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Celebrating over 28 years of Paroxysmal Afib
Hello All, my Afib started at age 19, bending over to get a drink of water. The event lasted a few minutes and I didnt pay much attention to it. Through the years I have had lots of palipitations (daily) and averaged about 4 Afib events a year, lasting anywhere from 30 minutes to a couple hours. I went to my dr. several times, in which they put me through all the typical test, EKG, Holter Monitor, Echo. Nothing was ever discovered. Finally at the age of 36 I had an event that lasted long enough for me to get to an ER in which they were able to diagnose me with Afib. They converted me with medication after about a 10 hour event. Since then I have been seeing a Cardiologist and take Metropolol along with a BP med. For the last 10 years I have averaged 2-3 events a year. At my Dr's direction, I typically take another Metropolol tablet at the onset and self convert within an hour. Unfortunatly, the last year my symptoms seem to be geeting worse. My symptoms have always seemed to be a direct cause of Vagal nerve reflex. Bending over, eating too much, being Hungry, posture, burping....have all seemed to contribute to my palipitations and Afib events. In the last few months, Eating/Swallowing is causing me to have palipitations and at least four events of Afib. (All have converted on their own within an hour with my extra dose of Metropolol). My Cardiologist ordered another echo (which came back fine). Other than that he prescribed Propafenone (225mg) to take at the onset of an event instead of the Metropolol. Other than that he just wants me to come back for a six month follow up. When I asked him about the swallowing he just said "yes, weve heard of that before". WTF? Every time I eat I sit there on edge that I'm going to trip into Afib!? I'm also leery to start taking Propafenone as the warnings on the label say you should take the first dose under medical supervision to make sure you dont have an adverse reaction due to un-diagnosed Long QT syndrome. Anyways, just feeling frustrated here. Not sure what to do. Very annoyed that everytime I swallow I feel my heart flip flopping in my chest for a couple secounds and not sure if this is going to precipitate into another bout of Afib. My Dr. did mention that the next step may be to set up an appt with an EP. It just seems like there could be more options with medicine instead of jumping straight to ablation. Any thoughts, similar expieriences, or advice is appreciated. Feeling frustrated at this point.
kenneth631, November 29, 2019 6:50pm EST
I opted to have an ablation done after 20+ years of paroxysmal afib events that were becoming increasingly resistant to the antiarrhythmic Rx, flecainide. The events became more frequent as the years went by, occurring up to several times a week, and lasted longer, some up to 14 hours before converting to normal after taking 300 mgs. My events were usually caused by eating too fast or too much, any amount of alcohol, reclining while eating, getting up from a sitting position too fast, getting out of bed to go the bathroom and returning to bed, or just doing nothing at all. Terrible, stressful, quality of life. Also increased morbidity and mortality issues re: long term afib. Alzheimer's risk also. Afib not a benign condition.
I was advised by several EP's that eventually drugs lose their effectiveness (I found that to be true) and the chances of a successful ablation go down the longer one waits and has more episodes. Also afib can progress to persistent and permanent if left untreated as the heart remodels itself.
I had the ablation done in May, 2017 and had short one episode during the "blanking period". No events since then except for some momentary "hiccups" every now and then. Also the premature atrial contractions I felt on a daily basis are now gone except for a few now an then. My advice to you is to find the most experienced expert high-volume EP you can find and if you are deemed a good candidate for an ablation, get it done. It's the closest thing to a cure according to EP's I consulted. Also, I found that non EP cardiologists were not aggressive enough and too passive in treating the condition. You need to see an EP and a good one.
Best regards and good luck.
rfedd, November 29, 2019 7:38pm EST
As you know, your esophagus runs right behind your heart. My first major event was triggered by eating ice cream and the cold shock to my heart. Like a brain freeze. There are studies and papers on this available on the web.
tolsen53, December 2, 2019 3:51pm EST
Like Kenneth631 says - Go see an EP. Don't wait, don't think about it, do it. Seeing an EP does not mean you have to have an ablation, but a really good EP will be honest with you about how they would proceed, and be open to questions about whether they use heat or cold to ablate, where they would ablate - do they do Pulmonary Vein Isolation, or perhaps Left Atrial Appendage Isolation, etc. You could also check out the "mini-maze" and "Wolf mini-maze" procedures to see if they were a better option. Also check out stopafib.org for more info, webinars from top EP's, etc.
All that said, ablation is not always the "cure". I've had three, going for a 4th (LAA Isolation) in early 2020, but if nothing else I feel I have been doing the most I can to feel better and control the beast.