Isolated A Fib episodes?

Heart health and blood vessels
1

I have been looking online for days with no sucess.  I have had two A Fib episodes 6 years apart.  Both were a day after heavy drinking.  I am 43 now.  So the first A Fib was when I 37.  I was then put on Diltiazem with Hydrochlothizade to control my high blood pressure.  I exercise and lead an active lifestyle with a physical job.  My first Cardio visit cleared me of any issues other than the high BP.  I will be taking an echo test along with a full blood panel next week.

What really bothers me is on this follow up (before any tests) the Cardio Dr. was suggesting putting me on blood thinners and / or having an ablation. I had stopped taking the Diltiazem about 6 months before my latest A Fib.  I am not comfortable with the blood thinners due to the possible side effects and danger involved.  Is it possible these two A Fib episodes were due to the alcohol?  Holiday Heart?  As opposed to having an A Fib diagnosis?  This has been a real wake up call for me, and I realize I can't drink like that anymore.

 

2

Duker ! 

No one wants to take blood thinners but they are better than a stroke which is what you risk by not taking them !

If you have AFIB - you need to take a blood thinner - end of story !

3

Care for your health. Agree better than a stroke..once that happens if not caught in time all over. 

4

Thanks for the replies.  But what I am questioning is, I have had two episodes, 6 years apart, and both were after heavy drinking.  My research online shows cases where people have several repeat episodes daily, weekly, monthly etc...  And that is a fib coming along without the "holiday heart" that I have expierienced.

So, I don't want to rush into taking a blood thinner if my a fib is just alcohol related.  If I had a fib more frequently without drinking than I would entertain the idea of ablation or the RX blood thinners.  But again, I have only had two episodes that were right after heavy drinking.  

I am reading and learning about this, and I am confused by the 6 year span between episodes.  Is there a seperation between an actual A fib diagnosis and a fib due to "holiday heart"?   That is what I am trying to figure out.  Thanks.

5

Talk to a goood electrophysiologist please . Don't diagnose yourself - dangerous !!

6

Would have thought this is an over-reaction to two episodes in 6 years unless there's something going on that you're not aware of. It's possible that the meds are going to more harm than good. I found that my BP meds (ACE inhibitors) made my pafib worse than it would otherwisw be. Moderate the booze and see what happens.

7

I still believe in seeing a good electrophysiologist! 

8

Thanks, I am not diagnosing myself, It's actually the opposite.  I am trying to obtain as much information on my own, becuase I am questioning if the Dr. is jumping to a conclusion / diagnosis and trying to prescribe a blood thinner when it may not be needed.  Again, two incidents both after heavy drinking.  No A fib just out of the blue.  That is what I am questioning.  I am not sure, so I am asking those that have A fib as a diagnosis, and those that have more expierience, and have spoken to Dr.'s more than I.  I have met with the same cardiologist both times, and there is a bit of a lanuage barrier, so I am not 100 percent sure he is understanding me, and I am not understanding him 100%.  I am still under his care, and I have tests scheduled in the upcomming weeks.  I also made an appointment with a new family Dr. that I will see in the next month, once my tests results are back.  

I am just trying to take a proactive approach by asking questions here and educating myself.  More and more Dr's today like to throw pills at you quickly, and some of the pills can do ireversable dammage.  I just don't want to take something if it is not needed, and I am trying to figure out if it is in fact needed.

