scared - new onset AF

[Whatawoman72]

I am a fit and healthy 38 year old. No previous medical history.

Last Friday night out of the blue my heart started pounding.. I could feel the palpitations and actually see them out of my clothes... then I realised as well as pounding I had what I can only describe as two butterflys on acid manically trying to get out of my chest....then I noticed my heart was skipping beats, sometimes going very fast sometimes very slow....

I had had a very stresful week which had given me a migraine and an Irritable Bowel episode so I thought this was just stress.... 3 hours later it was the same and I went to go to bed to 'sleep it off'' As I tried to go upstairs a tight band came around my chest like I as being bear hugged from behind and I almost passed out -  I coldnt get my breath at all....

I ended up being taken to Accident and Emergency by ambulance with blue flashing lights and sirens blazing.... in A&E they said I had eratic and fast Arterial fibrilation.... my heart rate was 176 at the lowest and 212 at highest  it was missing beats very irregulary sometimes after 2 beats or 5 beats or 3 beats, then it would race for a while then slow down a bit -  after medication they couldnt bring it down to a regular acaptable rate... it became very irratic... going from 44 beats up to 156 beats to 90 beats to 221 beats.... so they admitted me to a ward.

The main reasons for AF in a younger person is underlying heart condition (ruled out) thyroid problems (ruled out) I dont drink alcohol and have never had drugs (ruled out) I dont drink tea and coffee or coke (ruled out) stress can contribute (RULED IN) but normally at my age, the AF would apparently correct itself after a couple of hours.

So they want to do surgical cardioversion but an X ray and echo showed my upper heart chambers are filled with pooled blood.... and the fear of clotting has meant I am now on warfarin for 5 weeks to thin the blood before they will do the cardioversion... also I am on beta blockers to keep the heart rate down, though they still cant keep it below 90 my usual was 60-65.

I went to the anticoagulant clinic yesterday and the referal note said they were not opptermistic of a positive outcome with the first round of cardioversion because my heart rate is so fast and the irregular beat soooo excentric.

Currently I am very very breathless and have the tight band continually and about 20-30 times a day have the manic butterflys appearing (though not as pronounced as the original attack)....and have NO energy.... I can not believe how hard cleaning my teeth has become where I hold my breath and worst of all eating has become a chore instead of a pleasure as it is so energy consuming.

I have a 6 year old daughter at home and am a single parent... I also have a 22 year old son who has Downs Syndrome and Autism (he lives in a residential  college) with christmas coming up I am gutted to be letting them down and not doingthe things we had planned..

I volunteer in a primary school with SEN children while doing my NVQ - the drs said if I felt up to it  could go back to work after the holidays before the cardioversion -  but I cant even walk upstairs without sitting down for 30 mins to recover.....

I am scared and nervous and worried and just frightened about the future and the long term effects of this - any advice is really appreciated.

[Whatawoman72]

Had another addmitance to hospital to the post coronary care unit on 23rd December with a heart rate of 154, tightness in the chest, heavy feeling and cramping in my legs and arms. I begged them Christmas eve to let me out my resting heart rate was still 130, but they said the anxiety of me not getting home for Christmas for my kids was more worrying than the heart rate so they agreed, doubling my dose of beta blockers. My heart rate now seems stable at 55-75  and most of the symptoms have gone when I am at rest.. I only have to move a little and I am short of breath and the heaviness returns... when  take my own pulse now I cant feel the AF racing, lowing and missing as it was.... I am schedualed for cardioversion on 27th of Jan -  I have to wait as the echo showed my upper chambers - atria are filled with pooled blood and I am on warfarin to thin the blood and remove the risk of clots being there.

I am wondering if now they have finally slowed down the heart whether the AFib has corrected itself.....is an ECG the only way to be sure?

[CFS56]

I went into what I now know was afib when my husband was in the hospital having bypass surgery.  I know exactly how you feel.  I couldn't walk more than a block without wanting to sit down and rest.  Walking down the hall of the hospital I had to stop several times.  And I felt as if I couldn't catch my breath. I'm not sure what exactly causes those feelings but I suspect it may be from the heart skipping beats and your blood pressure being too low.  When I finally went downstairs to the ER my BP was 89/57.  I hope you start feeling better.

