How soon did people see a doctor when they first noticed AFib?

I wanted to compare notes on this. It seems that most, when experiencing AFib for the first time, run to a doctor immediately (I've read this here and in other websites).

It was almost a decade after my first long episode before I finally got in to see a doctor. I think I might have had several other very short episodes in the intervening time and before my first long episode but I'm not quite sure.

My first long episode occurred in 2004 during a weeklong bike ride in 104 degree weather all 7 days. It started early in the ride and lasted pretty much through the entire ride, and stopped when the ride was over. Due to the heat and dehydration, I'm sure my electrolytes got off balance. I didn't have any long episodes until I was 50 (I was 44 at the time of that first episode). I'm pretty sure that episode lasted almost 7 days so almost could be defined as persistent afib, except it stopped and I didn't have any significant episodes (and maybe none at all) in the subsequent years until it came back.

I guess my attitude at the time was that even though my heart was fluttering (I had no idea what it was doing though), I was still riding fine and not feeling bad in any other way. I didn't notice any loss of riding strength. It bothered me, but I just hoped it would go away, and it did. I also rationalized that maybe it was some other muscle that was twitching, rather than my heart (I do get occasional muscle twitches and have gotten them most of my life).

The second episode happened when I was 50 and had taken a job 2 hours away from home which required me to spend weeknights in another town. I was eating a bad diet (Mexican food with a Coke every night for dinner, and junk food during the day to comfort myself). Remembering back, it must have lasted at least a week, maybe even a month. It seemed to go on forever. But then it stopped, and I had no AFib for about a year, maybe longer. Again, I was busy with this new job, and was also afraid of what a doctor would say (I didn't want to be put on a medicine the rest of my life) and figured that whatever it was, it wasn't curable. Again, I hoped something else other than my heart was twitching. I felt fine otherwise and was able to work out while it was happening. I don' remember for sure how long it lasted, but I know it was at least a week.

I had a third long episode in spring, 2011 about the same length. In June, 2011, I left that job and took a job closer to home (but it turned out I really missed my old job and the people, and realized I had adjusted quite well to the situation, which still allowed me to work from home 1 to 2 days a week and spend weekends at home). I really didn't like my new job or the people nearly as much and regretted taking it.

Then in early July, 2011, it started up again and wouldn't stop (about a month after taking this new job). I had a 7-day bike ride planned that I had paid for back in February and been training for. I was planning to see a doctor about it after this ride was done (in September). At the time I attributed it to grief over leaving that job and stress over having to learn a new job. The AFib was discovered when I had to go in and see a doctor for something I feared might be breast cancer (fortunately it wasn't) but she said that what my heart was doing could be life-threatening and I needed to see a cardiologist right away, and also drop out of the bike ride if I couldn't get it to stop fluttering. She prescribed a beta blocker, which worked, except when I was in the doctor's office. Every time I went in for them to check my heart, the AFib started as I walked in the clinic. So they told me I couldn't do the bike ride. They also upped my dose of Metoprolol to 50mg. That still didn't stop my heart from going into AFib when coming in to get an electocardiogram, and they insisted I couldn't do the bike ride. I figured out that I didn't want to let illness stop me from living, and was willing to risk death to do the ride, and did it. I was fine (although in AFib every single night) on the ride. Then the AFib stopped as soon as the ride was over.

But the thing is, I put off seeing a doctor about it for so long, although I think I would have gone in to see a doctor after the bike ride anyways, since I was starting to get concerned.

Did anyone else wait to see a doctor, or does everyone run in to see a doctor at the first sign of AFib?

No, but then I didn't even know about AF until I walked into my doc for the annual checkup and happened to be in AF at the time. By the time I was rigged up with a Holter harness (a few days later) I was in NSR. When I looked back I realized I had been in AF intermittently for some years. I knew something was (occasionally) going on but wasn't curious enough to check it out.

