Will A-fib always come back?

[wildcat27]

Hi all,

Have never been able to post before...so even though I am doing better I thought I would leave a post with some of my questions. First, thanks to the doctors and CC for creating this site.

1. I had a lone A-Fib back in July...none since. Had some PVCs in late July and early August...but hardly any since. I guess I am wondering the million dollar question...how can I keep my A-Fib episode from coming back?

2. I have heard of people having A-Fib once and it not coming back...what are the percentages on this?

3. What are the overall numbers of no A-Fib recurrence for someone cardioverted? That was what was weird about mine...I stayed in it at the hospital for about 10 hours and the meds were not converting me...is this cause for concern?

4. I have been exercising (2 miles 4xs a week), and doing yard work type stuff. I am still afraid to lift heavy objects, and play basketball or football...would any of these things increase the risk.

5. It seems like A-Fib doesn't have to effect life exp. or quality of life...thoughts?

6. I went to see a regional research center EP in mid August. He looked over my myriad tests from both March and July. He said he saw a totally healthy heart and "zero" reason to even do an EP study...I assume there is no reason for another opinion?

7. Docs who cardioverted me put me on 120mg of Cartia and after Coumadin for 3 weeks I am now on aspirin...does this sound about right?

8. My AF just appeared out of nowhere when I rolled over in bed one night...any reason for concern? Thanks in advance...

[CCF-M.D.-BJ]

wildcat,

There is no magic bullet to prevent the recurrence. Some treatments such as antiarrythmics and ablation are very effective in some, and not as much in others.

The best thing you can do is keep phycically fit and control all of your cardiac risk factors such as hypertension, cholesterol and smoking.  Avoiding physical activity would be counterproductive.

A lot of people are in persistant a fib with no negative effect on their life quality. This has been looked at in large studies.

An EP study will be of little benefit for someone with lone a fib.

While you do not mention your other risk factors, generally a young healthy person with only lone a fib will only require aspirin prophylaxis.

good luck

[myowncrazybeat]

My thoughts and prayers are with you.  This can be so life changing!  I'll share my story and hope to help you feel some better in the process.  Might be a bit long.
  
I have had 2 episodes of lone(paroxismal) a-fib.  Oten, it seems if they can't find a cause for something, the general opinion is "oh, that is just stress related" or in a females case "hormone related".  Even when lab work shows all of that stuff is normal.  I have been told both times it was likely due to stress/panic and would probably not have a recurrance any time soon.     It would be nice if I really believed that.  I didn't feel I was distressed to start with, physically or mentally.  I wasn't depressed and certainly didn't feel anxious...then, anyway...

The first episode occured after I delivered my second child via sceduled c-section and they aren't sure how long I was in it.  I converted back on my own about 15 minutes after the nurse discovered it.  The second episode dropped on me like a bomb out of the clear blue sky exactly 2 months 2 days later.  I was laughing at my child and eating an ice cream cone.  I have continued with pvc/pac's, episodes of atrial runs and atrial tach ever since.  My loop monitor documented beats anywhere from 54 bpm at night while resting to 124 bpm when I feel the pvc/pac's start up.  They occur most every day for no apparent reason.  And I am the only one the least bit concerned with it.

I was initially not treated.  After the second episode, the E.R. doc did the Lovenox injections to prevent the clots and potassium tabs/i.v. (my labs showed very slightly lower than normal potassium that time) and I again converted on my own, though this time it took about 6 hours.  I was to be converted in the morning, but didn't need it.  I was placed on Tiazac 120 and aspirin therapy for a little over 3 months and was tapered off and am now going on 5 months with no meds.
    
I wore the 30 day loop monitors twice, holter once, passed the treadmill test and echo, with only one valve slightly leaky, still called normal results.  Don't drink or smoke, carry a few extra preggie pounds.  Avg. bp is 95-105 over 60/65.  No obvious cardiomyopathy, no peri/postpartum cardiomyopathy.  Low cholesterol.  Family hx of CAD, but really, whose family doesn't have a history nowadays.  

My provider will not refer me for an EPS for reasons similar to yours.  They don't even think I need to get a second cardio opinion, even for my own peace of mind.  I might pay for it myself anyway.  :)  My heart jumps, skips and races and it happens for absolutley no reason...just like you turning over in bed at night.  This, to my knowledge, has never happened before in my life.  I am a nurse and also prior active duty military and feel if it were stress related, well, something should have showed up years before.  

