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A-fib and sleep apnea?
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A-fib and sleep apnea?

I am a 54 year old female, 40 pounds overweight.  I had episodes of PAT for about 20 years which I learned to convert on my own.  Doctors were never too concerned about it.  About 3 years ago I had my first episode of atrial fibrillation.  I have had two other episodes, the last one being 8 months ago.  Each time I went to ER and was successfully converted with drug therapy.  I am now on flecanide 100 mg twice a day and take aspirin.  I was on coumadin for a few months and then taken off because everything appeared to be stable.  I also have high blood pressure which has been successfully under control with Lotrel until very recently.  I also have underactive thyroid for which I take synthroid.  I thought I was doing OK until the last few weeks, when I wake up with a pounding, racing heart.  Once awake, I can usually calm down but it is very disturbing when it happens.  Since I take my BP at home, I have noticed it getting higher (140/89 this AM).  What has me curious is that every time I have had an a-fib episode it has happened when I've been asleep and I wake up and realize my heart rhythm is irregular. I have been reading about the possible connection of sleep apnea and a-fib.  Could this be my problem?  I have never had a sleep test or been recommended for one. I plan to see my cardiologist within the next two weeks, but I thought I would seek some input here.  Thanks for your help.
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I didn't see that you have had an EKG showing this is atrial fibrillation versus another heart rhythm.  Atrial fibrillation that starts during sleep or as you start to fall asleep is usually vagal atrial fibrillation.  It also occurs when you swallow cold things like ice cream.  This can be treated with medications like flecainide or propafenone.

If you can break this rhythm with breath holding and pushing, face immersion in cold water, or pressure on your abdomen, this suggests that it is not atrial fibrillation

A sleep study is a reasonable test for the right patients -- overweight, snoring, no restful sleep (feeling exhausted when you wake up).

I hope this helps.
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Thanks for the information.  EKG did show atrial fibrillation each time.  Echo and stress tests were normal.  Cholesterol is well within normal ranges.  I do snore and sometimes wake myself up, but I usually sleep fairly well.  I get up at least once in the night to use the bathroom.  With these uncomfortable epidsodes of pounding/racing heart, I have hightened anxiety and almost hesitant to go to bed, which is of course making me more tired.  What particular questions should I be asking my cardiologist?  Are there other tests I should have done? Are there any side effects from fleciainide  -- I've been on it since July 07.  Thanks so much.
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