My experience parallels afibhound99's above as I too had only noticed that I was quite hyper and nervous before my exam but put that off to white coat jitters. The medical tech taking my pulse took it 3 times and thought she was doing it wrong since she counted the rate as 144. Obviously she had never seen fib before. My Internest at the time made the diagnosis and referred me to a cardiologist. I don't think there were any EP's at that time; certainly not in Central California in 2002. Since the appointment waitlist was about 3 months the internist put me on Amiodarone, Lanoxin and Coumadin right away. The cardiologist later had me wear a Holter monitor for 3 days and decided I had flutter instead of fib so I got an event monitor for a month with no events so he decided I was clean and just needed to take the meds indefinitely.

Fortunately, I think, I started noticing symptoms after a year or so as the Amiodarone quit working and my thyroid went into hyper mode so I had a right side flutter ablation whcih lasted perhaps two years before those nerves grew back.

As desirable as it may seem to have the silent fib if you have to have it at all, it's far better to know what you're dealing with, and Dr. Scheinman at UCSF confirmed the original diagnosis as vagal afib. He also converted my med to Tambucor but said UCSF wasn't doing ablations for vagal at that time.

Fortunately, I'm sure, I then decided that I really needed another expert and, thanks to several old-timers on this site, I got appointments with Salwa and Dr. Natale, was diagnosed with both flutter and fib so he subsequently did an ablation on both sides and I have beeen in NSR for the last 6 years.

If there is a moral to this story it's that we each have take responsibility for our own medical care and treatment, particularly the cutting edge type. If we don't we'll get some meds that treat only the symptoms, occasional checkups then parked into a standard treatment program that doesn't offer a solution.

Gordon

Even tho I went to see a doctor after years of very short episodes, it still would not present itself during a doctor visit, so it went for about a decade undiagnosed. I don't think it made any difference in the long run, and, who knows, maybe my life was improved by not having taken the crappy drugs that really don't do much good at all.

Dianne,

Yes indeed, I did "run to a doctor", when I experienced my first afib episode. Here are the details (from my first book):

On December 18, 1989 at around 7 pm my life changed forever. It was probably a good thing that I did not, at the time, realize just how devastating this change would be.

I am a chemical engineer by profession and at the time was consulting on a very major project involving 12-hour days, lots of stress, and a great deal of time spent in front of a computer. I had contracted a bad flu and as I sat down on my bed in preparation for an early night I coughed violently and immediately felt like my heart had exploded. It was beating wildly, totally out of control and I expected it to depart permanently via my throat at any minute. To say I was scared would be an understatement! On my doctor’s advice I went to the ER at our nearby hospital and was immediately hooked up to a lot of tubes and beeping gadgets. After what seemed like an eternity, but was actually 2 to 3 hours, my heart rhythm returned to normal. I remained in hospital for 3 days during which time I went through numerous tests to check out the status of my heart.

On February 27, 1990 I received the verdict from my cardiologist. I had paroxysmal atrial fibrillation and occasional premature ventricular beats (PVCs) with a slightly enlarged left atrium (44 mm), but no underlying heart abnormalities. Left ventricular ejection fraction was 59%. My cardiologist emphasized that my condition was not in any way life-threatening and expressed no concern when I told him that I planned on going cross-country skiing the following week. I felt sure that this was a one-of-a-kind episode and continued my life much as before with excess stress, long hours at work, and lots of computer time. Little did I know that the afib beast would essentially be in charge of my life for the next 15 years.

Hans

My early afib was always triggered by specific foods (as I learned) and was not recognized as afib per se because I didn't even know what afib was. The first time I consulted a doctor was during an episode where my heart would race and then stop for several seconds, race and stop, and I was unsure if it would start again. That scared me, and my doc actually made a house visit, by which time the acute episode was calming down - and so was I. She referred me for EKG next day which was normal, so still no diagnosis. But after that night the character of my episodes had changed. I'm not sure when I began to suspect afib but at one point wore a Holter monitor for three days with no results. It was not until I was, as I found out, in potassium depletion and gasping for breath that I ended up in ER and diagnosed with afib. After that afib became a frequent visitor, too frequent and disruptive to live with. Although, perhaps the most interesting part about my afib is that the earlier episodes were more painful and scarier - always self-limiting at 2-4 hours, but always associated with digestive upset, often with fainting, and causing shoulder, neck and arm pain, pounding in the head that I couldn't bear to have touch the pillow, and why I put up with and did nothing about it was probably because all doctors had said that these reactions were "all in my head"