I am at a complete loss as to why this happened and spend most of the time now worrying if it will happen again.  I am the only thing interfering with my quality of life.  Saying that and doing something about it just can't quite connect for me.  I am desparate to find an answer that can tell me why this happened and some way to never let it happen again.  Hard to treat a problem that no one can find a cause for.  :)  I will likely search in vain.  The pvc/pac's are a constant reminder of a very frightening time for me.  

My provider says this is certainly not a death sentence for someone and with interventions as/if needed, things will be just fine.  I have had patients in their 80's doing better with this diagnosis than me.  They are doing fabulous.  Quality of life is outstanding, as long as they don't have a major accident (Coumadin therapy).  Just have to be monitored a little more often.  He has encouraged me to get out there and exercise again.  I do have pvc/pac's on occasion when I try, probably is stress related now.  I sit here wanting to do it, frustrated at the whole mess because it is an uncomfortable feeling.  

I often come here hoping to "hear" something comforting, knowing there might be someone that has "been there" and in some way does understand without prejudice or skepticism.  Like we all share our opinions from the safety of home and it seems to be better than hearing a doc tell you in some sterile office.  

My personal research yielded numbers and percentages similar to what doc offices will have.  Exercise WILL strengthen your heart and in the long run help with any type of problem that may arise.  You can build your heart muscle and vessels.  If your MD says okay, enjoy the things that make you happy.  Work out that heart and work off that worry.  

I pray daily God can use this thing that happened to me to help/comfort someone else.

[mrbh]

Thanks for telling your story.

I have had a-fib twice...in 1992 and again in 2001. Both happened after turning over in bed. Also have lots of PVC's and sinus tachycardia since 2002. One cardioversion.

I don't have a good answer for you. The docs claim that exercise is very beneficial, yet my 2001 episode came at the end of a summer where I walked a mile every evening for 4 months. Now, with the frequent palps, I don't do anything out of fear. No insurance and almost no money, so I can't go to the E-R unless it is life and death.

Eliminating alcohol and tobacco is critical for anyone with this problem.

My uncle is 85 and has been in a-fib since 1943. People can do quite well, but I still wonder why the docs at the local hospital say "five hours max, or you are risking heart failure".

IMHO, there are too many opinions and not enough facts. It is truly Hell to live in fear of your next heartbeat going off into something distressing and potentially dangerous. I know because that is how I live.

Wishing all the best of health.

[bama jane]

I am confused about afib because I have several different arrhythmias and have misbeats and runs every day of my life and it is very life altering for me.  My father died 2 years ago and his cause of death was listed by the doctor on the death certificate as copd with contributing factors to death being afib and congestive heart failure. He was in constant afib and then did develop heart failure after that. I am not sure what to think.  He started out with racing heart and extra beats at the same age mine started. He really couldn't feel the afib either but I think it was because his heart was weak.  Maybe if your heart is strong you feel them more. My doc has said there is no magic bullet for these and to try and ignore them.  Difficult to say the least... I exerecise every day and always have misbeats while exercising. I was just at a party where it got so bad every time I opened my mouth to talk I had a misbeat. I have tried everything from medicine to prayer.  I know there are worse things to happen but this is pretty bad. Good luck to all of you having to deal with this.

[14 Years of APCs/PVCs]

It's difficult to explain to people who've never felt an APC or PVC what it's like living with these on a daily, hourly, or minute basis. I always tell people I live my life in 2-3 minute increments and smile. Every 2-3 minutes, I get an APC or VPC which interrupts any thought or action I'm involved in. I may not express anything externally but internally, all my thoughts focus on the bounding heartbeat and pulse that follows. There is nothing I can do mentally or physically to "ignore" it on any level. The strong beat that follows the pause is unforgivably detectable. I feel each one. I think that whatever cascade of events following these beats (initiated by barroreceptors, etc.) occur, they cause, even for a brief millisecond, a physical sensation of fear or discomfort that is difficult to describe. I've had ECGs, echocardiograms, Serum biochemistries, CBCs, etc.and all are within normal range. My cardiologist cannot find anything structurally or mechanically wrong with my heart, but there is obvioiusly an electrochemical abnormality that is poorly understood, often with multiple etiologies. Diltiazem and atenolog have not helped me. I currently live with them and without any medications. I look forward to bedtime since this is the only time I don't feel them.
In a twisted sense, I have learned to appreciate life more, at least in the 3 minute intervals when I can think and just "be"...without the physical and mental interruption.
As a veterinarian, when I detect these arrythmias in dogs or cats that otherwise seem healthy, bright, and thriving, I often wonder if they also live their life in 3 minute intervals that we just can't detect or ask them so. They have taught me to live life to the fullest, regardless of expectations.

