Afib: What causes an episode? What if I don't notice?

Posted by dfelix @dfelix, Sun, Jan 27 6:31am

yesterday I had episodes of afib. I was just laying down when my heart started beating fast. Over 100 beats per min, What are possible casues of these occurances?

@dfelix, as you get more responses and do internet searches you will find there are many A-fib triggers but what causes the condition in the first place is still somewhat a mystery. In my case it seems to be caused or triggered by an excess of thyroid hormone. I have been hypothyroid (underactive thyroid, not producing enough hormone) to I have taken either Synthroid or a natural desiccated thyroid extract. If one's TSH gets too low, A-fib can result. Although this may not be your problem, it never hurts to have your PCP do a thyroid workup and at least eliminate that as a potential problem. God bless.

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Stress will sometimes bring my on. Or sometimes I wake up with it. I think each person is a little different. Try eliminating caffeine if you drink it.

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I am not aware that I am in a fib at times until I take my blood pressure for routine monitoring. Is there a device l could wear that would alert me?

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@cadillac

I am not aware that I am in a fib at times until I take my blood pressure for routine monitoring. Is there a device l could wear that would alert me?

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Hi @cadillac, welcome to Connect. You'll notice that I moved your message to this discussion about atrial fibrillation episodes in the Heart Rhythm Conditions group (https://connect.mayoclinic.org/group/heart-rhythm-conditions/). Here you'll find many people discussing aFib.

Cadillac, you ask about not being aware when you have an episode until you take your blood pressure and if there is a device you could wear to alert you. I'd like to bring others into the discussion to help answer your questions, like @jimana @predictable @sal70 @karenatmayo and @sandyabbey

Cadillac, are there times that you are aware of having an a-fib episode? How long have you been monitoring your blood pressure?

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Hi @cadillac. Glad that Colleen invited me to join in this discussion so we can get to know you better. I think my a-fib is much like yours. I don't realize my irregular heart beat except in two situations — when my doctor is taking an EKG and when I'm taking my blood pressure. Otherwise, I am not conscious of my heart beat. How about you? Do you feel irregular beats? Would you remain anxious if you didn't know you are in a-fib?

I have had irregular heart beats for 25 years or more, but my a-fib diagnosis came only four years ago when it showed up on my EKG during my annual physical examination. Although I had no sense of the problem, I accepted the diagnosis by my personal care physician and had it confirmed by a cardiologist. We then agreed to two medications — Carvedilol, a beta blocker to smooth out and dial down my heart beat, and Coumadin, an anticoagulant to reduce the chance of blood clots forming in my atrium and getting sent off to sensitive organs like my brain or my kidneys. Would you share with us your current medication? Martin

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@predictable

Hi @cadillac. Glad that Colleen invited me to join in this discussion so we can get to know you better. I think my a-fib is much like yours. I don't realize my irregular heart beat except in two situations — when my doctor is taking an EKG and when I'm taking my blood pressure. Otherwise, I am not conscious of my heart beat. How about you? Do you feel irregular beats? Would you remain anxious if you didn't know you are in a-fib?

I have had irregular heart beats for 25 years or more, but my a-fib diagnosis came only four years ago when it showed up on my EKG during my annual physical examination. Although I had no sense of the problem, I accepted the diagnosis by my personal care physician and had it confirmed by a cardiologist. We then agreed to two medications — Carvedilol, a beta blocker to smooth out and dial down my heart beat, and Coumadin, an anticoagulant to reduce the chance of blood clots forming in my atrium and getting sent off to sensitive organs like my brain or my kidneys. Would you share with us your current medication? Martin

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Hi
I take Pradaxa for thinning blood and Tiazac (generic for dilitazm ? Spelling) to regulate heart rhythm. One way l can tell that I am in Afib and Aflutter is I am overcome with fatigue and feel like I must sit or lie down. I usually fall asleep almost immediately and wake up an hour or two or three later no longer in a fib. I sometimes feel a bit weaker for the rest of the day. I believe that by the time l feel the fatigue l have been in a fib a while. Also have shortness of breath. I am 82 yrs old and had a fib for some time before diagnosis 15 years ago. My concern is l don’t want to do further damage to my heart with these a fib episodes of which l am unaware.

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Is the heart being damaged by the A-fib episode?

