I don't feel qualified to answer your direct questions, but I will make a comment. Given how far apart and breif your episodes are, it does not seem like an ablation is appropriate for you. I think that would be overkill for you.

Generally speaking, A-fib is not a direct killer. Strokes (as you mentioned), yes. Depression that could lead to suicide, yes. Extremely rare cases of cardiac arrest have occurred from what I have read.

Hang in there.

So VERY sorry to hear about your mom. That stress probably has a large part to do with why you are dealing with a fib now. I'm close to my mom also and she's having health problems. I feel your pain.

I think you should ask your EP at what point do you call 911, esp when living alone?

I asked mine and my PCP. I think they said if my HR went > a certain rate for 2 hrs. Everyone gave me slightly different answers, but it's good to get parameters from your EP. Since you Ep kinda blew you off, should you be looking for another one as a second opinion at least? EP said if I'm in a fib > 2 days. But how you feel makes a big difference. Your symptoms are significant, so you should probably go sooner.

When they gave me iodine for the CT before my ablation, my BP shot way high and I was shaking uncontrollably. They documented it as an iodine allergy even though the symptoms weren't consistent with that. Could it be all the anxiety assoc with having the a fib? Again, a question for your EP.

Good luck to you. Sorry to hear about all your troubles!

Islandlvr: I have been wondering how you have been. I am so glad you posted! First, I want to tell you how sorry I am that you lost your mom. I lost my dad 14 year ago (he was very young when he died of congestive heart failure at 53). I was his caregiver (he was a single guy) and he was my friend up until the day he died. My heart goes out to you. Losing a parent is tough and I am so very sorry for your loss.

I am sorry that Afib returned for a visit in your life. In my opinion, you did the right thing by calling 911. I recently completed an EMT program and did many hours of ride time with fire/rescue paramedics and feel that you did the right thing by calling an ambulance. When youf heart is beating so fast, only an EKG monitor can tell you whether you are in Afib or if it is something else, like ventricular tachycardia. Ventricular tachycardia can degenerate quickly into V-fib and you are better off having a paramedic to transport you and if necessary give medications to convert the rhythm. There is always the chance of passing out when the heart is beating so fast and irregular because the ventricles do not have enough time to fill with blood to deliver blood and oxygen to your brain and other vital organs because they are beating too fast. The symptoms of coldness and shakiness where most likely due to the lack of adequate blood flow. When in doubt, call an ambulance. If you pass out, you could be injured so it is much better to play it safe.

As far as your EP, I think I would think about finding another one. health care is too expensive and your health, happiness and well-being are too important to tolerate a doctor who is not compassionate or proactive and poo poos your concerns.

Again, I am so sorry about your loss and sad for the return of Afib to your life. Please check in often and please feel free to message me if you ever need to vent. Take care and keep us posted.
Thinking of you,
Carrie

Great post Carrie, I totally agree with your answer to IslandLuvr's question.

IslandLur,, I am very sorry about the loss of your mother. I lost both my parents in a span of 18 months and I know how difficult and painful this is.

Carrie gave you great advice and I agree, find a different more compassionate doctor first of all. And do call an ambulance if your heart beats so fast that you almost pass out.

Glad to have you back and please keep us informed.

Yes...Carrie gave a great response.
One thing that helped me was to have a medication I could take at the start of an episode to slow down my heart rate. This is called pill in the pocket (PIP). Sometimes it is a beta blocker...sometimes an antiarrythmic. It really has helped to feel like I have some control of it. Just slowing things down makes the a fib more tolerable and less symptomatic. I too think you should consider finding a new EP.
I am so very sorry about the loss of your mom. I lost my mom about 5 years ago and I miss her everyday...but time helps and it will get easier. Take care

Hi Island~ Huge Hug your way from me!!!!!!!!!!!

PS. I totally agree with Marikay. PIP is the only way for me!
I used Metoprolol for 18 mos. It slowed my rate, but I stayed in afib.
I recently had some 'afib drama' and was given Rthymol, an antiaryhymethic. This brought my rate down and stopped my afib!

I am on my 3rd Cardio Dr. in 22 mos. of afib. So far, so good with this recent one...lol I didn't do too well with the EP either...

Hugs, Carol

Thank you all, so much. It's so nice to get this kind of support. I'm so overwhelmed with losing my mom, and now afib again.. :( I guess you can truly say I have a broken heart.