Diane - Over 17 years ago, when I had my first AF event, it was around 11 pm on Memorial Day Weekend triggered by pizza and too much red wine! I phoned the local ER to ask what they would do if I came in and was told that I should just cool my heels at home because I'd be worse off waiting in the ER on a holiday weekend. That's what I did and the AF stopped in a few hours and stayed away for a few months.

When it surfaced again, it was so dramatic, I did go to the ER and was admitted, tested, and discharged 3 days later with the classic drug, Betapace. The cardiologist on call for the ER and hospital saw me for a few months until I realized he wasn't very knowledgeable about arrhythmias and I began my own research on the topic and about cardiologists. I didn't learn until a bit later about EPs. I was determined to learn all I could about reversing the AF tendency without invasive procedures... and true to form, my events over that 8 years ecallated until they were daily or every other day and for very long duration... often 24-27 hours long with only 4 hours NSR and then back into another long AF because I hadn't learned then all that we know now about what contributes to AF.

I had read about remodelling and it was discussed with my Cleveland Clinic cardiologist but I still wasn't keen on having such an invasive procedure as ablation since I was gun-shy from previous unnecessary surgeries. He said there was nothing urgent about having the ablation which was comforting. I won't belabor it here because somewhere the Calming My Heart story is posted ... but I came just "this" close to cancelling my ablation date (8 years after the initial onset) because I had complete success in turning around my near-permanent afib to zero by boosting the essential electrolytes and watching other influences. That was long ago and much has been added to our knowledge regarding the many influences that contribute to a heart that tends to be prone to electrical disturbances.

My takeaway and I've said this repeatedly, is that AF is a warning or our own personal "canary in the coal mine" that there are major systemic imbalances or environmental influences that trigger the onset of the electrical conduction disturbance. Determining what's out of balance and correcting can be a major task but very important because while ablation may stop the AF, it doesn't correct the underlying core cause or imbalance that triggered it in the first place. My opinion and advice is that every afibber should work to detect and correct the imbalances while they are deciding whether or not to consider the ablation procedure. And if they do, then choose the very best EP known to have the safest and most successful track record for positive results. Ablations (just like any surgical procedure are not without risks) so become an informed expert so you can make an informed decision.

I wish you well with your research and decisions.
Jackie

First episode was scary, but was with a friend in Paris (in August heat) who was stressed about meeting up with her husband. Was thirsty and downed a couple of bottles of water. The weird heartbeat stuff went away. Was a couple of years before it came back, then just briefly and went away. First time I talked to my doctor about it was when I was there for something else and went into afib in the waiting room. They strapped an EKG on me and shipped me off to ER, but I'd converted before I got there.

Nancy

Hello all. When i first got an afib episode, i made an appt to see a doctor, but the episode went away before i could get to him. Of course he could find nothing, but he asked me to go to an emergency room if that happened again. Several brief episodes ensued in which i could not get anywhere before they stopped. The emergency room was several towns away and there is no public transportation in Maine even now except in the 2 biggest population centers, almost cities. I lived with my brother in the boonies.

Then i got one that did not go away. It was night time and i had to awaken my brother and his wife from well deserved slumber.At the emergency room i was admitted and kept until it stopped by itself. They tried to stop it with diltiazem but it was as useless then as it has always been since. When i saw my doctor he put me on digoxin. About a year later i abandoned this drug digoxin because it sapped my strength and endurance so, and i felt so much better without it. A few years later i found this site and learned the importance of electrolyte minerals and paleo diet, and went several years without any episodes at all. Since then i have fallen away from paleo diet, and have been getting maybe 2-3 episodes a year which i can terminate in about an hour with 1 tiny pill of ativan.

