The "cyclic" phenomenon still amazes me

I know I'm not the only one here experiencing a "cyclic" phenomenon with my afib. It's like a battery taking some time to charge and, when full, starting an afib episode to discharge. Once the "battery" is depleted, afib can't be triggered for some time (it may be a matter of hours, days, weeks, months...). Each parox. afibber has his own cycle length, probably more noticeable when relatively short. Mine rarely excess two weeks, the afib episode being followed by some 24 to 36 hrs of quiet NSR.
I'd like to know if this phenomenon has been studied. Would it be interesting to have, say, a blood test the nearest possible before and after afib ? And maybe some other blood tests till the next afib episode ?

I think it might be really interesting to know what happens during this period of time where afib can't be triggered.

If you haven't read it before, you might be interested in Hans' take on this from the Conference Room from 2004 <[www.afibbers.org]

I did experience this in the 2 months prior to my 2.5 month episode in July and August 2004.



Edited 1 time(s). Last edit at 07/12/2019 08:33AM by GeorgeN.

Hi Pompon.

I know exactly what you mean by cyclic phenomenon afib as that was more or less my case in the weeks just prior to my first ablation which was performed in India. My 'cycle' was around 24hrs of AFIB and then 12 hours of NSR bliss. The AFIB would stop like some one turning a light on and I came back to the world of the living in a matter of seconds, an unbelievable joy to behold.

This brings me to a little story of that first ablation. I flew to India from Hong Kong at a weeks or may be two weeks notice, as things were getting desperate on the AFIB front. On arriving in India in the early morning and I went straight into AFIB which was OK by me as I was scheduled to have the ablation the following afternoon which would be in exactly the middle of the 24 hourish AFIB cyclic phenomenon that had been happening for the last few weeks.

So all the preliminaries were carried out ready for the 1pm ablation and I waited in anticipation of a successful ablation as the Doctor would see the AFIB in real time and so have a good chance of eliminating the problem foci firing off inside my heart. Long story short the ablation was cancelled until the following day and me in full blown AFIB and hoping it would stay that way.

Around noon the next day and still in AFIB I fell my ears 'pop' (the first time that had happed in AFIB )and immediately I rejoined the NSR world much to my frustration as less than 30 minutes later the nurse arrived and said "Come along Mr Gordon" as she wheeled me off to the Cat. Lab. I consider that ablation 80% successful which was a good effort as no doubt the Doctor was shooting in the dark so to speak as my heart was in the NSR resting period. P.S. I questioned Professor Jais in Bordeaux about that India ablation and the fact that I was in a NSR cycle during the ablation and he said yes the fact that the initial AFIB attack had just stopped would have made the ablation much more difficult.

Barry G.

Barry,
Thanks a lot for your story.
I've lived something exactly like this when I had my first touch-up ablation.
I entered the hospital around noon to have some exams and blood test, the procedure being scheduled for the next day. I was fine, with just barely a couple ectopics in the afternoon. The EP himself wasn't sure I still had afib after my PVI 5 months before, two holter monitors having just recorded ectopics. But I was sure.
In the evening and out of the blue, afib suddenly came back and, of course, was recorded. I went back spontaneously to quiet NSR four hours later.
Next day, in the lab, they could not induce afib. Just some ectopics here and there, said the EP. I was furious, because I'd had a GA for nothing.
One year later, I had my second touch-up with another EP, in another hospital, under conscious sedation. I spent the night before the procedure sitting on my bed or walking around, just to avoid afib kicking in, because I had lots of ectopics.
In the lab, afib did start spontaneously. The EP made extensive ablation, until nothing could be induced. About 8 hours after having been rolled in my room, ectopics were back. And then afib.

I've made a post, some time ago on this forum, about my third touch-up procedure, performed in november 2018. Things went nearly the same way, but afib came later, as I was back home.
The EP says I'm a surprisingly difficult case. He says there are likely some ectopics points still to ablate, but it's hard to have them firing when they should, while in the lab with the catheters ready to work.
Knowing I'm not alone with this issue is reassuring, but it doesn't cure anything, unfortunately !



Edited 1 time(s). Last edit at 07/12/2019 09:58AM by Pompon.

I know exactly what you mean. My afib behaved in that fashion for years. I always knew an episode was imminent because I could feel it. And once the episode happened, that feeling was completely gone and I knew another episode was impossible for a while. Just like you described.

I once asked my EP about that and he was completely unaware of the phenomenon, so if there is research into it, it's either very new or very obscure.

I think it might be very interesting to know what is different in the body of an afibber during the hours when afib can't be triggered.

Yes Pompon it seems we all have sad stories of things not going to plan with this mysterious affliction.

