Can you get the peace of mind after these 7 years?

Yes. My peace of mind came way before 7 years. I just got fed up with digging a self distructing hole. To be 100 percent honest the "what if's" do pop into my head every once in awhile which I believe is normal for anybody who has a health issue. However I let it enter my thoughts, acknowledge it, then discard it and move on. This works for me and has aloud me to have a normal life. Btw I was born with a congenital heart defect that was corrected when I was three. I'm 58 now. And female. Why am I telling you this because I believe it's all about attitude towards life and fight for what you want. 3 weeks after my surgery at the age of 3 I beat the poop out of a little boy who was older than me. Sent him home crying lol. The fighter in me kept me going and I believe EVERYONE has this fighter instinct. You just have to dig a little deeper.

How long has your dad had afib?

Many years. I'm not quite sure. But just the fact he's 91 and doing well says a whole lot. His A Fib is treated a little different than mine as he doesn't know when he's in A Fib plus he is much older so he is on blood thinners.

Right on Jim!

Thanks Jim. I learned afib doesn’t kill me. And it might not shorten my life of stroke is prevented. But what’s draining me is I can never get the peace of mind again and always feel guilty that I messed up my life and my family’s. The day to day depression is real and I can never grunt out of it. I can never get back to the old me. Sometimes I just want to give up.

Jim nails it again!👍

I looked at the blood test that I did just one day before first afib, it shows protein was 7.7, which was the middle of normal range. It also shows calcium, sodium and potassium in the middle range, potassium was 4.2. Then on the blood test of first afib, which was the next day, potassium was down to 3.6, just slightly above he minimum of normal range. Not sure about magnesium though. And I don’t know why potassium dropped in just a few hours, maybe because of the heavy sweating.

As I mentioned in an earlier post, you have no reason to feel guilty. You did what many others have done -- myself included -- in going vegan based on some very credible research suggesting it will add years to your life by protecting your heart. I bought into that and followed the Caldwell Esselytein diet. And like yourself I went into afib on the diet. FWIW this was the second time I was on the diet and did not have any afib issues the first time, so I'm not entirely convinced it was the diet, but who knows. And not that I'm rushing back to being a vegan -- but I still don't think I made the wrong decision at the time and I would not rule it out in the future but perhaps being more careful with electrolyte balance and adding modifying it with some healthy animal fats as suggested by Dean Ornish.  You can't keep kicking yourself for being a Monday morning quarterback. The Vegan thing made sense at the time and there are millions of vegans out there without afib and millions of non vegans with afib!

Jim

Jim

I think my electrolytes were mid range as well, so maybe not that. Maybe the lack of protein and fats, or again, maybe afib and being vegan were just coincidental. I also had xtra caffeine the day of my last afib episode, and maybe the very low fat vegan diet made me more sensitive to the effects of the caffeine. Have given up coffee for now.

Blood tests aside, did you have your three following night time afib episodes confirmed by an ekg? If not, it may have been benign palpitations like PACs, PVCs, which often follow or co-exist with afib and may have a stress component. I have them myself on a daily basis now. And while I intellectually know what they are, I do admit they stress me out at times. But on a scale of 1-10, that stress was a "10" right after my afib episode, and it's a "1" or "2" now. I still get the same PACs, but I am getting more and more comfortable as the knowledge sinks in that there is really nothing to be concerned about. Palpitations, as scary as they may seem, are in most cases not the same as afib.

Jim

I went to ER for my first and second episodes, and they were confirmed. Waited at home for the 3rd and 4th episodes and confirmed by Kardia. All episodes ended exactly at 8am, don’t know why. During my second episode, they were going to shock me, but I converted myself after they sedated me.

Given your history of naturally converting, electro cardioversion may not be the best thing. I electro cardioverted myself several times but now I just plan on waiting it out after taking drugs to lower my heart rate. A lot of afib episodes resolve on their own.  Again, I'd get a second opinion on that Metropolol which may be making things worse.

Jim

If you know and can avoid all triggers, would you have afib again?

Jim how do you electro cardiovert yourself?

