Short and frequent AFIB

Hi,

I posted on this before, but did not receive a specific response (perhaps that was actually an answer). Also, my post may have been too discursive. So I will try to keep this very focussed.

I have documented AFIB with HR maxing out at 120 (normal rate mid 40's) . Episodes occur every day or two, in the evening initiated by a yawn, or at night waking me from sleep. Episodes last one or two minutes. Sometimes I get a repeat within a few minutes, but in any case usually have the feeling of fighting them off for an hour or more. I also have trouble with ectopics, which seem to preceed AFIB episodes. The ectopics can be around for extended periods, but have been told they are harmless (my main concern with them is their preceding AFIB ). Age 58 and testing shows normal heart structure and function.

Does anyone here have these types of short and frequent AFIB episodes? In any case, would this be considered a level of AFIB burden for which it is appropriate to obtain an ablation, assuming that other dietary or pharmaceutical treatments are neither effective nor desired (I have tried many things, but don't want to engage in that discussion here; suffice it to say I am not satisfied with the result)? I feel like I have to be careful to not push myself, which interferes with work and lifestyle, less the AFIB and ectopics seem to worsen. My local EP insists these short frequent AFIB are not that unusual, but what I see on this site is much longer and less frequent episodes.

Thanks for any info you can provide on this situation.

Paul

Hi Paul,

It sounds like you feel symptoms when you are experiencing the afib you describe. Do you have an AliveCor or some other device? I'm asking because I am wondering if your afib burden could actually being higher than you know, but perhaps you just don't feel symptomatic during all periods of afib. Do you ever feel like exercise could be initiating your afib? Exercise was certainly a trigger for me many times.

When I was diagnosed with afib, I was just lucky to have had a nurse feel my pulse and sense it was irregular. I was completely asymptomatic. Failed cardioversion immediately and then meds followed. I continued to exercise throughout with the concurrence of the initial cardiologist. Even though Tikosyn did a good job of putting me in NSR, I still had breakthroughs during exercise. I saw another doctor who put me on Flecainide. That was less effective. We later added Metoprolol, which slowed the heart and stopped the breakthroughs during strenuous cardio exercise-----but only temporarily.

The E/P then increased Flecainide and Metoprolol multiple times. The last holter monitor showed numerous 5 second pauses in my heart. The E/P said to cut back on both meds immediately and get an ablation. I had my Natale ablation on 1/27/15 and I am enjoying the NSR. I am having exercise withdrawals...lol......most of the knowledgeable folks on the forum have recommended I not jump right back into strenuous exercise......so I'm taking it easy for a little bit longer.

I was completely asymptomatic for most of this period after afib diagnosis until ablation (about one year). Early on, I had no idea when I was in Afib---just like I had no idea I was in afib when diagnosed!. I would notice my HR at the gym would suddenly spike to the 200-220 range at times, but I had no idea what was happening. I just continued my work out. The cardiologist had told me to keep exercising. Ugh....if I could do it over again, I would have stopped exercising early on to give my heart a chance to rest and try other things. I eventually tried every trigger removal and supplementation program anyone ever suggested. Nothing worked. The ablation has stopped the afib.

I think the best answer with regard to whether an ablation is appropriate for you is about how much it impairs your life. Early on, I didn't think it was much of a problem for me. It didn't appear to have any impact on my lifestyle or ability to exercise. However, as time passed and I became more educated, and I saw my heart affected by the meds ---and likely the afib----it was actually emotionally draining for me to watch and not be able to do anything to have a positive effect on the irregular rhythm. I approached everything as systematically and logically as I possibly could.

If your Afib is like mine was and many others on this forum, it will likely get worse, unless you are fortunate enough to find a specific trigger that has been causing it or remedy a specific deficiency that is identified. I would urge you to keep a close eye on it and seek out the assistance of a top, elite ablationist for a consultation to help you with your decision. As you well know from reading here, Dr. Natale is the popular choice on this forum.

Ocassionally, I will feel a skipped beat in my carotid artery (or an early beat) but that is a very infrequent occurrences. I check it with the AiveCor and I'm sure it is just some ectopics but they are not symptomatic to me.

During my pre-ablation afib, I was never awakened by afib.

Good luck, my friend! Best wishes for restoration of NSR. I'm sure others will chime in here with their experiences......hopefully some will be able to provide information closer to your experience that can give you some added insight.....sorry but my experience was very different.

Best wishes.

Sincerely,
Ken

Paul - Are you using the supportive supplements ie, minerals/electrolytes such as magnesium, potassium and taurine to help make sure that your intracellular stores of magnesium are optimized? First, magnesium and then potassium so that you are far less likely to have skipped beats caused by a low level of these to help maintain normal sinus rhythm.
Start reading The Strategy... [www.afibbers.org] so you have the background of how this can help. If you're already doing that, then consider that your intracellular levels probably have not yet been optimized as it often take quite a bit of time to replete. You won't likely hear about this from your cardiologist.

Typically, it's too much sodium in the diet and not enough potassium. Initially, afibbers are almost always found to be deficient in IC magnesium... and when that happens, what little potassium you do have, can't function because it's overpowered by too much sodium intake. Read more here: [www.afibbers.org]

If you drink alcohol, that may be a culprit as well. The Electrophysiologists say that alcohol should be avoided.

I'm in a rush to go out of town... so read at least these two and even more in the link at the top Afib Resources... and see what might mesh with your symptoms. Many people have reversed their Afib just by getting control of the electrolyte issue and changing dietary/lifestyle habits.

Ask questions so we can help.

Be well,
Jackie