PeggyM

It was September 1993, I was 59 years old and I had just finished 18 holes of golf, had one gin and tonic with the group, went home and had one scotch on the rocks and later that evening went out with the wife for a Chinese Dinner. Later that evening while in bed watching the late news on TV it felt like someone had thrown a switch and I felt my heart beating rapidly. No pain, but I felt nervous, anxious and irritable. My wife is a RN/Certified Nurse Midwife and said "we're off to Emergency". The episode passed in about 6 hours.I was seen quickly and tests were begun then and the next day. I had no history of heart disease and there is none in any part of my family history. My BP has also been very normal and my cholesterol levels likewise. The first year I had just a Internist as my Primary Care Physician and he prescribed Verapamil and during that first year I had no more than 8 or nine episodes of Afib lasting a few hours and then self terminating. I might add that my height 6' 4" and weight 198 lbs has always been normal and with running daily and Raquetball several times a week felt I was in fairly decent shape. Since retiring in 1992 I have spent four to six months each year in New Zealand where my wife was born and raised. I had an Afib episode in New Zealand in 1994 while visiting. A female physician friend of my wife's checked my pulse and went to her bag to get some digoxin for me. Fortunately I had found this Forum on the internet the year prior, had read "Towards a Cure", many of the postings and articles and told her that I thought that the digoxin might be contraindicated for me. She checked with a Cardiologist collegue and he agreed. No digoxin for me. From my reading the Forum, I had determined that I probably had Vagal Afib and when I got a U.S. Cardiologist that I found on the web that was in practice with my Medical Group, I mentioned this to him as well as giving him a copy of "Towards a Cure".
I picked this particular Cardiologist because I was impressed with his educational backround and what appeared to be extensive experience. He made a mistake by telling me that I probably was in Afib many times and didn't know it. I always know when I start and when I finish. It became apparent to me that he and I just were't going to get along. I asked several nurses in the Medical Group who they thought was the best Cardio and they suggested a collegue of my first Cardiologist, right down the hall. I made the switch and still have this particular doc. Year by year the Afib episodes would gradually increase despite taking a daily pill, pill in the pocket approach as well and was always triggered by bending over to tie my shoes, swallowing a piece of food, sleeping on my left side, but never while doing any exercise. I did discontinue all hard liquor and stayed with just beer and wine which never seemed to be a trigger. If I had known then what I know now I would have started taking the supplements, particulary magesium and potassium. I mentioned to my Cardio in 2005 about having an Ablation and he said that I should stick with the meds, which for most of the following years was Flecainide and prior to my PVA Multaq. Finally as the episodes became more frequent, lasted longer, and required cardioversion (I have had eight) I told my Cardio that I really wanted a Ablation. He agreed and referred me to a Electrophysiologist within the Medical Group. I had of course heard of all the great docs and places like the Cleveland Clinic through my participation on this Forum. I told my Cardio that I would really like to have Dr. Andrea Natale do the procedure if I could ever get to see him. He felt a bit disappointed that I did not want to follow up on his referral and I told him that I really wanted someone that had a better track record (I can be blunt when need be). Finally, thanks to this Forum I was able to get an appointment with Dr. Natale, had the PVA in San Francisco May 2011 and have been in NSR ever since, and look forward to staying that way. I am taking supplements as a precaution.

Thanks everyone for posting. It looks like several of you, like me, waited to see a doctor. It was also good just reading everyone's stories.

I am sure you will first find a cardiologist you trust and see if there are any underlying heart or sleep issues.

I did not have any other disease triggering afib episodes, so I stopped going to the emergency room except if the event lasted more than 48 hours.

From this site, I learned I could convert to NSR by moderate exercise. I found a 1/2mile walk up hill that stressed my heart just enough to trigger conversion NSR. I discussed this with my electrophysiologist and the thought that was OK for me. For what ever reason, the added demand for oxygen proved to be a conversion mechanism.

Key is to be checked out to make sure there is no underlying heart or lung issue that is triggering the events. Go from there.