 

9

Duker, it is funny you say that because i was suffering from AFIB right after a day of heavy drinking at a wedding. No, i do not drink regulary but it was a wedding and my 3 30 yo sons were there and i really went overboard with the drinking-then the next few days they were still home with us and we visited my nephews newly opened beer brewery so there was more drinking and he gave us beer to bring home so a little more alcohol. Mind you i am not used to all that alcohol - soon thereafter i noticed my heart thudding out of my chest- thought is was anxiety and stress because my elderly Mom is very sick, i had a change in lifestyle having just retired and so on and so forth- i suffered for almost a week and a half before going to dr. It was AFIB was put on blood thinner and beta blocker- i went back into sinus rhythm sometime during the following week and have been since then. So was it related to the alcohol. Not sure? I do have HBP which has been pretty much under control. dr. said to stay on meds six months- make note of any fluttering in chest after six mo he will do a week long holter moniter and if no afib picked up i can go off blood thinner and on baby aspirin. So let's see. Thank GOD the week i suffered prior to going to Dr and thinking it was anxiety i was taking a baby aspirin or Dr said i could have had a stroke and should not have waited to see him. Good luck and talk to your dr before doing anything. I felt the same way and ask i am in rhythm could it have been a one-time thing and why stay on meds. 

10

Have you had a recent EKG ? Try and find an electrophysiologist- they are the heart rhythm experts . Sometimes cardio guys overreact or mid diagnose .

11

Get your doc to do EKG before you do a bunch of tests etc - If it shows you are in nsr then don't worry any more !

12

Duker, afib is a symptom. Holiday Heart is afib. In many cases the problem initially manifests itself in widely separated episodes, often years apart. If you quit drinking, quit excessive caffeine, exercise regularly and in moderation, get adequate sleep, the episodes may continue to be years apart and unintrusive. You should also have lots of sex. I made that last part up, but you need some good news too. But see, here's the deal about afib: the episodes put you at an increased risk of stroke and if you don't take anticoagulants and thereafter have a disabling stroke, your wife will be all over you harping at you for putting her in the position of having to care for you. If you do take the blood thinners and still have a stroke, she will be sympathetic and concerned. So take the meds the doctor recommends. Look, statistics are very powerful that the afib will not kill you - that you will live all the way to your use-by date. Often the disease is progressive, which is to say that the frequencies of the events increases. In my case I went ten years before I became chronic (afib all the time). That was twenty years ago that I went into forever afib. I am 78 years old, quite active, and take only a blood thinner. This whole afib thing is doable. Good luck.

13

I know your pain!

My AF was triggered by excess alcohol (with other contributing risk factors; severe sleep apnoea, overweight , bit of smoking, genetics and work /life balance).

Pushing the envelope with alcohol probably led to me having 3AF episodes earlier this year, which end up with me having an ablation in April.

Have been all good since, but have been told to keep below three standard drinks per week (is very, very hard to do).

Am almost completely med-free now (just 2mg of perindopril a day).

You might be lucky, but I suspect that you'll need to live a very virtuous, clean and healthy life and address any possible risk factors, to have any chance of staying in rhythm without any meds or other interventions.

AF doesn't just just go away, it seems to be lurking in the background waiting for you to make a slip up with your lifestyle,!!😏🤕

14

Also, if you're not in AF, why do you need to be on thinners?

I just been I can stop my thinners(6months post ablation).

The danger is that if you go into AF and don't realise, you can develop a blood clot witch in turn leads to stroke.

i have gone into AF 5 times in total over the last two years, three of those times I was unaware that I was in AF, my blood pressure machine that I use daily has an AF function on it, and It has been 100% accurate at diagnosing me every time I have gone into AF.(also wear a Fitbit 24/7 an keep a close eye on my heart rate)

So, in theory, if you checked yourself daily with one of these machines, would that save you from having to be on blood thinners?

My understanding is that if you Cath your AF within the first 24hrs, doctors at emergency dept. are OK with cardioverting right away. If you have been in AF for an unknown amount of time, they won't , and put you on blood thinners for a couple of weeks to reduce chance of stroke when you are cardioverted back into sinus rhythm.

So really, in theory, if you were able to closely monitor your AF status on a daily basis(accurately), you'd probably be OK.

Now for the disclaimer: I am not a health professional and strongly recommend you run anything I suggest here past your doctor before doing it.

But I think you do have a fair point.

Also, I suspect that you heart becomes more sensitive to alcohol with each episode of AF, so what you used to b able to get away with will most likely not be tolerated by your heart anymore.

good luck with it all.

