Afib and Scared!!!

So here's my story back in 1/2013 I had a crazy episode was at the gym on the tread mill started with like a couple of skipped beats heart went racing then it stopped. 2/2015 at 3am in the morning had the crazy heart beat again and woke me up out of a dead sleep lasted about 15 minutes and stopped by the time the medics arrived it was gone and I never caught the episode. Now again like clockwork almost every two years to the date I get another episode the whole week I noticed extra pacs but didn't think nothing of it I was s couple of days away from my menstursl cycle and was a bit stressed at worked. Thursday the 19th I woke up and I felt that weird palpitation and up went racing I called the medics and they caught it on the ekg. Medics said psvt but when i saw the cardiologist he said afib "lone afib" I have no heart issues or high bp I don't smoke nor do I drink. I suffer from anxiety though. I'm so scared and upset. I'm afraid next time it happens it won't stop I'm just so disgusted and scared I'm gonna have a stroke or heat attack. Dr did not give me any aspirin just a beta blocker and I don't like how I feel on it. Please give me advice or hope or something.

Have you excluded WPW (Wolfe Parkinson White) illness? WPW patients have multiple pathways in their AV nodes. They can have high atrial rates. If it is this, the ablation fix is much easier than afib ablation.

George

The Dr didn't say anything about wpw. I'm 35 years old and never ever had pacs/pvcs until I started lexapro was on that 8 years and I think it caused my problems now. It's like I get a run of pacs and then my heart goes racing like up to 200bpm I was able to stop the last episode by putting my thumb in my mouth and blowing hard. I went right back to nsr. I'm just worried about blood clots for being in the episode for about 25 min. Dr says I have low stroke risk but still I'm scared.

OK, your being able to stop it with your thumb sounds like you have an adrenergic trigger <[www.afibbers.org] . Other vagal maneuvers may also stop it - bearing down, carotid artery massage, submerging your face in ice water. Here is a search on vagal maneuvers <[www.google.com]

If you can stop your afib in 25 minutes and you are low stroke risk, I would not worry about that. The standard for electro cardioversion is they won't do it after 48 hours of afib unless you've been on a blood thinner like warfarin for 3 (I think) weeks.

A lot of stroke risk also depends on co-morbitities. See the risk factor scoring <[en.wikipedia.org]

Obviously not having hypertension or diabetes would be high on the list of things to avoid in this regard.

Hi George, yea I'm a female so I get a 1 score. I have no other issues besides anxiety. I'm 5"6 128lbs ef is 65% everything normal. I'm taking the beta blocker toprol xl 12.5mg and have already woken tonight with an elevated heart rate ugh twice. I'm not if I should even be on this. What is Ardrenic triggers all I did was sit up had a PAC that felt like it was 20 in 1 then my heart took off.

Pretty Kitty,

Do you have a copy of your 12 lead EKG that the Medical tech said was PSVT and your doc suggested was lone AFIB? if you wish you can send it to me a PM (private message) you can click at the top left of each forum post of the person you wish to contact. Send me your cell number on the same PM and I'll see if I can help you get more clarity on the arrhythmia you had. It doesn't sound much like WPW... PSVT quite possibly but need to see more.

Regarding carotid artery massage, it can help terminate a PSVT but you have to be a little careful to
understand just how to perform carotid artery massage properly and safely and do not press too hard as to occlude the full side of the carotid artery one is massaging.

Do it only with another person in the room.

Take care,
Shannon

Kittay,

An adrenergic trigger is from over-activity in the sympathetic nervous system. I'm guessing your anxiety/stress may qualify in this regard. So the correlation of the start of your arrhythmia with the start of taking lexapro may be from the anxiety.

One thought is that stress can deplete magnesium. For some of us, supplemental magnesium has helped keep our arrhythmias in check. The standard advice is that magnesium glycinate is the most bioavailable. However, in my case any magnesium works. Another suggestion is to start slowly and work up to bowel tolerance and then back off just a bit.

The beta blocker will help keep your heart rate lower when you do get arrhythmia.

George

Pretty Kittay - Regarding George’s last reply to you on magnesium being depleted by stress:

Definitely consider that deficiency as an underlying factor for facilitating the arrhythmia. Also, the anxiety factor plays right into that. Stress depletes magnesium and optimal magnesium inside heart cells is mandatory. Unfortunately and typically, the first medical response to anxiety is to prescribe a drug and not address the underlying problems that stress and anxiety produce. There are many reports describing how this works. Here’s one from one of the many magnesium experts, Carolyn Dean.

The introduction offers this:
Magnesium Deficiency Induces Anxiety – Expert Article by Carolyn Dean, MD, ND

A 2012 study in Neuropharmacology1 initially sounded promising “Magnesium Deficiency Induces Anxiety and HPA Axis Dysregulation” but then the second part of the title “Modulation by Therapeutic Drug Treatment” made no sense at all.”
This study proves that in an animal model magnesium deficiency induces anxiety and dysregulation of the way the hypothalamus-pituitary-adrenal axis works. The interactions among [the hypothalamus, the pituitary gland, and the adrenal glands] make up the HPA axis, a major part of the neuroendocrine system that controls reactions to stress and regulates many body processes, including digestion, the immune system, mood and emotions, sexuality, and energy storage and consumption.

