New here: First & only AFib episode on June 12. Status & Questions

Hi all. Great resource here. Long post. Thanks for such good info and support. This is all so new and scary. I’m 61, female. Thought I was healthy! Maybe 15 pounds overweight. On Saturday, June 12, I felt my heart fluttering most of the day. I’d been to a family barbecue (vaccinated), ran errands even went for a hard 30-minute walk, all the while noticing a flutter here and there. By evening when I sat still, it wasn’t so easy to ignore. It felt like my heart was flopping around my chest and I called my niece who’s an ER doc & lives around the corner to take my pulse and tell me what’s happening.

I’ve felt heart flutters before (just for a second) but this didn’t stop. I had gone to a cardiologist about them. Stress test, monitors, echos, etc. He found nothing alarming. I didn’t even bother to go back for yearly check ups. My niece asked if I felt lightheaded, etc. and said I should just go straight to the ER. What?!! I was feeling fine. Just the awareness of my heart beating weirdly so I stalled, made dinner and then suddenly, most definitely felt lightheaded while eating. There was no mistaking it and it was terrifying. Went straight to the ER.

Dang. When they hooked me up to the ECG the tech said, “it’s a good thing you came in.” Full on AFib. Heart bouncing between 165 and 100. I’m still incredulous 2 months later. They gave me cardizem through an IV and my heart stabilized around 100 and stayed there. Injected blood thinner too. Admitted me to run tests, etc. Echo normal. Blood pressure normal. Discharged on the ok of my cardiologist who I saw the next day. Got the new Apple Watch and obsessively checked my rate and took ECGs. Love that thing.

So my cardiologist put me on 25mg of metoprolol which we then cut in half at my request because my heart rate goes a bit low. 40-50?! No blood thinner. He does not think I am at risk of a stroke. I’ve kept exercising, eating very well. Hydrating. Lost 7 lbs and have 7 more to go.

Well fast forward to today, the month long heart monitor revealed no more Afib (yet) episodes but something is going on with “sinus node dysfunction.” I don’t understand at all and my cardiologist wants to discuss options which include waiting and seeing. He mentioned a “pacemaker!” but said he does not recommend that step “yet?” He mentioned an ablation procedure but also thought it wasn’t yet time?? Said I’m experiencing what might feel like flutters probably, about 2% of them time. Sounds right. He used the word tachycardia but I think he’s seeing when I exercise. My heart rate goes quite low while I sleep. Then he mentioned it going to 135 at odd times like 8 pm. (Well I have done aerobic exercise at night.)

I’m in a bit of denial. What the heck? I feel suddenly old and diseased. My heart?! How serious is this? My mom died from a stroke caused by Afib. But was 87! I’m too young. A possible pacemaker?? Why not just stop the metoprolol? I’m not a smoker or drinker. Anyway, I know stress is a factor and I’m super high strung, a worrier. Lol. Two kids in college with one who causes me sleepless nights and major stress. (Love her. Please get back to campus.) I truly think I was dehydrated the day of the afib incident. Rambling here. Scared. Confused. Incredulous. How do you keep from freaking out?

Sounds a lot like my very first bout with Afib in 92...my next ep. was 96...then 03...08...then starting in 2012 got about 10 that year...more the next....2014 around 40 until for the next 4 years around 2 A WEEK until my Ablation 2018 that fixed me.

Just wrote that to give you an idea how long it takes sometime before this gets serious...although it can obviously progress A LOT faster then that.

I see your wondering to yourself kinda what am i doing wrong well every afibber thinks that way all the time esp. in early onset blaming themselves mostly but its so random in dif. people it's unbel. esp. hearing their stories on this site cements that...once you have it there is very little to nothing you can do about it short of an Ablation to fix it. Some are lucky through supl. like Mag. + many others to slow the onset + make life pretty normal but they are in the vast but lucky minority.

The Doctor is correct...he is telling you its not bad enough yet for an Ablation...very true...you might progress like me or Boom within the next couple of years go into weekly bouts or worse.

Unfort. what i am saying is help is not on the way for a final solution to your problem aka an Ablation...until you do get worse and that word is very subjective.

You are now in a simple wait + see game like most everyone in your extrem early onset status of this horrible malady.

A pacemaker does not seem in the cards at all for you + frankly putting you on ANYTHING right now is an overreaction....there is plenty of time for those bandaids down the road but if i were you if things start to ramp up with your Afib get in your doctor/cardiologists face with ABLATION ABLATION ABLATION...NO drugs.....1 of my worst mistakes was not doing that myself...well as the old saying goes.....better late then never....don't be late Nat. B.

All the best

Thank you for this!

