New Afibber

Hello all,

I am 30yo and had my first afib episode on Nov 8th of this year. Used to smoke for 15 years, which is what I was doing when it hit me. I went home, after converting 12 hours later on my own, with a prescription of 50mg atenolol and full strength asprin. After about ten days on the medicine I stared having episodes of shorness of breath, slight lightheadedness, and anxiety. I had my doctor reduce my atneolol to 25mg. He also prescribed me buspirone.

Had my first visit with the cardiologist yesterday. He doubted that the atenolol was causing the syptoms I described and chalked it up to the fact that I'm focusing on this condition and making myself sick. He allowed me to stop taking the atenolol and prescribed me rythmol for on-demand treatment. After being off the atenolol for 48 hours I still seem to have episodes of increased anxiety and nervousness. Last night in bed, I felt so nervous I though I was going to be sick. I'm focusing so much on my rythem, at one point I was dammed sure I felt palps from the anxiety. Not sure how much longer I should be feeling this way, but it's seriously affecting everything I do. There are periods that I feel great like I did before any of this happened, but they are followed by the panic type attacks that make me miserable and sick to my stomach. Any advice or insight would be greatly appreciated on how best to deal with this.

-Eric

Welcome to the club. I had my first episode when I was 33 and am now 63 and get AFIB twice a month. Just remember when you get scared that you are most unlikely to die from this and that some people have it all the time. You will get used to it in time even if you can,t make friends with it.
To start with get Hans book and read it. Then study the hundreds of messages on this board and you will find how others with your characteristics of AFIB have learned how to deal with it.Best wishes

It sounds like you are having an anxiety reaction to your episode of afib. This is understandable and I sympathize with you very much. My first episode of afib was very upsetting to me and caused me much anxiety for which I immediately sought help.

My suggestions: stop using any caffeine or alcohol for the time being. Both increase anxiety, the caffeine immediately and the alcohol the next day.

Learn some relaxation techniques: progressive relaxation (as from a relaxation tape); abdominal breathing (very simple, breathe in slowly and deeply and let your stomach poke out when you inhale; do it while sitting comfortably; try it for ten minutes). Take a class in anxiety management or find a book--there are lots of them.

Get a prescription for a tranquillizer such as xanax to help you in the short term. You need only a very small dose to get rid of anxiety. You can also use herbal relaxants such as kava (tincture; it is just as effective as xanax for me) or valerian or skullcap or even chamomile tea.

Finally, get out and get some exercise every day. A half hour's walk is very effective. Then there is the soak in the hot tub. And so on.

you are smart for realizing that your anxiety about the situation is the culprit. Reducing that factor will minimize the afib episodes and perhaps
with a mild heart rate drug, their severity.

I commend your doctor for being open to the on demand approach.
As long as your episodes don't last too long (and the rhythmol may
help in that regard) this condition will prove nothing more than a nuisance.

I agree with Michael's general post, I use the drug Ativan. I find that it
helps with the anxiety and has prevented numerous episodes. It even
prevents me from going into Afib when I drink wine. Caffeine definitely
has a cumulative effect on me but everyone is different. I would eliminate
those typical triggers (alcohol and caffeine) and get a handle on things.
Then,if you enjoy drinking, work it in, but don't stess about it. Can the caffeine if you can, indefinitely.

Stress and anxiety reduce the threshold that we all have thereby
making us more susceptible to episodes. Chill out and you will be fine.

Follow the basic guidelines that you read about on this board, but keep in
mind that there are a number of people on this board who are incredibly obsessive about everything they eat, drink and do. It may work for them but it may make you more anxious. Find a healthy balance of diet, supplements, exercise and live your life. You are too young to let what
is really a nuisance affect your life too dramatically.

Personally, I think the serious risks associated with Afib, particularly in young people are way overblown. I would venture to say that the number of thirty year olds who have serious complications from Afib is very small if not nonexistent.

Thanks for all the advice. I do have a few questions though:

1) If the atenolol was not the cause of my anxiety symptoms, was it a wise idea to stop taking the drug and switch to an on-demand approach?

2) With procedures like PVA (Dr . Natale performs this relatively close to my location once a month), why would I opt to remain taking medication for years when I could potentially be remedied with a few procedures? Are the risks and side effects that bad?

