Atrial Fibrillation

@dao that is a long time between AF episodes! For the last 10 years I have mainly had afib once a year with heart rate around 195. In 2023 I had it twice. I saw an electrophysiologist since my cardiologist thought things were getting worse, and the EP said that if he had done an ablation on me and saw two episodes a year, he would consider it a success!

I recommend the book The Afib Cure by Day and Bunch. two cardiologists. For some patients, they say that progression is not inevitable if triggers are identified and lifestyle changes are made. They even write about getting off meds. That said as responsible physicians, they write about meds in depth as well as cardioversion and ablation.

I declined blood thinners with my first dramatic episode in 2015 and am still not on any. I don't take any medications regularly knock on wood. I am humble and understand things may change. I take magnesium, drink low sodium V-8 for potassium, calcium and D3. I walk and do tai chi and try to keep stress down- not always successfully. I don't eat after 6pm and don't recline after eating, and never lie on my left side. Gas X relieves GI gas and can avert an episode. We are all different and over time these have been helpful things I have learned.

I have had "pill in a pocket" diltiazem for years and have taken it a couple of times but always end up in the ER because low blood pressure makes treatment difficult. Last fall I finally got permission to have Eliquis, a blood thinner, also as a "pill in the pocket," meaning when needed after an episode > 5 hours. This is a new protocol and avoids the side effects of daily blood thinners to cover afib that is so infrequent.

If I make it to April I will have gone a year again. Fingers crossed. But every year that goes by I am ready for a change!

How did you realize you had AFib?

I felt it right away my heartbeat in my throat and my chest. I felt the irregularity and after 30 minutes I started to feel weaker. I thought first I had a panic attack, but having had them in the past, I felt there were some differences. In my PA, something calm down after 10-15 minutes and although I can have palpitations, I don’t feel the heartbeat irregular. I have now an iWatch that can measure heartbeat and if I have a AFib episode, it will tell me. Hope this answers your question.

Windy, as far as I know, the extra score for being female was abandoned due to lack of evidence almost four years ago now. It's confusing, but maybe you should chase that up. It's well known over on afibbers.org.

Thank you so much for your comment. I am in about the same situation. When I turned 50, I started with my first episode. For 12 years, I had them once, sometime twice, a year. But for the past 3 years and a half, nothing. I take no med and I did not have ablation. I think I will make an appointment with my EP to help me understand what is going on. Merry Christmas 🎄

I am not obese, do not have diabetes, and my blood pressure is actually low. Doctors referred to my blood work as “pristine”.

While they can be major factors….it isn’t a factor in my case. Lack of those co-morbidities isn’t a “home free” pass.

The remodeling of the heart increases the poor performance of the heart…and all the issues that come with it. My advice? Do whatever you have to to stop the Afib episodes

There is a body of evidence from various studies that the risk of blood clot comes a few days after the Afib episode. I felt that any risk of a stroke was too much, so I had a watchman as soon as I could. The best thing in 2024 for me was stopping Eliquis. The huge cost was killing my budget.

@gloaming
Thank you for that very informative and visual response! My anxiety went up reading it all but I feel like I have a better understanding about the procedure over what I’ve previously read. 3-4 hours, yikes! I’ve had propofol for colonoscopies, but those are quick. Meds are so toxic to my body.

The video in your next post was also great! I now have a much better understanding about why people are saying they had to have 2 or more ablations or why the ablation was only effective for x amount of time.

Yes, important to have the best EP but knowing who that is, is probably the next challenge. I’m sure cardiologists know but maybe they think their EP golfing buddy is good enough. Where’s the trust? My cardiologist wanted to send me to his local EP. Doesn’t mean he’s bad just because he’s local. He might be great. I don’t want to travel but I am also close enough to UCLA to get a ride there if they had the right EP. . How do you determine which EP has the best record and handles complicated cases?

I’ve been hoping to control my afib by eliminating my triggers; but the video addressed that too. As a person who has had a slew of serious adverse side effects to many meds and a complication with most every medical procedure I’ve had, I’m not sold on taking action just yet due to my history but I know it may come to that. I don’t like hearing the various procedure risks because I’m always that one off case where something unexpected happens. You might say my body is not user friendly. Fear of history repeating itself tends to inhibit me from taking action. Also, because of my cancer, I’ve been stalling on any elective procedures thinking I’ll hold out till the next scan results and the next, but my cancer situation is going better than I expected so I may have to rethink some decisions if I’m going to be around longer than I thought.

Again, I really appreciate you taking the time to provide so much info.

Sorry, Zebra, I forgot that you had at least one question. You choose the best electrophysiologist because you want highly skilled, hard-working, and highly sought ones with a great record of success and for whom many will wait months to get under his/her auspices and care. These 'best' EPs are not exactly rare, but it's not like there's one in every hospital as well. Be careful using the on-line 'rate my MD' sites because so many who have great success can't wait to get outdoors again, go shopping for themselves, go hiking and camping, and enjoying life; they can't be bothered to offer kudos on those sites because they're quick to move on and to look forward. Instead, it's the angry and disappointed people who most often populate those sites with their comments, and they're not very flattering.

Referrals and sites such as these, or affibers.org are good because they are frequented by people who know the subject malady and who field such questions. Certain names get bandied about more often than others. You can also call university faculties of medicine and ask if you can speak to a cardiologist who might be willing to recommend top grade EPs he/she knows. It's at least a start to getting some names and finding contacts with others who might offer yet more opinions.