Hi all
I had an attack at Xmas lasting for 2 days , then it’s happened again Wednesday evening woke up this morning and it’s still there but now my heart beat is 80 bpm but quite
Irregular.
What’s the average length of attack ? And when do I go see my gp and see the ep dept ?
Is one episode every few months for a few days ok to live with without treatment?
Cheers Andy

There is no "rule" for episode length. It is individual-specific.

Generally, if an episode is less than 3 days old, it can be cardioverted without a TEE (trans-esophageal echogram, aka "swallowing a telephone receiver"). Stroke risk is significant even after about 6 hours of AF, so depending on one's CHADS-Vasc score, anticoagulaton therapy may make sense. Again, this is individual-specific.

I've never heard of a 3 day criteria. The guidelines used to say <48 hours but that's been called into question recently as being far too long. In any case, I wouldn't want to be without anticoagulants for any episode lasting more than a few hours.

As Wolfpack wrote, this is individual specific.
Mine last only about 1 hour... but I get them two times a week!
I don't even know if it's potentially more dangerous having about 110x 1h afib a year or 2x 55h ; but having had longer and much less frequent episodes (15-24h) two years ago, I can say I found afib far more tiring back then.

I wouldn't live with afib without any treatment! I think it's better trying to keep a couple things under control: risks of stroke and heart rate, notably. If you can live with your symptoms, this may be enough ; but keep in mind that afib often gets worse as years go by. It's said that the longer you've had afib, the harder it's to ablate.

Thanks folks.
Going to see my gp next week to ask him to refer me to a spacailist or give me some meds to help when the attacks come on.
Got me worried now thinking of the stroke risk

Assuming your heart is structurally sound, you may want to talk to your EP about a "pill in the pocket" (PIP) approach for an on-demand med such as flecainide to terminate your episodes in a relatively short period of time (generally a few hours). This is appropriate for infrequent episodes. I've done this successfuly for 14 years. See <[www.nejm.org]

As "afib begets afib," (due to structural & electrical remodeling) minimizing the time out of rhythm is my objective.

Just some of my history of diagnosed afib. I recorded all episodes for six years before my successful ablation 11 yrs. ago.

Number of episodes - 192
Average number of episodes per month - 2.6
Average length of episodes - 9.4 hrs
Number over 48 hrs - 4
Longest - 72 hrs

Converted only once at the ER.

Would my gp be able to prescribe the pill in pocket for me ?

Maybe, but that's not something a GP should really be doing. You should see a cardiologist.

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Lenlec
Would my gp be able to prescribe the pill in pocket for me ?

Most GP's will not be comfortable prescribing an anti-arrhythmic med like flec. These meds do have risks, if your hear is not sound. I even had a cardio said he wouldn't prescribe it. My buddy had to shop around to find an EP that would do a PIP prescription.

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wolfpack
There is no "rule" for episode length. It is individual-specific.

Generally, if an episode is less than 3 days old, it can be cardioverted without a TEE (trans-esophageal echogram, aka "swallowing a telephone receiver"). Stroke risk is significant even after about 6 hours of AF, so depending on one's CHADS-Vasc score, anticoagulaton therapy may make sense. Again, this is individual-specific.

I asked the cardiologist about clot formation. He said that it can happen in two hours. Wonder if he is overcautious?

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Joe
I asked the cardiologist about clot formation. He said that it can happen in two hours. Wonder if he is overcautious?

He's probably basing that on a single study that found that clots could form very rapidly (even less than 2 hours), but that study was based on very sick elderly patients with significant heart disease. So yes, I think he's being overly cautious. On the other hand, I think the old standard of 48 hours is probably too generous. I used to go by that standard myself but I sure wouldn't today.

Good to know! Thanks!

Joe - this brings up the important reminder that everyone - and not just afibbers - should be conscious about the markers of inflammation and such that contribute to hyperviscosity discussed in past posts and is always included as a reminder by the integrative cardiologists who caution about the damaging effects of 'silent inflammation' and the risk of clot formation. When your test markers show you are on the low side of those normal ranges and if you also regularly use some of the various natural thinners to reduce fibrinogen, there is far less risk. When I wasn't on a formal anticoag, and would begin an AF event, I'd always take more of my 'regimen' and if the event became prolonged, I'd dose again... even though my test levels were all in the low/normal range. The hyperviscosity risks aren't only with arrhythmia, so it's a healthy regimen overall.

Jackie

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Lenlec
Hi all
I had an attack at Xmas lasting for 2 days , then it’s happened again Wednesday evening woke up this morning and it’s still there but now my heart beat is 80 bpm but quite
Irregular.
What’s the average length of attack ? And when do I go see my gp and see the ep dept ?
Is one episode every few months for a few days ok to live with without treatment?
Cheers Andy

I would be in heaven if I had a 2 day episode every 3 months. My episodes usually go 2 days on and two days off and its debilitating for me. I've never been cardioverted, (why bother), and I've never had a stroke. I am on eliquis tho.
I believe the average is much less than mine.
As for your treatment, I would definetly get an EP and you likely need to get on a heart monitor so they can see what type of afib you have etc.. I think you also need to get an echo, ekg, and stress test as well to find out the condition of your heart. You'll probably need to be on blood thinners as well for stroke prevention. Good luck. Afib just sucks.

I had all the tests a few years ago after my 1st episode. My heart was fine they said and called it lone af.
Mine allways follow after lots of alcohol. I’ve cut down a fair bit now.

