New to AFib

Hi everyone,


My name is Kevin. I was recently diagnosed with atrial fibrillation at the age of 45. The first time I experienced an AFib episode (that I'm aware of) was mid July of 2021, two weeks after my second dose of the Pfizer vaccine. My episodes have been mostly sporadic, coming once or maybe twice a month and lasting up to 24 hours or so. Initially, I brushed the episodes off as being atrial flutter or something. For that reason, it wasn't until November before I was finally diagnosed with AFib. I really wish I had taken the initiative to get a diagnosis sooner—I just didn't think it was serious at the time and my symptoms, other than the bouncing heart rate, were mostly mild.. I'm currently on a blood thinner and an anti-arrhythmic, which hasn't helped me much. I do have an appointment with an electrophysiologist in a few weeks to discuss the possibility of an ablation. The problem I find myself faced with though is that the clinic where I'd be getting the ablation done is fairly new and I'm unsure as to how many abaltions this particular EP has carried out. Moreover, I'm in Canada and the wait times here can be horrendous.

Does anyone here have any advice? I'm all ears.

On a side note, it's possible that my AFib has a genetic component linked to it. My father, who recently just passed away, had AFib off and on from around 1999 to 2008. However, following an ablation in 2008, he remained AFib free right up until his death in November of 2021. Similarly, my uncle (my dad's brother) has been in permanent AFib for the last 24 years, but he's asymptomatic. Having said this, I find the timing of the vaccine and my first AFib episode difficult to ignore.

Hi Kevin,

Tell us a little more about yourself. Do you exercise a lot, moderate, a little, not at all. How is your weight? Under, over, medium? Do you drink a lot, a bit, not at all. Any chronic illnesses (hypertension, diabetes type 1 or 2 & etc.). And so on. Where in Canada do you live (for ablating EP purposes)? Which blood thinner and which anti-arrhythmic, what dose? Sounds like you are aware of the episode when you are in it?

Hi George,

Well, I'm a career firefighter. I'd like to think I'm physically fit, and my GP certainly thinks I am, but I definitely could stand to lower my overall Body Mass Index a bit, and I'm currently working on that. I run frequently. However, I usually keep the running to around 4-6km. I've also been walking quite a bit. I quit drinking following my diagnosis, although I would hardly have considered myself a big drinker before that. I'm not aware of any chronic illnesses, but I'm currently doing a battery of tests (e.g., 24hr blood pressure monitor, 48hr holder monitor, echocardiogram, etc) to rule things in or out. I'm an hour west of Toronto (Waterloo Region), which is where the new arrhythmia clinic (at St Mary's Hospital) is located. The clinic appears to be a state of the art facility, but it's only been opened since early 2021. Of course, that's not to say they don't have good EP's. I'm currently taking 25 mg of Rivaroxaban (once a day) and 120 mg of Sotalol (twice daily), neither of which give me to much in the way of side effects. That said, I'd rather not be taking drugs at the age of 45. Yes, I'd say I'm aware of the episodes, but I wouldn't consider them debilitating. In fact, during my last episode, I went for a 40 minute walk.

If there is one thing I'd say I'm worried about regarding my AFib diagnosis is that the condition will shorten my life span—I'm only 45, and I'd like too make it to 80.



Edited 2 time(s). Last edit at 01/04/2022 10:38PM by Kev.

Hi Kevin,

I am a 56 year old female and joined this forum just this week. I am recently diagnosed with paroxysmal Afib after experiencing attacks intermittently over past 10 years. The attacks became more frequent. Initialy I was only getting one yearly or so. Then this last year every month, but I had been suffering from anxiety this year. Mine funnily enough became more frequent after my Astra Zeneca vaccines, but not sure if they had anything to do with it. Covid and lock down hasn’t helped anxiety of course. My attacks would self terminate after 8 -12 hours before drugs.

I share your concerns as I am struggling with the diagnosis. I don’t get on very well with beta blockers - I take Bisoprolol but it does control them. It’s the side effects I hate. They make me feel tired, though they don’t help my sleep. I have asked for an ablation, but it’s quite a long wait here in UK and I’m not even sure if I’m going to get referred yet. I’m not on blood thinners - I have a CHADS score of 0 currently.

I wish you all the best and hope this works out for you.

Tweez



Edited 2 time(s). Last edit at 01/05/2022 03:52AM by Tweez.

Tweez
I sent you a PM.

Kev,

Relax a bit. Keep reading here and you will learn a lot. My afib started 26 years ago. Five years of afib undiagnosed, then caught on an ECG, then 6 years on meds, then an ablation. An ablation is a good response to afib, but there may be no need to rush into it. You are on a blood thinner, so the risk of a stroke is almost zero. I did have a second ablation after 13 afib free years and now, no afib again at age 76. During my first 11 years of afib, I documented over 200 episodes, lasting from 2 to 72 hours, all resolved on their own. Currently, I take no prescription meds, am very healthy and fit and see no reason that I can't keep up with my father who lived to be 97.