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I'm in the same boat as you. My first incidence was a doozy. I went by ambulance to the ER where I was diagnosed on 3/8 at around midnight. I suspect that alcohol was the culprit of my developing afib. Either that or smoke inhalation which compromised my lungs. Or it could be stress/worry/depression. But it came on suddenly–within two weeks after a friend's visit where we drank wine every night and one night drank too much. But now I can't even predict when I'll get an episode. After my heart being calm for two days, I just now woke up in the middle of the night in the middle of an episode. I'm now wondering if I have some sleep apnea. Cannot figure out any other reason. I was diagnosed a week ago and have spent a lot of time over the last week trying to figure out why I got it, how to cope with it, what brings on episodes, and how long my lifespan will be now. From what I've read it will cut my life short, even with drugs and intervention. I've cut out coffee and alcohol, started to walk more, drink more water, and try hard not to get anxious over anything (which means avoiding politics and some people, at least until I get it under control, if that's possible). Maybe we can check in with each other as we figure this out–trade notes. I have my first appointment with my GP next Tuesday and she'll set me up with a cardiologist. But, it is a big deal. I'm really sorry I did whatever I did to make me get this.

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Dear catmom, Don't be too discouraged. You can lead a full and healthy life. Afib can be a warning to the body that you are not treating it right. It can even be a blessing in disguise. Sometimes conditions such as this, diabetes or conditions related to being overweight or a smoker can jolt a person into major lifestyle changes. Take charge of your own health.
As we know, we do not eat enough vegetables and instead eat lots of carbs in the form of bread and junk which cause inflammation in the body. Read Dr Axe to learn more. Simply changing one's diet and exercise routine can eliminate a lot of ills. I know. I did it. I overcame a serious case of Afib.

At age 46, I had Afib that was so bad that I didn't have 3 normal beats in a row. The cardiologist said he had never seen such a severe case as mine. The Holter monitor even malfunctioned! With daily walking/slight running on a treadmill pushing my heart, over a month I was able to gradually (important) and completely get off the high dose of beta blockers I was on. (320 mg of Sotalol per day) The cardiologist couldn't believe it and said it would not last. Fast forward 24 years and I have had warning signs….but NO Afib.
Having said that, I have to be very careful. As the cardiologist recommended, I must not drink any alcohol, nor eat excessive sweets (which cause palpitations and 'bumps'), and I must avoid all stimulants such as decongestants, the standard dental freezing medication, caffeine in coffee, tea, chocolate, Coke etc.. When on the rare occasion I have had a bit of coffee, let's say, a few blips will happen and I am reminded to not do that again. Carbs as in desserts can cause my heart to race.
I recommend that you take charge of your cardiac health. No one can be more committed, nor as interested in your own health, than yourself. My aunt suffered from Afib (and continued to smoke!). She was on beta blockers and had a number of cardioversions in her senior years… and she lived to 88 years old and died of old age. With a commitment to listening to and taking care of your body, you will outlive everyone around you! Pass the broccoli!

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@afrobin

Dear catmom, Don't be too discouraged. You can lead a full and healthy life. Afib can be a warning to the body that you are not treating it right. It can even be a blessing in disguise. Sometimes conditions such as this, diabetes or conditions related to being overweight or a smoker can jolt a person into major lifestyle changes. Take charge of your own health.
As we know, we do not eat enough vegetables and instead eat lots of carbs in the form of bread and junk which cause inflammation in the body. Read Dr Axe to learn more. Simply changing one's diet and exercise routine can eliminate a lot of ills. I know. I did it. I overcame a serious case of Afib.

At age 46, I had Afib that was so bad that I didn't have 3 normal beats in a row. The cardiologist said he had never seen such a severe case as mine. The Holter monitor even malfunctioned! With daily walking/slight running on a treadmill pushing my heart, over a month I was able to gradually (important) and completely get off the high dose of beta blockers I was on. (320 mg of Sotalol per day) The cardiologist couldn't believe it and said it would not last. Fast forward 24 years and I have had warning signs….but NO Afib.
Having said that, I have to be very careful. As the cardiologist recommended, I must not drink any alcohol, nor eat excessive sweets (which cause palpitations and 'bumps'), and I must avoid all stimulants such as decongestants, the standard dental freezing medication, caffeine in coffee, tea, chocolate, Coke etc.. When on the rare occasion I have had a bit of coffee, let's say, a few blips will happen and I am reminded to not do that again. Carbs as in desserts can cause my heart to race.
I recommend that you take charge of your cardiac health. No one can be more committed, nor as interested in your own health, than yourself. My aunt suffered from Afib (and continued to smoke!). She was on beta blockers and had a number of cardioversions in her senior years… and she lived to 88 years old and died of old age. With a commitment to listening to and taking care of your body, you will outlive everyone around you! Pass the broccoli!