Also, CAREFULLY select both cardiologist and electrocardiologist. I went to a different cardiologist, and he imeadiately admtited me to the hospital and wanted me on amioderone and coumadin, and god knows what. When my regular cardiologist returned, he put a stop to all that craziness. He explained that each case is different. Hard to find 2 exactly alike. What works for one, is not right for another.

Hello Edgar. About converting back to NSR with exercise, before i accidentally discovered the ativan conversion technique, i used to use a trip up the stairs to convert. I am about a hundred pounds overweight, and climbing stairs will increase my heart rate quite a lot. At the top of the stairs is my bedroom, and i would sit on the end of the bed to catch my breath, and the afib would give one last big thump, and convert back to blessed NSR. This method i found very reliable, though any physician i told about it had a bad reaction to the concept. One told me i would have either a stroke or a heart attack or both if i did that, and forbade me to do it. He was an emergency room physician, and wanted to admit me. I declined, left against his advice, took a cab home, climbed the stairs to my bedroom, converted at the top as usual, and went to bed to recover from the whole ordeal.

PeggyM

Yes, exercise would convert me as well. Milder exercise (like a brisk walk) would convert me for a while but after a while it stopped working. A 20-mile or so bike ride always seemed to work, but wasn't always something I could do. Flecainide has, so far, been 100% effective at keeping me in NSR.

Thank you all for your stories. I just joined and left a couple of posts but see that I need to read more to ask the right questions.

I first noticed an irregular heartbeat and occasional rapid heartbeat in early 2010. I went for my annual physical in March and mentioned it to my pcp. He sent me for a 24-hr Holter monitor and then to a cardiologist who put me on motoprolol and coumadin. I had an echocardiogram, which showed no other issues. I said in another post that I was in "permanent" afib, but I realize now I was not using the term properly because I have never been converted. I guess it is "persistent?" because I am in afib 24 hours a day. It is not usually noticeable unless I feel my pulse. My pulse is always a little high on a blood pressure machine, but that my be because it is so irregular it cannot be taken accurately. I am a 63 year old woman 5/3+ and 119 lbs. I've always had bp of around 90/60 and it's usually around there or a little higher on my little home monitor.

I am currently only taking Pradaxa. I was put on Multaq (and off Metoprolol) but it didn't seem to make any difference so I stopped because I figure why take another heavy duty, expensive drug if it's not working. After reading about everyone, including me, who had afib for awhile (even several years for some) without even knowing it, I am wondering just how serious the risk of stroke is? But, alas, I am not brave enough to go off the Pradaxa. I am wondering why aspirin won't work. I took a trip for a week in December and FORGOT to pack my pradaxa, so I took a couple of ibuprofen 3 x a day and was fine.

After seeing another cardiologist last week, who did not seem interested (after checking my heart I said the Multaq wasn't working and he just shrugged and said to keep taking it), and reading Jackie Burgess's report, I have now stopped the Multaq (as mentioned above) and given up coffee, alcohol, salt (at least shaking it), cheese and chocolate. I have also been taking magnesium, potassium and CoQ10 in addition to my Omega-3 fish oil and D3. I was also taking calcium but have stopped for now. I have ordered more vitamins from this site's vitamin store (hopefully I can up my magnesium with the chelated, because now the laxative effect is keeping me from taking more than 500 mg/day. I have also ordered Taurine.

I pet sit and walk dogs as a business, but I realize that over the last 4 years, except for weight training (for tone, nothing serious), I have not really done aerobic exercise. Walking dogs, as you know, is a "start and stop" activity and usually not very fast. So I have also started walking very fast for 30 minutes separately from my dog walking. When I originally went into the Dr. in 2010 I was given a stress test and they took me off right away saying my heart rate was 200. I didn't feel anything at the time, but was then afraid to raise my rate by exercising. Now that I see many of you convert yourselves by exercise I am braver and the thought actually had come to me that fast walking might "re-set" my heart before I read any of this. (When the student is ready, the teacher will appear!).

So thank you all. I've only just started this regimen and the new vitamins will be here this week, so I will keep you posted!

Louise