The HPA axis is often impaired in depression and anxiety as well as chronic fatigue syndrome creating too much cortisol as a manifestation of stress. It’s not specifically known what comes first, stress or HPA dysregulation. This is a very important animal model proving the serious effects of magnesium deficiency as the possible cause of HPA axis dysregulation. Continue: [www.nutritionalmagnesium.org]

Underlying the stress and anxiety factor, is what happens to adrenal glands as a result. I speak from experience in this regard and learned about it only after treating a holistic oriented MD who suffered from this same scenario himself. He linked my symptoms to my early onset Afib events… just as you have described in your case… to stress, low blood glucose levels, hypoglycemia and eventually, adrenal exhaustion or burnout.

Basically, this is the how it works:
Unmanaged stress becomes part of our lifestyle habits. Of course, we are aware of the stress and may try to do something to help, but typically it’s ineffective and not long lasting, plus prescribed drugs don’t address the underlying problem… only attempt to mask the symptoms.

In my case, I often went too long between meals…or when I did eat, it wasn’t the right type of sustaining foods such as protein and healthy fat. So when that happened and blood sugar levels dropped, that triggered both cortisol and adrenaline produced by the adrenal glands. The adrenaline spike is a signal to the body that the blood glucose was too low and the brain was in danger of losing “fuel.” It’s an alarm mechanism to remind me that I needed to eat. This happened to me during sleep, with exercise and if I didn’t eat every 3 – 4 hours. And, always, stress was running behind the scenes as well. And, of course, it triggered Afib events. In the beginning, they were a few palps – just as you describe; but then, I had outright full-blown episodes.

Long term stress over years produces hormonal problems related to insomnia, exhaustion and anxiety. Eventually the adrenals exhaust their reserve and the body will produce epinephrine (adrenaline) and norepinephrine as a reminder to get sugar for the brain’s protection. That adrenaline surge is what stimulates that jolt of a dramatic skipped beat or a racing heart and perpetuates a low-grade anxiety that never seems to diminish. It’s common to happen in while sleeping.

So along with your heart diagnostics, consider consulting with a functional medicine practitioner or similar who can do the appropriate test evaluations to assess your entire HPAA system function.

Here are links to a 3 part report on Stress, Anxiety, Insomnia …

[www.afibbers.org]
Part 2 [www.afibbers.org]
Final [www.afibbers.org]

Here are results from the advanced search feature here for Stress, Anxiety… you’ll find many helpful threads on this important topic because it is so influential on Afib.
[www.afibbers.org]

There’s a lot of information to absorb so don’t feel compelled to respond but certainly, I’m happy to offer assistance.

Best to you,
Jackie

Kittay:

Your not in AF long enough to warrant worrying about Stroke or taking Anti-Coagulants. Heart Attack risk is not what we worry about when an AF episode happens.

I take a very low dose of a Beta-Blocker every night, then if I have an episode, I immediately increase the dose.
It sounds like your episodes are so short, that an increased dose would not take effect in time. I would ask your Dr. about a Calcium Channel Blocker drug like Diltziam, it does not not make people drowsy. Afibbers have to experiment a little to find a way (Drug combination) to control their HR during episode, so this is important if the episodes last longer. The lower your AF HR, the less symptoms you will have. Even if your episodes start lasting longer, you will find a way to control your HR, and then it won't be so traumatic.

Thank you all and yes it's very traumatic for me. It's like 10,000 palps and then a racing heart. I feel like I'm a lost dog when it happens. It's only happened so far every two years around the same time. My mag is 2.1 normal now my potassium tends to go from 4.1 to lowest 3.3 but even that low no afib episode. I see the electrophysiologist tomorrow. Also the dr gave me two toprol ones fast acting and the other one is long acting he said take extra if I have an episode. So right now I take 12.5mg of xl and if I have an episode I guess I pop the whole 25mg of the fast acting acting one.



Edited 1 time(s). Last edit at 02/01/2017 06:12PM by Pretty kittay.

Kittay,

The human heart is a well-innervated organ. It has sympathetic drive (adrenergic) and parasympathetic drive (vagal). Think of the former as the "gas pedal" and the latter as the "brake". If you're excited, or scared, the sympathetic drive takes over and increases your heart rate. Conversely, if you're tired or perhaps digesting a big meal, the parasympathetic drive dominates and slows everything down. Many lone AFers can readily fall into one category or the other when it comes to triggers. If your AF happens as a result of exercise or excitement, then you may well fit into the adrenergic category. If your AF happens at night, or after a meal, it could be vagal.

In either case, the theory is that the electrical substrate in the atria is upset in part by an ion imbalance. Generally speaking, sodium and calcium are excitory ions that tend to make muscles "twitchy". In a very basic sense, atrial fibrillation is twitchy heart muscle. Potassium and magnesium, on the other hand, are calming ions. We here tend to believe that this electrolyte imbalance has an important role to play in AF genesis. Therefore, we suggest supplementation with magnesium, potassium and, often, taurine to restore the balance of ions in our body tissues. Over the counter supplements, mind you, vary in their efficacy as they are not regulated nor anywhere near as potent as a prescription medication. Choose a good source (magnesium glycinate for example) and give it a goodly amount of time to work (months, not days).

Above all, stay calm and work the problem. AF will make you feel bad but it will not kill you. Instead, you will kill it with patience and perseverance.

Thanks Wolfpack I try to stay come even know it happens basically every two years idk now when it's coming. I get panic attacks fast heart rate and all but no afib it's so weird. I can deal with a fast heart rate just not the chaotic beating I try not to scare myself my hr was clocked at 226 for a couple of seconds till I calmed down somewhat then it stayed at 180 until I broke it with blowing out my mouth. My thing is with the anxiety on top of it what happens if it happens while I'm driving or on a trip ugh