Unique23rec
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Unique23rec, November 30,  2020  1:28pm EST

What to do when I detect AFib?

I had quintiple bypass surgery six months ago and my recovery has been going very well so far. That said, I do occasionally wake up with AFib. Is there an ideal way to respond at the time? For example, should I be moving around energetically, lying still, drinking liquid, etc?

Any thoughts?

8 Replies
  • Heartfe6878
    Heartfe6878, November 30,  2020  1:38pm EST

    Just a quick queston ... you mention Afib at night....Have you been worked up for a Sleep Study? Afib at night can find it roots sometimes in sleep...Most of us have had a sleep study done and use a CPAP or Bipap at night.

  • ginahmk
    ginahmk, November 30,  2020  1:49pm EST

    Dear Unique,

    Glad to hear your recovery is going well.  Good question about the a fib.  First, I am curious how you know you are in a fib.  Have you been diagnosed by your care team?  If so, have they provided any instructions?  One item for discussion with them could be, if you are going in/out of a fib, whether they would want to anticoagulate you.  I have had paroxysmal a fib and because of risk factors, am taking apixaban for stroke prevention.  As far as the a fib itself, my heart rates would go up to the 140's (I am in my 60's) and I could tolerate it.  However, if it lasted more than 12 hours, if I felt short of breath or lightheaded, or developed cardiac/neurological symptoms, I would plan to call the doctor and go to the ER, if needed.  They can give medications which break the episode.  I have done that twice.  Another option they had suggested was to use the "pill in pocket,"where I would take an anti-arrhythmic medication, such as flecainide or propafenone, to break the attack.  Again, check in with your care team and see what they would recommend.  Your situation may be different.  If you are not sure you are in a fib, consider alerting your care team.  They can set up cardiac monitor for you to get to the bottom of this.  

    Good luck and hope you continue your recovery!

    GinaHMK

  • Unique23rec
    Unique23rec, November 30,  2020  2:43pm EST

    Good points, both of you. Very helpful. Thanks.

    Background: I'm 70 and on eliquis 2x daily.

    I'm fairly certain that I don't have sleep apnea, it's just that I wake up occasionally with Afib. How do I know? I'm one of the ± 30% of heart patients who have afib post-op. and I'm therefore tuned in to the sensations. My heart rate this morning for example was 139, more than double my normal resting. Like other times, things were back to normal an hour or so later. (Gina, I can't imagine 12 hours of afib! So sorry you had to deal with that.)

    That heart rate reading -- and the frightening feelings -- prompted my question this morning. My next appt with my doc is in a few weeks (covid delays things, as you know) so I'm just seeking interim behavioral wisdom. Thanks.

  • patrickg
    patrickg, November 30,  2020  6:45pm EST

    Unique, I had a rare AFib episode recently and yes, it lasted for 12 hours, more than twice as long as the few I've had. Unfortunately it started at 10 pm so it was a sleepless night spent doing breathing exercises trying to relax my heart which has worked in the past but didn't this time. So shortly after sunup I got up and went for a brisk walk as I had read that exercise sometimes helps...and it did! YAY! My HR went from 120 before my walk down to 80 almost immediately...and after returning home after a one mile walk, not only was my HR back to normal (my resting rate is 50-60), I was back in NSR!

    So give it a try next time, can't hurt! FWIW, I was diagnosed with paroxysmal AFib in January 2018 and am taking Dofetilide and Pradaxa to manage my AFib. I am 71 and in otherwise good health and ride my bike 25-30 miles every day. I'm pretty sure this recent episode was triggered by "Holiday Heart Syndrome" and my daughter's wedding as I was eating and drinking outside of my regular routine.

    Good luck going forward and improved health to you!

    Patrick

  • patrickg
    patrickg, November 30,  2020  7:38pm EST

    Thanks for the link...some helpful info there! Sometimes it's hard to relax when your heart is thumping like Morse code and HR and BP are elevated. And during a pandemic, I expect that most of us are under unusual stress which only exacerbates the situation. Ah...modern life and the golden years!😉

    Patrick

  • egmcmahon
    egmcmahon, December 4,  2020  4:01pm EST

    i adjust my Metoprolol and take Pico form of Magnesium when it starts (I'm one of the lucky ones that know immediately when it starts).  My heart rate will shoot to 160 or higher and my normal resting heart rate is 50.  I take 12.5mg (very low dose x2/day)  of Metoprolol for rate control and Xarelto each evening for anticoagulation.  When it begins I will take 50mg of Metoprolol plus additional magnesium and rest/meditate.  If the heart rate doesn't go down I take 50mg more in 4 hours up to 250mg.  I can usually get it down into the 90BPM range.  Sinced this is new for you and I am a helath professional, I wouldn't mess with your meds unless you know what you are doing. I also just had a cardioversion after 10 days of afib so I agreed to start Multaq for rhythm control.  This is just for illustrative puproses of what works for me. I also try vagal manuevers and drink ice cold water slowly.  Check with your cardiologist and the people here are helpful too.   

  • Unique23rec
    Unique23rec, January 4,  2021  11:47am EST

    Thanks, egmcmahon. Yes, I'm decidedly not a health professional, so won't mess with meds until I see my heart doc in a few weeks. My main cause for concern at this point is that my resting heart rate has crept up over the last few months. BEFORE (as in pre-op, back in May) it was generally high 60s / low 70s. Now it's more generally 80s and 90s. Don't want it to climb further, so am paying close attention.

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