Its especially frightening because my mom was all the family I had left. I'm not married, no kids... no special man in my life. I'm it.

Yes, I have friends, but they're all busy with their own famiies.. and I'm not going to wake them up at 1 in the morning to drive me to the hospital. So, I have to do the ambulance thing. And then, I take a taxi home from the hospital.

Carrie, thank you so much for your in depth response. You should be an EP. You sure seem to have a better grasp on what happened than the two I've been to (they're partners.)

When I have afib episodes, they're violent. They're not just a little rise in heart beat with skipped beats.. my blood pressure goes above 170 over 100, and my pulse goes over 200. I can't even describe what it feels like. It's just awful. It feels like my heart is a runaway train, and it's headed off the tracks. I truly feel like I'm dying when it happens.

And it's so frightening.. because I'm alone. I fear of passing out and never waking up.

The day after these violent attacks, all I want to do is sleep, and my chest hurts.

Now I feel fine.. except for my PACs.

Since two out of the three afib attacks happened while I was sleeping, I'm going to do the dreaded sleep study. I know I don't get enough sleep as it is, and I do know I snore.

Do any of you get these types of violent afib attacks?

I used to before any medication. Feels like my heart is slamming around inside my chest. I always felt very fatigued with some chest pain for a few days after. It is a very scary feeling and hard to tolerate for very long. This is where meds can help. I used PIP for several years but the episodes got progressively closer togrther and I ended up on flecainide, an antiarrythmic, which keeps me in NSR about 99% of the time.
You definitely need to go to ER if your B/P and heart rate are this high. Again...meds can help slow things down and make you less symptomatic and safe to stay home instead of those trips to ER. Find a Dr who is willing to work with you to find something that works for you.

I did ask about a PIP, and he said that he didn't want to give one to me without me being monitered first... that it would be too dangerous without seeing how my body would react. That makes sense.

But.. he said the next time I have Afib, to call his office, and they'll give me the PIP and put me on a monitor. But how do I do that, when it always happens late at night or early in the morning???

First, my heartfelt condolences on the loss of your mom. I lost my mom a few years back and it was devastating. I'm glad you're seeking help to deal with the grief.

It's likely that the stress and grief you've suffered played a role in your recent Afib. About 17 years ago I was at the place you are now with this condition. I was having episodes of "something" but without an actual EKG recording the doctors had nothing to assess for diagnosis. I would start with a Thyroid check as a starting point, a simple blood test is all you need. Next I would get an echocardiogram to test valve function. Both Thyroid and valve irregularities can induce Afib. Lastly, I would suggest about wearing a 30-day EKG monitor to try and record an episode. Those three steps got answers for me. I can't say that they will for you but it's a good starting place. You're already keen on the Apnea sleep study, that's something else that's wise to look into. It's entirely possible that the blood test, echo and sleep study will not give you answers but at very least you'll know that they have been eliminated from the cause suspects. Hopefully the monitor will capture an episode and from there a more targeted treatment can begin and speculation will end.

I've had episodes that were severe enough to make me feel close to blackout but those were fortunately not the norm. Being alone, driving or doing anything that's potentially dangerous when an episode occurs is one of the scariest things about Afib. The unpredictability of it can make every day function very challenging.

Heart rate control is critical in avoiding lightheadedness. Beta Blockers are good at this. You'll have to work with your doctor on determining which one and how much is right for you. If your Afib were to become more frequent, high heart rate for long periods can cause changes in the heart that you need to avoid.

Afib in the early stages for many people induces anxiety. The combination can compound you symptoms considerably. You'll want to seek ways to calm yourself in order to avoid the domino effect. This takes practice but remind yourself that your heart is quivering and racing but it's not going to stop functioning. Hopefully any medication your doctor suggests will keep your heart rate down and your anxiety to a minimum.

In the late stages of my Afib I would stay out of rhythm anywhere from a few hours to a couple of days at a time. Before my sugery I was out of rhythm about 70% of the time. I was always in Afib when I would lay down at night and throughout the night. I've read patient posts about those that would seek emergency care very early on in an episode and many would elect for cardioversion. In nearly 17 years of Afib I was never cardioverted, chemically or electronically. We all have different tolerance levels for this so what's right for one person may not be right for the next. There is a point at which everyone in Afib should seek help, you don't want to stay at a high irregular rate for multiple days or heart muscle fatigue can occur. (This is another reason that rate control medication is so important). Those with other underlying heart and health issues need to be especially cautious. If you feel the need at any time for help, by all means call 911, better to err on the side of caution.