3) I forgot to ask my cardiologist what to do if an episode occurs while I'm driving or away from home. The on-demand approach seems reasonable at home, but I travel in heavy traffic daily. I'm assuming that the first few episodes will be the worst.

4) I suppose it's not realistic to think that I may have had an isolated event that will not reoccur, is it?

5) It seems like my heart is beating out of my chest (albeit at normal sinus) when I even slightly exert myself. Could this be the residual effects of the atenolol?


I do appreciate all the information provided on this and other forums, but to tell you the truth, it scared the hell out of me even more reading through it. All the procedures, medications, and complications discussed painted a grim picture of a potential future for someone who's never been hospitalized (never even broke a bone). Once I can get by this anxiety, I'm sure I can start to getting back to my normal activities. Thanks for listening.

-Eric

hey Kerry, who you calling incredibly obsessive? (:
Peggy

Eric:

2) With procedures like PVA (Dr . Natale performs this relatively close to my location once a month), why would I opt to remain taking medication for years when I could potentially be remedied with a few procedures? Are the risks and side effects that bad?

Eric: You have gotten great advice from Alistain, Michael and Kerry. With only 1 episode of afib, it's not nearly time to start thinking about any procedures, and yes they can have side effects and can be very risky. Keep posting your progress, and try some above approaches and if your condition should get markedly worse, you might reconsider aggressive measures.

Pam

Eric

I am a 45 year old female who has episodes 3 to 4 times a year. I just had an appointment with Dr. Natale last week. He wouldn't even consider (just about laughed) an ablation for me. He said not until they were every other month or so. And yes, I get a very fast heart rate (180 to 200) each and every episode. I have used rythymol on demand but it only worked once to convert me. He now put me on tambocor on demand. He does not feel my episodes are frequent enought for daily antiarrythmics or blood thinning medicine either. I only take an aspirin a day. I am suppose to continue with trying to convert in 12 hours, after that go to the hospital for cardioversion.

Again, he called this a nuisance issue, try not to dwell on it and get on with my life. After 5 years of this, I am not dwelling on it, but it sure is a pain in the neck to have to go to the hospital and spent 2 days just to be converted. I would have thought there was an easier way. I have 3 children, one who is very disabled and the thought of having to drop everything to go spend time in the hospital is always in the back of my mind, especially if I would be out of town or something.

Oh well, just thought I would let you know that unless you are having frequent episodes, ablation doesn't seem to be an alternative.

Eric,

The little snippet of research below indicates that you have an approx 50:50 chance of no further AF episodes.

If you have any further AF episodes, then continue to use this excellent forum as a support of support and information.

Main thing at the moment is......... REALLY try to reduce your anxiety over your AF episode as per the comments of other posters above.

Here's hoping you don't have another AF episode.

FROM: [www.medical-congress.com.fr]

Natural History of Lone Atrial Fibrillation in 234 Males: Follow-Up of 22 yearsAnts Palm-Leis, Theodore V. Arevelo, Jeb S. Pickard, William B. Kruyer. USAF School of Medicine, Brooks AFB, TXKeywords: Atrial fibrillation, Epidemiologic methods, Supraventricular tachycardiac.

ArrhythmiasBackground: Little information is available regarding the long-term natural history of lone atrial fibrillation (AF) in a young and otherwise healthy population.Methods: From 1957 to 1993, 300 US Air Force male aviators were found to have AF and were evaluated at a central facility approximately 6 months after the initial episode. Two hundred thirty- four of these patients (78%) were found to have lone AF (atrial fibrillation in the absence of cardiovascular disease, hypertension or precipitating factor). We reviewed the records of initial and serial evaluations performed on these 234 aviators with lone AF and obtained further follow-up via questionnaire surveys, telephone interviews and death certificates. Arrhythmic events considered were hemodynamic symptoms, cerebral ischemic events, and sudden cardiac death.Results: Initial evaluation: Average age was 37 (± 8.1) years at the time of initial occurrence of AF. Age ranged from 20-59 years old. One hundred eighty-six of the 234 (79%) had an isolated episode of AF, 30/234 (13%) had paroxysmal AF, and 18/234 (8%) had daily or chronic AF. Follow-up: We obtained follow-up on 211/234 (90%). Total follow-up time was 4,685 person years with a mean of 22.2 years (range 2-40 years). At the time of follow-up, 106/211 (51%) still had only an isolated episode of AF, 81/211 (38%) had paroxysmal AF and 24/211 (11%) had daily/chronic AF. Of those initially presenting with an isolated episode, 63% had no recurrence, 36% developed paroxysmal AF and 1% developed chronic AF. Of those presenting initially with paroxysmal AF, 15% subsequently developed chronic AF. Of the 37 deaths in the study, 10 were cardiac, 21 were noncardiac, and 6 were unknown. Nine had cerebral ischemic events of unknown cause of which only one (chronic AF) had the event before age 60. Annual event rate prior to the age of 60 was 0.4% per year.