How can you electro shock yourself? I’ve quit taking metoprolol since the forth episode and have had another one yet. I don’t hope by paying attention to what I eat and not sleeping on the right can prevent afib forever.

LOL. Put that down to bad sentence structure! No, I electro cardioverted in the hospital three times. Two times were successful and the last time wasn't, however I naturally cardioverted the next day. I was scheduled for a fourth electro cardioversion a few years ago but I naturally converted right after my TEE prior to the cardioversion. Should I go into afib again, and given my history, instead of rushing into electro cardioversion,I will probably just take cardizem to lower my rate and then wait at least a week to see if I can convert naturally.

Jim

Lol ok. I thought I was unaware of a new technique haha. I can't take cardizem cause it lowers everything too much. Also because I'm not on blood thinners I can't wait very long before I get cardioverted. I could take another flecainide but for some reason I hesitate to do that. Gut instinct I guess

There was an episode on the new TV show "The Resident" where the head resident threw a bucket of ice water onto the patient to shock her out of afib! What's interesting is that oftentimes what puts us in afib also can get us out of it. In the old days they used to do carotid massage but not sure if that's a good idea on my aging neck arteries.

So, if you don't take cardizem when you go into afib, how do you get your rate down, or doesn't it go up that high? My HR is over 160 when in afib and around 200 if I move much, so they always first gave me something to bring it down. Now I just have Cardizem at home.

In your case, electro cardioversion seems to work, so as long as you're sure when your episode started, then cardioverting within the 48 hour window makes sense and why change something that works for you. That said, I've read that many people naturally cardiovert within that 48 hour window, so an alternative strategy is to wait a few days and see if that happens. If it doesn't, you can always get a TEE preceding the electro cardioversion which will protect you from procedural stroke risk even if you're not on thinners.

Jim

Yes my heart rate goes up to 160 or more. I usually go within the hour or so to get cardioverted. If I were to come back into rhythm myself it will usually happen within the hour or too. What is a Tee?

Wow. That's fast service!!! At my hospital, even if I go to the ER, they've never scheduled electro cardioversion same day, always next day. And, they don't do them on weekends, so if I have afib on Friday (happened once) you don't get electro cardioverted until Monday.

TEE stands for Transesophageal Echocardiogram. They basically put a tube down your throat and check your heart chambers for clots. If no clots, then you're safe for electro cardioversion, regardless when you went into afib and regardless if you're on thinners.

Does your bp drop too much on rate control drugs? In my case, my bp drops significantly when in afib, however my cardiologist isn't concerned about the cardizem because once my HR drops, my bp goes up.

Jim

Jim

An interesting thread folks, thanks for sharing. I picked up on a couple of points, firstly the TEE, had to Google that TLA. So this is a scan to check for clots forming around the heart, is that right?

Secondly, you comment on a 48 hour window between an Afib episode, and the risk of a stroke, again is that the medically recognised no-stroke window you have, assuming you know when you went into Afib?

I know when my three episodes were, and the first two I had absolutely no idea what was happening, and hence did not seek medical advice or help. The third was the mildest, lasting maybe 15 minutes, but I had the stroke several weeks later. Is it possible I had a later episode without even knowing it, i.e. much closer to the stroke?

Clearly an arrhythmia predisposes us to a stroke, but does anyone know what the time frame of events is, i.e. how soon after, or how long after an episode could a clot form, and then of course, I suppose the breaking away of the clot and doing damage, could be as long as a piece of string!

Got me thinking, which is a good thing!

Allan

Hi - whatever your name is.

?I first got AF in my late 40s. I was depressed about it at first- then like grief you get to acceptance. I worked out what my triggers were by keeping a food log and checking the ingredients. Alcohol, preservatives and MSG were the main things. Am on Metoprolol- which incidentally slows the heartrate to help you avoid going into rapid AF. and on Flecainide to help with the rhythm, I was previously on Sotolol which didn't help me much. It is all a matter of trial and error and what triggers one person and what medication helps another are different. I used to be in AF for 4 days at a time and would end up with no energy. Now it doesn't last more than 1-2 hours so l am really pleased. Best of luck- hope you cheer up soon and don't let this "pain in the arse" condition ruin your life!!