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That's quite a warning!! I am having a hard time believing that my one or two glasses of wine after dinner most nights caused this. I've been a health nut my whole life, am pretty active, had low pressure (110/60 at its highest and 100/50 at its lowest), eat lots of salads and have yogurt/fruit/granola most mornings for breakfast. I hardly ever eat any meat at all, and only eat red meat when in the company of other people or when I get invited out to dinner, so drinking the wine must have been the culprit. The only other thing I did that was bad was be exposed to toxic smoke four years ago. I got smoke inhalation pretty bad and I'm pretty sure got some carbon monoxide poisoning. I was sick for at least a week after that.
But, like you say, nothing I can do now but deal with it. My afib isn't as bad as yours was. I had two days with no real occurrences but last night woke up at about midnight with my heart pounding hard and fast (84 bpm) and it didn't calm down until 4 am.
I am already trying to get more exercise even though I haven't seen my doctor yet. I have to see her before I can be set up with a cardiologist.
Thanks for the reassurances though. I'm 65–just went on Medicare!! I have a new grandson I want to see reach adulthood to make sure he's OK.
If you think of any more good advice, let me know. I'm hungry for information on this. I know already that there is no one-size-fits-all to it. Each person has a different experience, different causes, and a different prognosis, but it really helps to hear about others' experiences and what works for them. I feel at this point I will do practically ANYTHING to stop the episodes! They are awful!

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Right now this must all be scary but rest assured, you sound ok. You'll be going to your grandson's wedding one day. It sounds like your lifestyle (except for the wine) is perfect. Can you give it up for a while plus any stimulants until you get the issue resolved?
I'm sorry to hear that you have had to go through such a terrible experience as carbon monoxide poisoning. I did a quick check and there are cardiac residual effects. But this was 4 years ago so I can't imagine you would suffer any residual effects at this point. I think you are right; all that wine was too much, especially the one evening of excess and that was an assault on your body.
When I first saw the cardiologist with my wild heartbeat, he was alarmed and he told me that of 10 people who go to see him with an arrhythmia, he only medicates 1. And I was that one. He told me that unless an irregular heartbeat compromises one's quality of life, he does not medicate. In my case it did as I suffered from air hunger…needing to constantly take breaths to get enough oxygen and feeling faint. I really couldn't function well. You mentioned that your heart rate was 84 bpm. That is absolutely normal.
Suggestion: sleep on your left side to prevent irregular or pounding beats. I found that helpful. If your heart really does race (e.g. 120 bpm), bearing down as if you are doing a BM can really help.
Some of this could be hormonal. When my Afib was at its worst, I took estrogen as an alternative to beta blockers and it completely stopped. But when I added progesterone (which one needs to do), the Afib returned in part. I take Vagifem and bioidentical progesterone…both creams. Not that I am suggesting you do. But keep these things in mind as options to explore.
And in the meantime, don't worry until you see your doctor next Tuesday. While you are waiting for your cardiology appointment, live a 'clean life'. Your body needs a break from stress, alcohol, toxic environments and any stimulants. Go for big walks (with the baby?) and breathe in the fresh almost spring air. GOOD LUCK! Let us know how you fare.

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Thanks. That is very helpful. I am used to sleeping on my tummy, but will try to modify my sleeping position. I am OK not drinking wine. I've been winding down anyway over the past couple years due to acid reflux. Giving up coffee was actually a little bit harder. I had a headache for a couple days, but there could be a couple reasons for that, as my BP went up to 144/75 when I had my first scary episode.
I tried a technique the last ER doc told me about. I put a straw in my mouth and covered the other end and blew really, really hard, until I felt I was going to pass out. It didn't stop the episode though. I also splashed my face with cold water. That stopped it for about 10 minutes but then it came back. This was at about 1 or 2 am.
I just talked to my mom and she said she's had a irregular heartbeat for over twenty years. So hers started when she was my age. She has dementia, which could be a consequence of the afib. Her sisters did not/do not have dementia, nor did/do any of her brothers, and one of them has been an alcoholic most of his life. So, it might not be my nightly wine with dinner that's causing this after all.
I can't get in to see a cardiologist until my doc gives me a referral, and I see her next Tuesday. Even after than it takes more than a month to get in, so I won't have any definitive answers until then. But, I feel more like I'm going to live a while. You never know how important it is to live until you think you're dying–and then all of a sudden you come up with all kinds of good reasons.
I'm going for a long walk today (two miles) in the sunshine, and maybe do some pushups and yoga. Get disciplined. It helps that spring is almost here.
Thanks again for the wise words and encouragement. I feel more hopeful now and less defeated.