[Whatawoman72]

Thank you both,

I hadn't had butterflys or palpitations before.... they have said that my atria are fibrilating and not working efficiently and that both chambers have filled with pooled blood.

Its the breathlessness that is so debilitating and scary...and of course the time of year makes it harder...

I have always been so healthy and physically fit and organically sound.

[skydivediva]

Hi Helen,

I'm sorry that this frightening event has occurred. As an ICU and ER nurse, I've dealt with many, many people with afib, both new onset and long-term, so I know it can be scary. I just want to assure you, however, that most of the time it can be controlled and the risks of complications reduced or nearly eliminated, especially in a young, healthy person like yourself. There are meds that can treat it, electrical cardioversion can treat it and ablation or surgery is sometimes used. Have you had some earlier bouts of "butterflies?" The reason I ask is that the clots normally form in the atria (top chambers of the heart) because the chambers have been fibrillating (vibrating or shaking like jelly rather than squeezing forcefully) irregularly and as a result haven't squeezed the blood into the lower chambers well. Since it's been just swishing back and forth in the atria, the blood clots. The warfarin won't dissolve the clots that have formed but will prevent new ones from forming while your body breaks down the old ones. Once the old ones are gone, they will likely try electrical cardioversion (which could move a clot forward causing a stroke which is why they postpone it 'til the clots are gone.) You are sedated for the procedure and it is done with emergency personnel at your side so while it is scary and, like all medical procedures has some risks, it is really quite safe. If it is unsuccessful, they may decide to do "EP" (electrophysiology studies to determine exactly what part of your heart is causing the mischief and then they do an ablation in which they thread a tiny wire into a blood vessel, advance it to the trouble spot and "short circuit" the trouble maker. Often these various treatments take some "trial and error" so don't be discouraged if you experience some recurrences following treatment. Just keep your docs informed of any symptoms. If you are on birth control or smoke, these things can increase clotting. While on the warfarin, keep your intake of greens consistent as they contain Vitamin K which opposes warfarin. You can have them but don't eat a ton daily for a week then none for a week or it'll make it difficult to control your clotting; the clotting clinic should instruct you about dietary and safety (avoiding contact sports, using a soft toothbrush, etc.) issues. A number of our friends from the weight loss & dieting community also have a history of AF, Helen, so they may be able to tell you some of the practical day-to-day things they've learned about managing it and also to reassure you that the fear your coping with now is entirely expected and "normal" given the situation. It IS scary, but try not to be too fearful. I believe---based on the many, many hundreds to thousands of patients with AF that I've cared for---that you are going to be fine, that your little girl and sweet son will have you to teach and protect them for many more decades, and that you'll soon be back to work & volunteering and enjoying life's little pleasures again. Hang in there. Your friend, MaryAnn

[Jerry_NJ]

I am back.

You said surgical cardioversion, was the word "ablation" mentioned?  You are still young in "heart years" so surgery may well be the best plan if the AFib persists.  Then too, the medication may begin to help as you continue to take it.

In my knowledge, you should not be at any risk from a resting HR of 90, even 100.  But, I wonder about the trouble going up one flight of stairs.  Go slow and be careful to hold on, it may get easier.  As far as returning to your volunteer work, I'm sure they need you, you have to decide if you have the strength. The "ok" from your doctor to return to your work strongly suggests you are not at any (significant) risk of a heart failure or clot.  I recall you are on a blood thinner (Warfarin or similar).  

[Jerry_NJ]

I give this quick response just to let you know your post is being read and considered.  I don't have any immediate advice other than follow up with your doctors.  I'll try to find some time later to give more though to what you have told us.

This post will put your post back to the top of the list, and it may help you get more helpful inputs.

In closing at this point I say I think you are safe, just take the medications prescribed and try to be a settled and optimistic as you can manage. That too will help.

Wishing you a good outcome for a Christmas present - better health.