 

15

Hi, this is all getting way out of hand. Unless there is something you are not saying, you have rare afib, are 43 and have high bp. Check where you are on the Chads2 scale and see what is recommended. If you can work on any of the factors there to reduce your score to 1-2, you can work out for yourself whether and at what level you need blood thinners. I only score 1 on the scale, so no blood thinners required. If it wasn't for the fact that I'm now 61 I would also can the medication as my cardio reckons that for people under 50 their systems are resilient enough to recover completely from afib and given you have had two episodes in 6 years sounds to me like your doctor's getting a bit too gung-ho with his prescription pad! But get that bp down! And see a different cardio/electrophysiologist. Good luck.

16

You say there has been a six year span between episodes, but are you sure?

With the benefit of hindsight, I suspect that I have probably had short, self correcting episodes of AF for the last 10-15 years, that were becoming more frequent over the last couple of years leading up to to my heart failure/cardiomyopathy/AF.

Many people have episodes of AF without realising it. I had a short AF episode (for 2-3hrs apparently) when I was two weeks post ablation (which wasn't of any concern as there is a three month 'blanking period' post ablation). I had no idea that I had this episode, it was only picked up by my Electrophysiologist because Iam part of an AF research study and have had a loop recorder inserted into my chest to monitor for AF.

That's the big danger with AF. Quite often, stroke victims are subsequently diagnosed AF(or something similar) that was probably the actual cause of their stroke.

17

I am not leaving anything out.  But just some more info.  I have always been about the same weight within 10l-15bs or so for the past 10 years.  I'm 6'5" and always in the 250lb range.  Fully dressed I look very fit, but I have "love handles" my chest is bigger due to weight traing years ago (never any illegal drugs or enhancers of any kind) so it hides my chubby tummy.  Last year after a physical my Dr. said my sugar was on the high side, and as always my BP was high (I was on Diltiazem and Hydrochloathiazide) so I got real serious and dieted and started running / walking everyday along with my physical job.  I got down to 210 lbs.  My Dr. loved all my numbers but kept me on the meds.  I felt weak at 210, and checking my BP at home it was low, and I was light headed.  I stopped taking the Diltiazem on my own (I know I should have consulted my Dr.)  I started eating ocasional junk and lifting weights alittle, but quit running / walking daily.  So now I am back to around 240, and my BP is on the high side.  This wake up call has made me revaluate my diet, my drinking, and my exercising.  I haven't drank, I have cut carbs, and have started walking.  Granted, it has only been a week.

I had an EKG at the ER last week when I had the A Fib.  My next test is an echo gram scheduled and full blood panel.  That is where I am now.  I don't smoke, and do no ilegal drugs, nor have I ever.  I have been cafiene free for 5 years.  I haven't had any hard liqor in 20 years, only beer.

18

I know I keep referring to this interview that's on medscape, but if you take the time to watch the interview, it really lays it all out there and explains a whole lot of stuff about AF very nicely.

If you google search 'Legacy PI throws down the gauntlet to US physicians', and scroll down a bit to the interview, you'll find it.

I found that this clip really put everything into perspective for me.

I hope it helps you too??

19

Yes. Alcohol is a known trigger for a-fib.Not just heavy drining, but sometimes even small amounts.

Warfarin has been used by many years since 1954.it does require careful monitoring though.I had my choice of the first drug that came out as a blood thinner.

i recalled this advice.

"Do not be the first or the last to take a new drug.

I have been on Wafarinfor 4v years without any difficulty in remaining with an INR between 2 and 3.

20

I can't give you a definitive answer, but I believe alcohol is a trigger for afib, also coffee and chocolate. Being dehydrated, which is caused by alcohol as well can also lead to episodes of afib.

I have given up all these triggers and feel better for it, in fact I've been taken off Bisoprolol and Flecainide, but I will be on blood thinners for life as a safety measure.