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Lenlec
I had all the tests a few years ago after my 1st episode. My heart was fine they said and called it lone af.
Mine allways follow after lots of alcohol. I’ve cut down a fair bit now.

Alcohol is a huge trigger for me. I used to drink often and I really enjoyed it. Nowadays, a drink gaurrantees me afib almost imediately. You'ld do well to cut down as much as you can.

Alcohol in moderation has never given me any issues whatsoever - if anything, it noticeably reduces ectopics (maybe by slightly speeding up my rather slow resting HR of high 40s/low 50s?).

Now....MSG on the other hand....A good wallop of that and AF will absolutely follow 2 hours later!

I had about 8 pints the other week and no problems. Wednesday night 2 small wines and it kicked af off.
Can’t work it out.

Alcohol is going to deplete you of electrolytes as well as generally dehydrate you. As to when all of that “catches up with you” is probably variable.

I’m guilty of it myself, as I suspect many of us are. Heck my last episode on Monday followed my 44th birthday party which may or may not have involved a beer keg. Can’t confirm nor deny.

If you know you’re going to indulge, why not supplement some extra potassium and magnesium and be very diligent about having water? Of course, if alcohol sets it off for you like clockwork then avoidance is the best policy.

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Lenlec
I had about 8 pints the other week and no problems. Wednesday night 2 small wines and it kicked af off.
Can’t work it out.

It seems we're numerous struggling to find our unmistakable triggers.
My hypothesis is that when we're in a receptive state (= vulnerable), a lot of different things may trigger afib. When we're not, most of all we thought being possible triggers don't do anything.
Isn't afib still a mystery?

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Pompon

I had about 8 pints the other week and no problems. Wednesday night 2 small wines and it kicked af off.
Can’t work it out.

It seems we're numerous struggling to find our unmistakable triggers.
My hypothesis is that when we're in a receptive state (= vulnerable), a lot of different things may trigger afib. When we're not, most of all we thought being possible triggers don't do anything.
Isn't afib still a mystery?

Very true.
What’s the best way to load up on potassium and magnesium?
I have 2 bananas a day as they are full of potassium

Quote
Lenlec


I had about 8 pints the other week and no problems. Wednesday night 2 small wines and it kicked af off.
Can’t work it out.

It seems we're numerous struggling to find our unmistakable triggers.
My hypothesis is that when we're in a receptive state (= vulnerable), a lot of different things may trigger afib. When we're not, most of all we thought being possible triggers don't do anything.
Isn't afib still a mystery?
Very true.
What’s the best way to load up on potassium and magnesium?
I have 2 bananas a day as they are full of potassium

There are here lots of people more competent than me to answer your question. Bananas are full of carbohydrates too, so I don't know if it's that good.
I'm taking magnesium and potassium supplements myself, following advices I've read here. Too soon to talk about the effects...

Potassium is easy to get from foods. Magnesium, not so much. You’d want to purchase a good, over the counter supplement such as magnesium glycinate. You can get pills or powder forms. Just don’t mix the powder in the beer!

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Pompon
Bananas are full of carbohydrates too, so I don't know if it's that good.
I'm taking magnesium and potassium supplements myself, following advices I've read here. Too soon to talk about the effects...

Concur, unless you eat very green bananas, which are a resistve starch. If it were me, I'd use potassium citrate powder. The citrate will convert to bicarbonate in the body, which has additional benefits. Assuming good kidneys, I'd try to work slowly up to 5 g/day of potassium in this way (As I recall, 4700 mg or 4.7 g of potassium is the adult recommendation).

If your kidneys are well (NOT on dialysis), they should excrete any excess potassium. Dvide your doses.throughout the day.

George

Thanks, George. I'm taking potassium citrate, precisely. I didn't knew that much about the daily intake.

George,

Where do you get your K citrate please? I’ve tried the bicarbonate but it tastes aweful!

Mike,

I actually use the K bicarb and take it straight into my mouth as a powder. Tastes like a salt

NOW products makes a K cit powder. I have some other K cit, but they are crystals and really do taste awful (a lab use source), so won't recommend....

Cheers,

George

Thanks George..... I think!

The thing for me though is that any electrolyte supplementation I try ends up making me more prone to ectopics and AF rather than less. Magnesium supplementation has always done it. Even IM Mg injections did it and after 4 weeks of them I had AF (this being 5 or 6 years ago). I do OK with the Concentrace mineral drops though so stick with those for at least 300mg ionic Mg per day (although I appreciate that's nothing compared with your own intake) + almonds, nuts and green leaves in abundance. I recall an Exatest I had 10 or so years ago came back with well-below bottom range for IC Mg (and way above top range for IC Ca) and I'm well aware of the roles both play in regulating cells. I recall Pat Chambers (PC) here on this forum many years ago really going for it for a year or two with Mg supplements and still not being able to shift his IC Mg (as measured by repeated Exatests) off it's right at bottom of range floor. As for K bicarb, I'd been trying modestly supplementing with that for the 2 weeks prior to and during my recent Majorca break when I got AF on my birthday as (extensively!) posted about elsewhere here on this forum. I suppose I had wondered if K citrate might be more agreeable for me as well as not tasting as lousy as the bicarb!

MSG is by far my most potent trigger and it's kind of obvious why when MSG let's more Ca flood into my already overloaded (with Ca) cells. As such, my present focus is to eat as healthily as I can (NO MSG and minimised free glutamate) and see what effect - if any - that has upon my ectopics and AF. It might buy me a bit more time before a visit to Bordeaux or it might not.

Cheers,

Mike