Afib can impact individuals very differently, some don't know they have it and others are impeded greatly while in afib. How quickly you move toward an ablation should be guided by how afib impacts your lifestyle. And by the way, an ablation is not a permanent fix, afib will likely return at some point. To keep from damaging your heart, meds and or an ablation are essential.



Edited 1 time(s). Last edit at 01/05/2022 09:31AM by Ken.

Hi Joy,

Thankyou - I replied ( hopefully it worked!)

Tweez

Get the book "The Afib Cure" by Dr. John D Day, and do everything it says, and your age, you may be able to control it without drugs or ablation. If you decide to get an ablation, you still need to walk the line to keep it from returning. (Hardest part is avoiding stress). You most likely have a genetic tendency toward it, but we are not ruled by our genes. Our lifestyle and dietary choices overrule genetics. My mother, brother and father all had arrhythmia issues. I did not find this website or Dr. Day's book until I was well into my Afib journey otherwise I may have avoided the ablation I had two years ago. . None of the drugs worked for me except Amiodarone and I knew I couldn't be on that long term. The ablation took me out of Afib for a few days, but it did return just as before, so I asked to be back on Amiodarone for a few weeks to get me through a stressful time in my life. (A move during covid before vaccines). It worked, once I weaned off it, and began following Dr. Day's advice and that of Dr. Denis Goodman (Magnificent Magnesium) who says keep your RBC Magnesium level above 5.5, I haven't felt a single misbeat! Good luck! WE are all different and all need to find our own way through this, but I must say the ablation was wonderful! Easy, no recovery period, (just taking it easy for a cpl weeks), and once my heart settled back into normal, I think with the few weeks on Amiodarone as I healed, my heart is happy and so am I drug free! You are smart to check the statistics on your clinic and the EP. The doc needs to have done thousands of them , before yours .

Quote
Kev
If there is one thing I'd say I'm worried about regarding my AFib diagnosis is that the condition will shorten my life span—I'm only 45, and I'd like too make it to 80.

Hi Kevin, the founder of this site, Hans Larsen, of Victoria, CA, is about age 90. He started having afib around 1990, so a long life with afib is certainly possible. The two big risks with afib are stroke, and you are taking Rivaroxaban to mitigate this. The second is cardiomyopathy from an episode with a high heart rate that continues for weeks leading to heart failure. This is why I asked about your awareness of afib. You won't let that happen. I had my first episode at 49, and shortly thereafter a 2 1/2 month episode. I'm now 66 and I doubt that afib will stop me from making 80. My military son-in-law had his first episode at 30 and is doing well with his afib at 35. I don't see it shortening his life.

As to ablations, there are stark differences in ablating EP's skills. We recommend going to the best EP you are able to. Typically a high volume center where the EP has done many thousands of ablations. In the US, and elsewhere, some people travel many thousands of miles to go to the best EP. From my experience on this board, you are relatively close to one of the best ablating EP's in Canada, Dr Atul Verma at Southlake Regional Health Center in Newmarket Ontario. See moderator Shannon's comment.. Your local EP's should be fine for medical management of your case.

As to exercise, it can be a path to afib. Chronic fitness was mine. Doesn't have to be that excessive. See my posts in this thread. In my case, my exercise trigger is the product of intensity times duration. Today I maintain good fitness, but pay attention to this trigger. When I started detraining a bit, I gained weight, so modified my diet to handle that, rather than increasing exercise. As you are a first responder, I recommend the book, The Circadian Code, by researcher Satchin Panda. Know you likely have disruptive shifts, but this may help you to mitigate the effects. From a diet perspective, recommend minimizing ultra processed foods and focussing on whole real foods as a first pass.

In my case, supplementing with magnesium to bowel tolerance, was also beneficial. Stress depletes magnesium. From what you've written, I assume you have good kidney function as they will excrete any excess. I also put 2 tsp of potassium citrate powder (4 grams of potassium) in a liter or so of water and drink it over the day - my version of timed release. Potassium taken in a large dose will immediately be urinated out. Same comments for potassium about kidney function.

These are my thoughts. Others may join in, too.

Thanks for the insights and encouragement, George. I will most certainly look into the EP you mentioned that works out of the Southlake Regional Health Centre, which is only about 45 mins from where I live. I've got the one book, The AFib Cure, that another individual recommended above, and I'll have a look for the one you've mentioned. My cardiologist has told me to head to the ER when I'm having an episode and get cardioverted; the less time I'm in AFib the better he says—I'm assuming he knows what he's talking about lol.

Hi Tweez,

It's possible I've had previous episodes. However, it was only after my second dose that I became aware of my racing heart (thanks to my Apple Watch). If I was having episodes prior to July 2021, I was certainly not aware of them. The meds I'm on haven't been too taxing, but Id rather not be on any of them, period. The UK sounds like Canada in terms of wait times; I really do hope you can get in to see someone soon. I'm not sure what my CHADS score is. I should probably inquire.

Thanks, Tweez. And best of luck to you as well.

Thanks for the encouragement, Ken, it's much appreciated. For me, I just want to know what my options are, and which ones will likely benefit me the most. If I could stay off med until a later date, that would be a bonus. If I can't, so be it.