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@afrobin

Right now this must all be scary but rest assured, you sound ok. You'll be going to your grandson's wedding one day. It sounds like your lifestyle (except for the wine) is perfect. Can you give it up for a while plus any stimulants until you get the issue resolved?
I'm sorry to hear that you have had to go through such a terrible experience as carbon monoxide poisoning. I did a quick check and there are cardiac residual effects. But this was 4 years ago so I can't imagine you would suffer any residual effects at this point. I think you are right; all that wine was too much, especially the one evening of excess and that was an assault on your body.
When I first saw the cardiologist with my wild heartbeat, he was alarmed and he told me that of 10 people who go to see him with an arrhythmia, he only medicates 1. And I was that one. He told me that unless an irregular heartbeat compromises one's quality of life, he does not medicate. In my case it did as I suffered from air hunger…needing to constantly take breaths to get enough oxygen and feeling faint. I really couldn't function well. You mentioned that your heart rate was 84 bpm. That is absolutely normal.
Suggestion: sleep on your left side to prevent irregular or pounding beats. I found that helpful. If your heart really does race (e.g. 120 bpm), bearing down as if you are doing a BM can really help.
Some of this could be hormonal. When my Afib was at its worst, I took estrogen as an alternative to beta blockers and it completely stopped. But when I added progesterone (which one needs to do), the Afib returned in part. I take Vagifem and bioidentical progesterone…both creams. Not that I am suggesting you do. But keep these things in mind as options to explore.
And in the meantime, don't worry until you see your doctor next Tuesday. While you are waiting for your cardiology appointment, live a 'clean life'. Your body needs a break from stress, alcohol, toxic environments and any stimulants. Go for big walks (with the baby?) and breathe in the fresh almost spring air. GOOD LUCK! Let us know how you fare.

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BTW, I feel a hunger for oxygen also. I feel I cannot get enough air. I've felt that way for about a year. The doc thought it was because of my acid reflux. I'm tired a lot. I used to have so much energy that this is totally uncharacteristic for me. Once upon a time I worked/raised a family/did all the cooking & housework, and found time to sew clothes for myself and my girls. Now it's hard to get through the day. But, hopefully after I see the cardiologist I will have more answers.

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@afrobin

Right now this must all be scary but rest assured, you sound ok. You'll be going to your grandson's wedding one day. It sounds like your lifestyle (except for the wine) is perfect. Can you give it up for a while plus any stimulants until you get the issue resolved?
I'm sorry to hear that you have had to go through such a terrible experience as carbon monoxide poisoning. I did a quick check and there are cardiac residual effects. But this was 4 years ago so I can't imagine you would suffer any residual effects at this point. I think you are right; all that wine was too much, especially the one evening of excess and that was an assault on your body.
When I first saw the cardiologist with my wild heartbeat, he was alarmed and he told me that of 10 people who go to see him with an arrhythmia, he only medicates 1. And I was that one. He told me that unless an irregular heartbeat compromises one's quality of life, he does not medicate. In my case it did as I suffered from air hunger…needing to constantly take breaths to get enough oxygen and feeling faint. I really couldn't function well. You mentioned that your heart rate was 84 bpm. That is absolutely normal.
Suggestion: sleep on your left side to prevent irregular or pounding beats. I found that helpful. If your heart really does race (e.g. 120 bpm), bearing down as if you are doing a BM can really help.
Some of this could be hormonal. When my Afib was at its worst, I took estrogen as an alternative to beta blockers and it completely stopped. But when I added progesterone (which one needs to do), the Afib returned in part. I take Vagifem and bioidentical progesterone…both creams. Not that I am suggesting you do. But keep these things in mind as options to explore.
And in the meantime, don't worry until you see your doctor next Tuesday. While you are waiting for your cardiology appointment, live a 'clean life'. Your body needs a break from stress, alcohol, toxic environments and any stimulants. Go for big walks (with the baby?) and breathe in the fresh almost spring air. GOOD LUCK! Let us know how you fare.

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I have a question. Did the doc tell you why you couldn't breathe good? I have thought over the past year my breathing issues were because of either acid reflux or the smoke inhalation I suffered. I have thought it was my lungs. Was your breathing problem because of your heart?

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@samtobias1968

I have had a abnormal heart rate for about two weeks..when i take my pulse it very irregular ex. beat beat beat then 3-5 very fast beats than slow to three or so beats than maybe a pause than back to 4-5 very rapid beats on and on and usually 130 avg beats per min. I have a history of paroxysmal afib which is usually controlled..occasional i go into afib but doesn't last more than 24 hours and usually not rapid heart rate . i take a beta blocker and propafenone and have for years any ideas / really worried about fast heart rate as this has not happen before for this long….I just went to dr office and saw another provider as mine on vacation…they did multiple EKG's all with hr 130-145 not sure on rhythm could be fib or flutter increased my beta blocke and put on blood thinner …….any ideas what is going on has this happen to others ??
..

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That's too bad that your Afib has taken this turn. I have said this before and I will say it again; cut out ALL stimulants such as coffee (not even 1 cup), tea, alcohol, stress, chocolate, dental medications etc.. When I had Afib (I cured myself of the worst case the cardiologist had ever seen) I was told not to EVER have those stimulants again in my life….and I listened. That could certainly help you BIG TIME! Good luck!

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