After my 2nd ablation, 1st in Bordeaux, I went back into AF only an hour before I was to be discharged. I spent Saturday and Sunday in an hotel before returning Monday for another ablation. As it turned out the ablation was for Left Atrial Flutter as the AFIB had change to the Flutter. Professor Haisagurre was very happy about this as he could see the problem in real time rather than instigating the arrhythmia, he was humming to himself throughout the procedure. Never the less I was back in Bordeaux some months later for another AFIB ablation followed a few more months later with another visit for another Left Atrial Flutter ablation, a very difficult arrhythmia. Apart from a few ectopic storms soon after the last ablation I have been in perfect NSR for almost 10 years until this current visit by Atrial Flutter. Note: Bordeaux virtually burnt the left atrium to a cinder to stop the AFIB so the weak link now is the right Atrium Flutter which previously would have proceeded onto atrial fibrillation.

Talk about Bad Day at Black Rock.

Barry G.

Before my ablation and touch up I too experienced this cycle, exactly as Pompom described. Felt as though energy had built up then discharged.

Gill

Quote
GeorgeN
If you haven't read it before, you might be interested in Hans' take on this from the Conference Room from 2004 <[www.afibbers.org]

I did experience this in the 2 months prior to my 2.5 month episode in July and August 2004.

Interesting debate !
This aldosterone/cortisol thing may be something to investigate...

I had five years of documented afib episodes, length of each episode documented and the date that it happened.

192 episodes during the five years.
Average 3.2 episodes per month
6 of the 60 months had no episodes
Most episodes in a month was 10

I could see no pattern.

Mine originally was exercise induced but not every time so they weren't really cyclical. I also could tell when I was about to have an episode as well. Normally I was pulled to the side of the road and clipped out before it actually happened. Unless I was being stubborn or racing. Like the rest of you I would convert to NSR, which back in the early days it would convert usually within 10 minutes. As a rule, I could then continue to ride as hard or as far as I wanted and not trigger another episode. It was only on a few rare occasions, as things progressed, that I would sometimes trigger a second event.

My cyclical episodes this year have run in about 14 day increments. They have quieted down as of late but I have been laying low until my touchup ablation next week.



Edited 2 time(s). Last edit at 08/10/2019 02:49AM by rocketritch.

During the first year of my arrhythmia (it was mostly Aflutter), I rarely if ever had back-to-back episodes, and once I converted, was reliably good for a while (days). In the last 6 months or so (mostly Afib), that "benefit" has all but disappeared, and now I'll often have a succession of (short) episodes during "vulnerable" periods (usually anywhere from early evening to sunup).

I can definitely feel when I'm vulnerable to having an episode(s) as well. It's difficult to describe in words but something a bit like the feeling of having my "heart in my throat", or a mild "lump in my throat". I'm planning to have my first AFib ablation in September sometime. Thanks to many of you on this forum, and a long conversation with Shannon, I'm going straight to Dr. Natale. One question I still have is--does that feeling that often precedes an episode remain, even after one has had a successful ablation?

Hello ! I, too, usually have cyclical afib. It's not 100% predictable, but usually somewhere between a week and 2 weeks. Although on occasion it will do some different things.
Like I'll have afib 2 days after the last one....on occasion, not usually. And then I had 6 months (5 months ago) I with almost no afib.

I can just about always tell when it's coming by "feeling" my heart here and there for some hours before it starts and sometimes having little periods of "feeling" it here and there for days prior to really getting afib. I don't know if this feeling has a name but it's just there's a prescence, which isn't usually there.

So.....I looked at the link that George sent in this string where Hans talked about the cyclical thing. I really tried to read it all and to understand it but I had trouble doing both. It's super long, so just time was an issue.....but also, it's so technical....I am not very scientific....but I did understand the main idea and it sounds very interesting and I think it might be helpful to me to understand it better. The cyclical thing is the most significant thing I have noticed about my afib....way more than any triggers.

I have some questions about this that I would appreciate if anyone would answer. I have tried to figure out these answers by myself, from looking over the website and many posts, but as yet, I haven't been able to.

1. so I understand (enough) the basic thing that Hans discovered and that he thought a person should be tested to figure out if this situation is going on with them.....although I can't do testing now, being in a foreign country.....but I understand all that.

What I wonder is.....did Hans have and use any method to deal with this situation and correct it? I wasn't able to find that.

2. If so, what was that method?

3.. Did his afib stop as a result of this discovery and the findings that he had fron the testing and using some method to deal with it?

4. Did his afib stop as a result (also?) of other discoveries and methods that he used?

5. Has he died?

6. Are his books available for free...or only to buy?

thanks to anyone for any help on this

Barbara