Conclusion: Progression to chronic AF from a single episode or paroxysmal AF was unlikely (1% and 15%, respectively). The arrhythmic event rate prior to age 60 was low (0.4% per year) and the likelihood of a cerebral ischemic event before age 60 without chronic AF was minimal (none in this study).

Thank you, Mike F. That is a useful piece of information amd one i am glad to have read. I hope it has helped Eric's perfectly understandable anxiety, and i wish i had come across it when i had my first episode.
Peggy

NOT YOU OF COURSE.

I have the potential to be the worst offender when it comes to obsessiveness. takes a lot of effort to overcome.

1. It is entirely possible that you will not have any more or at least
very infrequent episodes.

2. No competent EP would even consider ablating a 30 year old
after one episode. And yes, there are risks and the procedure
is just a few years old. forget about it.

3. i don't see what using the drug on demand has to with travelling.
Carry the drug with you and take it if you are travelling. By the way,
if the rhythmol doesn't do the trick, flecainide seems to work very
well on demand for many people, including me.

4. The drug didn't cause your anxiety- you did. Once again,
lower the anxiety and you will have fewer episodes.

5. The symptoms you are having on exertion are probably somewhat
anxiety related and due to the fact that you are focussing on your heart right now in everything you do. The same happened to me and when
I stopped thinking about it all the time it completely went away.

I would like to thank everyone for their comments and suggestions. I suppose I must focus now on taking care of my body and adapting to this new lifestyle (not just afib, but the alcohol and cigarette absence). I think meditation and some dietary suppliments mght be in order as well as less frequent visits to the drive-thru. It's very tough sorting through all this information, but I am surely greatful that there are resources like this to provide me convienient access to the information I need. Thankfully the holiday season will keep me busy enough to help get my mind off of it. I wish everyone the best of luck, health, and prosperity. Happy Holidays!

-Eric

Hey Eric,
I just posted a new thread that reads much like this one, I wish I'd seen it first!

I've been beating myself up for the past two weeks trying to figure out what I'm doing wrong! I'm so psyched that there is a forum like this out there for people like us to ask and learn.

don't obsess about the alcohol absence. You may find that you can tolerate
it in smaller amounts, indeed you may have no trouble at all. I used to have a problem with it, but i found that if I take a small dose of ativan before drinking , I never have an episode. I am not recommending this yet,
just posing that everyone is different and with a littlle rest you might be able to resume moderate consumption.. either way I would use the Afib
as justification for stopping smoking as I did for stopping caffeine intake.

you are not destined to a life of abstinence if that is what you are thinking.

Michele,
thank you for the informative post. I am curious as to how often you "self-convert" vs. how often you must go to the hospital for cardioversion. I can see how this would be very disruptive to your life if you had to do the hospital cardioversion more than once in a great while. I have so far always self-converted in about 10 to 12 hours, but I dread the day that I won't, and have to do hospital time to cardiovert, especially if that were to become a recurring necessity. Also, how well does the tambocor work for you when you are trying to self convert? Thanks.

Eric,

It is my opinion that one needs to focus on getting their body back into optimal shape. (Read my post to Seth). You're body is crying for the correct nutrients. It is a miraculous work of nature, but it needs the right components to work properly. Taking a drug, to allow you to drink another drug, is NOT the answer. That's pure common sense. Once you have established a correct way of eating, and have gotten your body back into a state of well-being, then maybe you can have an occasional drink, but the focus should be to remove ALL toxins, and give your body what it needs.

Richard