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Natalie B
So my cardiologist put me on 25mg of metoprolol which we then cut in half at my request because my heart rate goes a bit low. 40-50?! No blood thinner. He does not think I am at risk of a stroke. I’ve kept exercising, eating very well. Hydrating. Lost 7 lbs and have 7 more to go.

Metoprolol likely won't keep you out of afib. You might discuss using it on an "on demand" basis, if you go into afib, to keep your rate down then.

Sounds like you are pretty healthy and something else to discuss is the use of an on-demand or "pill in pocket" (PIP) drug to put you back in rhythm. One med is flecainide. Note that the max dose is 200 mg/day for those under 154 pounds or 70kg and 300 mg for those above. Here is the original 2004 paper on the topic [pubmed.ncbi.nlm.nih.gov]

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He mentioned a “pacemaker!” but said he does not recommend that step “yet?”

Afib should not be a reason for a pacemaker. Perhaps there is something else he is seeing? There is a very archaic out of favor approach for afib where the AV node is ablated (killed in this instance) and a pacemaker put in. If someone suggests this, run away to another doc. EP's (electrophysiologists) give better afib advice than cardiologists.

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two kids in college with one who causes me sleepless nights and major stress. (Love her. Please get back to campus.) I truly think I was dehydrated the day of the afib incident. Rambling here. Scared. Confused. Incredulous. How do you keep from freaking out?

Afib is a chronic condition that can be managed, so you can relax. The two dangers are stroke and cardiomyopathy. You've mentioned you aren't at high risk for stroke. Cardiomyopathy happens when you have a high rate for a long time. You won't let that happen. If you are in high rate afib, take the metoprolol, convert with a PIP med, go to the ER if necessary for conversion or treatment. Point is, you are in control, so you don't need to worry about that risk.

If afib starts to be an issue, an ablation by a top EP at a top center (ask for advice here, don't just go to anyone) should fix you up.

Exercise in moderation is a good thing for afib. Long duration, higher intensity endurance exercise can promote afib in the susceptible. Don't know where you are on this continuum. If you give us more info, can give you better advice.

Yes, work on stress, that is useful for all of us.

Wow, I had to look twice to see if I had written your post. Almost totally identical circumstances. (Except I have 2 sons in college lol). If you can, go back and read my first post (I was absolutely terrified.) Still don't like it AT ALL. I haven't had an episode like that again, but I certainly do have flutters and at times feel like an Afib episode is going to start.

But, I was put on 2 BP meds, because of high blood pressure. I had always attributed it to white coat syndrome, but the 1st cardiologist I saw after my episode in Dec. 2018 insisted that my BP was too high and that I HAD to take the BP meds. I take bisoprolol and amlodipine They also put me on Eliquis, but after a visit to the electrophysiologist, he took me off because he said I wasn't high risk.

I've taken them since 12/18. My pulse hovers around 50. I personally think that's too low and keep thinking I am going to ask the doc to lower my mgs. I HATE taking the beta blocker because it has greatly reduced my exercise endurance. I can't walk up 4 flights of stairs w/o getting breathless. It also does not help with weight control, which it's hard enough for a woman my age (64 now).

Oh, as far as "freaking out," I can't help you there....I know that if/when I have another one, I will not handle it well, but I'm still crossing my fingers I'll buck up.



Edited 1 time(s). Last edit at 08/14/2021 02:58PM by katesshadow.

Thanks so much for replying. I’m going to back and read your first post right now.

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Natalie B
How do you keep from freaking out?

You come here and read, read, read. Glad you did.

AF and a pacemaker? Yeah, that's a reason to fire a cardiologist. More often than not, anyway. The only reason I could possibly think of for that would be extremely long pauses (3 seconds or more) upon converting from AF (a-fib) to NSR (normal sinus rhythm). And in most cases that would be caused by too much beta-blocker, which can be medically managed. We just don't implant battery powered heart stimulators for AF. It's no reason to start on a journey to becoming a cyborg.

My suggestion would be to read all of the resources that are offered on Afibbers.org. Especially Dr. John Day's book "The Afib Cure" and Dr Mildred Seelig's book "The Magnesium Factor"

There are so many factors that contribute to the cause of Afib, but I'd start with getting a Magnesium Red Blood Cell test from requestatest.com to just find out what your Mg status is. It may be a cause and maybe not. If you don't test, you are only guessing. Anything below 5.5 mg/dl id a deficiency in the eyes of a good cardiologist, per Dr Denis Goodman (cardiologist) wrote in his book Magnificent Magnesium. The sweet spot for Potassium, per Dr. Day is 4. You can get that serum test as part of a regular check up.
Mg and Potassium are the two electrolytes which can be so easily depleted and affect your heart rhythm.

There are many more factors, so turn every stone, relax, take a deep breath, read everything you can on Afibbers.org (besides the forum) and hopefully it won't come back. PM me if you want more info.

LaniB