Hi Lani,

I got that book (The AFib Cure) for Christmas—Merry Christmas me lol. It's a great book. I'm glad you've found something that works for you. Hopefully it stays in remission.

Kev said: "My cardiologist has told me to head to the ER when I'm having an episode and get cardioverted; the less time I'm in AFib the better he says—I'm assuming he knows what he's talking about lol."

I wouldn't assume so much. See an Electrophysiologist. I had well over 200 episodes and ONE cardioversion early in my history. Can you imagine if I went to the ER over 200 times for a CV? It is true that the longer you are in afib, there is the possibility that it will damage your heart, but if you are on a rate control med that keeps your heart rate somewhat low during afib, damage isn't an issue.

Others here will elaborate on this issue with better details than I can provide.

I've had three cardioversions in the span of a month and I've been told by multiple Drs that they're harmless. Personally, I'd rather be in NSR, and if a CV accomplishes that, and the associated risk is minimal, then I'll be going each and every time. I'm on an anti-arrhythmic drug (see post above) and it really hasn't done a thing. Moreover, I have no clue what's considered to be an an acceptable heart rate when I'm in AFib. 100? 120? 130? 140? Each time I've gone to the ER to get a CV, my pulse—according to the ECG machine—seems to be all over the map. My Apple Watch, on the other hand, tends to indicate a lower heart rate when I'm in AFib. During my last episode, for example, I went for a good walk and it never got any higher than 130 bpm, with the average having been mostly around 100 bpm. I'm much more inclined to believe that the ECG machines are more accurate, rather than my Apple Watch, but I really don't know.


I meet with an EP this month.



Edited 3 time(s). Last edit at 01/05/2022 04:36PM by Kev.

Quote
Kev
My cardiologist has told me to head to the ER when I'm having an episode and get cardioverted; the less time I'm in AFib the better he says—I'm assuming he knows what he's talking about lol.

While the less time in afib the better is correct. Cardioversion several times a month as a long term strategy is not. I recall 17 years ago, during my 2 1/2 month episode, the EP said he could cardiovert me, but the big question was how to keep me in NSR after the cardioversion. Absent a different plan, with a working rhythm med, then ablation is likely your best option. However, I'd wait to get on Dr. Verma's schedule and take the cardioversions while you wait, rather than get on a shorter list with a different EP.

I will definitely be inquiring about the possibility of having Dr. Verma perform my ablation, if I choose to go that route. I do have another question. Is it possible for premature ventricular contractions to precede the development of atrial fibrillation? I'm curious, because apparently I have them.



Edited 1 time(s). Last edit at 01/05/2022 06:27PM by Kev.

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Kev
(...) Is it possible for premature ventricular contractions to precede the development of atrial fibrillation? I'm curious, because apparently I have them.

I don't think so.
I may have lots of PVCs (mostly in bigeminal pattern), they never turn to afib. They come and go by themselves.
PACs are another story. Runs of PACs, particularly, can turn to afib. I don't even know if there's a defined border between long runs of PACs and afib, since, on a tracing, the difference may just be a couple "normal" beats lost in the middle of the PACs. I'm used to call that "unsustained afib". To get afib, I need PACs. Before ablation, a single one meant immediate afib. Since ablated, runs of PACs not necessarily enough to do so.

I concur with Pompom. What I have observed is having a lot of PAC's or PVC's means my heart is "unhappy" and I'm more likely to go into afib. Not as a immediate initiation, just as a background observation. I attribute this, in my case, to having my electrolytes out of balance. If I get the electrolytes "right" then I tend to have few of either.

Hi Kevin, I had my first episode a few weeks before you. On the night of my first vaccine.
Sure the timing is hard to ignore and since then not one doctor has found it equally suspicious, but who knows.
I was on a monitor at the time so I was having palpitations a couple weeks prior.
Anyway, people here have a lot of insight, so take advantage.
I had an ablation in October and am off Amiodarone but still on blood thinner.
So far so good, but I know maintaining a lifestyle is my best option for a stress free life.
My episodes freak me out and causes me anxiety because they generally happen when I'm sleeping or wake me up.
Find out your triggers and best of luck.

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Kev
My cardiologist has told me to head to the ER when I'm having an episode and get cardioverted; the less time I'm in AFib the better he says—I'm assuming he knows what he's talking about lol.

The ER is the last place I’d go (having done it and regretted it) unless I was dizzy or gasping for breath. ERs treat a-fib with a sledgehammer and a side of poor bedside manner.

AF is just not a medical emergency unless you can’t breathe.

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wolfpack
My cardiologist has told me to head to the ER when I'm having an episode and get cardioverted; the less time I'm in AFib the better he says—I'm assuming he knows what he's talking about lol.

The ER is the last place I’d go (having done it and regretted it) unless I was dizzy or gasping for breath. ERs treat a-fib with a sledgehammer and a side of poor bedside manner.

AF is just not a medical emergency unless you can’t breathe.

Add having high tachycardia (>150 that won’t convert for days) and angina.

A short run of tachycardia won’t give you heart failure..but accumulation of episodes is a poor quality of life if symptomatic and there is nothing more calming than nsr.

You should pick a different ER. Some are quite good.