As for the shaking you described, that may a stress fall out, both physical and emotional. Hopefully when you've got some answers on whether or not this is Afib, the proper treatment will help minimize both.

I'm not a physician, nor do I play one on TV. My suggestions are strictly based on my care, research and experience as a long-time patient.

There are better days ahead and I hope you find answers and relief soon. If you feel down or stressed, have questions or anything at all, we're here and willing to try and help.

Hi Steve,

Thanks for your very detailed post, and for sharing your story. This was my third really violent afib attack.

A year and a half ago, I had a couple of weeks of really annoying skipped beats, so I went to see an EP for the first time. I had all kinds of things.. stress test, echo cardiogram, ekg, blood work, etc.

I DO have thyroid issues.. I actually had hyperthyroidism.. and it's now hypothyroidism-- but controlled with thyroid medication.. and I'm checked every 6 months..

The valves were fine, the heart is fine.. the only problem they found was high blood pressure. The EP put me on a holter moniter, and.. what are the odds of this... the next day, while wearing a monitor, I had a full blown afib attack. There was absolutely no question.. it was afib. My heart shot up to 220 bpm, my blood pressure to 170 over 100. The EMT started pushing cardizem through a vein right on my living room sofa!

He had to give me more in the ambulance.. and that's when I converted.

It seems that most people don't have the dramatic high rise in heart rate and blood pressure that I do during an attack. I could deal with feeling "uncomfortable"... but when your heart rate goes this high... you can't just wait it ou.

I have no idea what sets it off.... I don't drink alcohol at all, I have never had a cigarette in my life, nor have I ever even tasted coffee. My only vice is chocolate.. but before my last attack, I only had two chocolate chip cookies hours before.

I have had skipping heart beats since high school, and I've had episodes of tachicardia following back surgery in the 1980's. The skipping beats would last for days and weeks.. but the tachycardia always corrected itself in a matter of minutes. My internist just dismissed it, and said not to worry about it.

But.. then.. I had the first big afib around ten years ago.. the second one 15 months ago.. and this one.. just two days ago.

Wow Island! Your BP gets really high. Marikay gave you some great advice. The ER is where you need to be when you BP gets that high. I have been very fortunate in the fact that my BP and HR do not get extremely high. Even though I have Afib every day, my HR rarely went over 150 with no meds. On a rare occasion it went to 170 for a short period of time. I take a small dose of beta blocker every day (atenolol) and even though my rhythm is irregular, the med keeps my HR low. It seems as though many people who have occasional episodes tend to have the most violent episodes that require the ER andthose episodes sound extremely frightening.

I, too, am glad that you are in grief counseling. I also attended grief counseling when my dad passed and it really helped me. I think the biggest thing I took away from the counseling is that there is no timetable when it comes to grief. Everyone needs their own time to work out their feelings. I kept feeling like I just wanted things to stop until I felt better. My father passed in the month of July and suddenly, I looked around and the leaves had begun to change color and fall was approaching (I lived up north at that time). I was like "wait a minute!" I wanted time to stop passing by until I was ready to move on and move away from the moment. I felt angry. Like... "how dare the world go on until I am ready for it to go on without my dad! But as others have mentioned, time really does help and memories will make you smile again someday, they wont hurt as much as they will someday make you smile again. I think the PIP idea is a good one. It will give you some control over the situation. Take care of yourself. You have been through alot both phyically and emotionally. Thinking of you, Carrie

I think the PIP your EP was considering was an antiarrythmic med like flecainide. They often monitor you when starting that type of med. I also have high B/P and heart rate in a fib without any meds on board. I also converted in the ER with IV cardizem. My family Dr actually came up with the idea of using cardizem as a PIP. It has to be regular cardizem, not the extended release. I was also started on a low dose beta blocker every day. I would take cardizem at the start of an episode and that combo kept me out of the ER. You shouldn't need to be monitered to start a beta blocker or cardizem, etc. Taking a beta blocker every day also helped to keep my heart rate lower during an episode.
There are lots of options. Don't settle for your present situation.

I love that idea, Marikay! I'll suggest it.

I've been to two EPs ( they're in practice together) . I'm not thrilled with either one. I don't know who else to go to. I haven't even found a primary care doctor I like.