| Name | Anon |
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| Location | Tonbridge, UK |
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| Age | 47 |
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| Diagnosed condition | Paroxysmal Atrial Fibrillation |
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| Years with condition | 2-3 |
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| Frequency of episodes | About every 5-6 weeks on average |
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| Duration of episodes | 24-36 hours |
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| Event preceding first AF | Stress at work |
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| General health | Very fit - do lots of running, moderate+ drinker, very good health otherwise |
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| Current state | Living with it, evading permanent medication or ablation |
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| Triggers | Stress is a primary trigger and is always prevalent before an attack along with one or more of the following secondary triggers:
- alchohol: usually only one or two beers
- pizza and beer together (usually only one beer)
- lying down: attacks occur when relaxing on the sofa or when asleep in bed
- having a lot of things to fit in a day (e.g. travelling to muliple appointments)
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| Preventions | None of the usual tricks seem to work for me. However I've discovered recently is that my heart sometimes races for periods of about 30secs or so the day before an attack of AF. My cardiologist thinks this could actually be what is causing the AF. So if I get this I try and destress as much as possible and take propanalol. I haven't assesed yet whether this is effective in practice.
I have also discovered that, for me, my AF attacks seem to go in three phases - these are subjective but I have got to know these stages fairly well:
phase 1 - the heartbeat starts to go irregular but the irregularity does not seem that excessive (may be 4-8 hours)
phase 2 - the heartbeat is extremely irregular ( may be 16-24 hours)
phase 3 - the heartbeat becomes less irregular and almost seems to be trying to come back to a normal rythym.
When I have got to stage 3 I usually find a short relaxed work often flips the heart back in Sinus rythym. I may have to try this several times some hours apart before it works. I suspect the key here is more that the walk relaxes me rather than the gentle exercise. There is no hope of this working in phase 1 or 2. |
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| Current medications/side effects | Supposed to be taking a daily aspirin (75mg) which I do when I remember and have them (which isn't very often).
I take Propanolol when the attacks occur and stop taking it when back in Sinus. (10-20msg 3 times a day). This does seem to help in that it reduces the length of the attacks.
Also have the option of taking Flecainide permanently instead of Propanolol, have resisted this so far as don't want to go on permanent medication if I can avoid it as the cardiologist has said once I go on it he may not be able to guarantee I can come off it. |
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| Past medications/side effects | Atenolol - just made me dizzy when I got up, didn't like it
Sotalol - Too strong, doctor said it lowered my BP too much, made me very chilled (quite nice stuff actually!) but also zonked me out too much. Think it was probably quite effective as an anti-aryythmic but just too strong for me. |
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| History of surgery | Minor (unrelated) operation in 1988. |
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| Future plans | Cardiologist has suggested an ablation may be a possibility if still having problems in 6-9 months. However last few years have been extremely stressful and this stress should be significantly reduced over the next few, so am hoping this will eliminate the AF. Am also trying to avoid medication as long as I can. |
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| Personal comments | This is a very scary condition when it first happens to you. I have been looked at by medics and told my condition is not life threatening although I am supposed to take daily aspirin to minimise the risks of stroke when the attacks occur.
The worst thing for me now is that when these attacks happen I feel tired and weak whilst in AF and for a day or so afterwards (the latter I suspect because I have been taking Propanolol during the attack and it stays in the system). I cannot run or cycle when these attacks occur which is very frustrating as I really enjoy both and know that I am losong a great source of stress relief. When I am in AF I feel it is difficult to cope with even minimal stress levels and this just increases my anxiety about the attack. |
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| Check list |  acebutolol | amiodarone (cordarone,pacerone) | anisindione (miradon) |  atenolol (tenormin) | aspirin | azimilide | | bepridil | betaxolol | bisoprolol (monocor,emconcor) | | bretylium | bucindolol | carvedilol | | cibenzoline | dicumarol | digitoxin | | digoxin (lanoxin) | diltiazem (cardizem) | diphenylhydantoin | | disopyramide (norpace) | dofetilide (tikosyn) | dronedarone | | encainide | esmolol (brevibloc) | ersentilide | | flecainide (tambocor) | gallopamil | ibutilide (corvert) | | lidocaine | mibefradil | metoprolol (lopressor,toprol xl) | | mexiletine | moricizine | nadolol | | phenytoin | procainamide | propafanone (rythmol) | | propranolol (inderal) | quinapril (accupril) | quinidine (quinaglute) | | sotalol (betapace) | tedisamil | timolol | | tocainide | trandolapril (mavik) | valsartan (diovan) | | verapamil (calan,isoptin) | warfarin (coumadin) | asthma | | diabetes | GERD/acid reflux | hypertension | | hypotension | hyperthyroidism | hypothyroidism | | adrenergic | vagal | familial | | idiopathic/lone | paroxysmal | permanent/chronic | | atrial flutter | cardiomyopathy | CHF | | PAC | PVC | SVT | | syncope | bradycardia | tachycardia | | heart block | myocardial infarction | rheumatic heart diease | | sick sinus syndrome | stroke | WPW | | electrical cardioversion | defibrillator | pacemaker | | ablation | bypass | maze | | Male | Female | |
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