[myowncrazybeat]

My sympathies for the loss of your Daddy.  We never really get over losing someone we love, we just learn to deal with it better.  I will certainly say a prayer for you.

I have read some of the research on the relationship between heart disease and a-fib.  If memory serves me, one of the contributing risk  factors of developing a-fib is heart disease.  If your Dad was diagnosed with COPD before the a-fib, that might be a reason.  

Not sure if this helps you in any way.  It's often hard for us to figure out isn't it, which came first...the chicken or the egg...the a-fib or the "other" heart problems...

[wildcat27]

From my understanding...a lone A-Fib and PVCs with a healthy heart are not a concern that would warrante an EP or any type of ablation.

AFib related to cause of death is (from what I can understand) the byproduct of something else, heart disease, heart failure, etc.

I agree with everyone that these are hard issues to deal with.

I believe God's grace is sufficient and He is helping me learn not to let these alter my life. It is hard some days though.

[manyana]

hi
i also suffer from pacs and pvcs - some days only a couple and others every few minutes - it makes me very depressed on days when i get lots - i dont know how to cope with it and the thought that the rest of my life could be like this is not one i find bearable
i have tried all the supplements to no avail and have had ecgs and holter monitors - i am told my heart is healthy and that these are benign and to ignore them!! ignore them!! yeah right 0 cuz you can really ignore your heart - its such an insignificant part of the body!!!
i have also had a very short bout of atrial flutter - caught on ecg as i was already in hospital and hooked up to a heart monitor - one of my many trips to ER in a panic due to pacs every 10 seconds! i was told it was too much thyroxine and had my dose reduced - that was june 06 and no atrial flutter since but plenty of pacs
i was wondering as you are a vet - do any of the pets you see with pacs/pvcs seem distressed - i suppose not as animals are not aware of their mortality - so lucky i think!
but do they go on to develop atrial fibrillation or flutter or any other bad rythmns or do they usually just have the pacs/pvcs? i wonder this as my docs told me pacs/pvcs are safe and wont lead to a-fib or flutter but i have had it - do you prescribe meds for pacs/pvcs in animals?
hope you can find the time to answer and hope your pacs/pvcs lessen for you
i have recently tried a beta blocker - propranolol 10mg 4 times a day - seems to quiten them down a little but does not eradicate them
take care
lynne

[Stelladallas]

I have had an enlarged heart for years probably from years of severe asthma tx w/ cortisone.  So for that reason I was predisposed.  In '91 I was diagnosed w/ Cardiomyopathy and I never did believe this dx.  I had my first episode of AF in '96 and that yr. I had 4 episodes which were really bad.  I never converted on my own.  Then in '01 I had 3 episodes and an ablation did not help.  Had 1 episode in '02, 2 in '03, 4 in '04, and 2 in '05.  In '04 I went to the Mayo Clinic and they concluded I did not have cardiomyopathy but diastolic dysfuntion which was causing the AF.  They also noted that I was beginning to have bradycardia when not in AF and would probably need a pacemaker.  Sure enough in Dec '04 my pulse dropped to 30 so a pacemaker was inserted.  After this I had 2 mild episodes of AF.  I am on gobs of meds which I really dislike. I am 65 and I know that if I had been as young as some of you, I would go either to the Mayo or Cleveland Clinics.  And yes, I have heard that it may come back and that the day may come when I am in it and will not even know (I doubt that I will not know).  I hope you do not live in fear but have a plan of action of what you will do when the symptoms get out of hand.  One thing I did find out through these experiences is that my symptoms usually occurred after a heavy meal and/or eating something cold like ice cream.  I hope you find answers and live your life to the fullest.  I am!

[pattycake1111]

A related discussion, living with pacs was started.