Hi Robyn,

Some studies suggest Metoprolol may not be a good choice for vagal afib. Don't want to mess with success but you mentioned "trial and error" and perhaps another rate drug could cut your episodes down some.

Jim

Hi Sherpa,

Tee (Transesophageal echocardiogram) is basically an ultraound of the heart but instead of placing the probe on your chest (regular echo cardiogram)  the probe is swallowed under anesthesia in a procedure similar to an endoscopy. The main purpose when done in conjunction with electro cardioversion is to look for clots in the atria heart chamber. If they find a clot, they will not do the electro cardioversion. If they don't find a clot, then it's safe to go, regardless when you went into afib or if you're on thinners.

The protocol is that if you have electro cardioversion within 48 hours of afib onset, or if you've been on thinners for a required number of weeks, then electro cardioversion should be safe. However, sometimes you can't pinpoint the time you went into afib. In this case, you either need a TEE prior to electro cardioversion or you should go on thinners for the required number of weeks before having it.

Hard to say regarding your stroke. Afib episodes make us more susceptible to strokes but people without afib also have strokes. In my case I seem to have very distinct episodes spaced years apart so I opted not to take thinners. I would probably go on thinners if I started having more frequent episodes, or perhaps if a lot of short episodes were picked up by monitoring.

As to timing, don't know. But with electro cardioversion, it's such a shock to the heart, that a stroke in theory could happen immediately if there happens to be a clot in the atria.

Jim

Very interesting Jim, thanks for the heads-up!

I realise I'm still a newbie when it comes to Afib, but as they say knowledge is power, and I've learnt a lot on this forum, much of it from you.

I've also just come across a blog by a Dr. Richard Bogle; found him when I googled Vagal AF, some interesting comments there as well.

Allan

Ya never had to wait more than 4 hours. Usually less here in Ontario Canada for a cardioversion. Very routine however they don't do a TEE. Never had one done before a cardioversion but I did have something similar back 7 years ago when I was first diagnosed. Because I wasn't properly taken care of and was in flutter for a week. They scoped me first but they went down into the lungs to check for clots not around the heart. And right after the all clear I was cardioverted. Ya I have low blood pressure generally so the cardizem made me feel nasty. Funny thing my heart rate goes up when in A Fib. Quite a bit like 180/85 approx. When my heart rate drops my BP goes back to normal. Funny ah we are opposite of each other and we have the same condition

@sandi: Funny thing my heart rate goes up when in A Fib. Quite a bit like 180/85 approx

----------------------------------------------------------

I think you meant to say your "bp goes up" when you're in afib? Yes, I'm the opposite, when my heart rate goes up, sometimes close to 200, my bp tanks. Then when I take cardizem to bring the rate down, my bp goes back toward normal.

So, sounds like very different in Canada than in the U.S. If they don't routinely do TEE's there, I'm assuming that if a patient can't identify when they went into afib that they will put them on thinners for a month or so before electro cardioversion? That would be the only other safe alternative if they don't do TEE's.

What you described seven years ago sounds exactly like a TEE. They actually don't go into the heart but they basically scope you and then take a picture of your heart with a small ultrasound device looking at your atrium chamber for blood clots. Are you sure that's not what you had, because it's the clots in the atrium that potentially concerns them when performing electro cardioversion.

Jim

 

Haha yes I meant BP! I don't recall what they called that procedure 7 years ago but ya it was probably a TEE. And I'm not sure what the procedure is here in Ontario if a person doesn't know when they went into A Fib cause I've never had that problem. I always know lol. And my dad who has it too he never really knows when it comes on so he doesn't go to the hospital for it however he's on Coumadin and rate lowering drugs for his. Each person's symptom picture is sooo different. I find it fascinating actually. I tried to talk to my dad about the FODMAP diet as he has stomach issues too but at 91 he's just not open to any changes lol

My mom is in her 90's as well. At that point they really think they know more than anyone else, and they're probably right given they've gotten that far! Yes, I'm sure that was a TEE you had seven years ago. Remember it, because if for some reason you ever miss the 48 window, you want to insist on it prior to electro cardioversion.

Jim