Emergency!
If this is the first time you’re having symptoms of atrial fibrillation— palpitations, rapid or irregular heartbeat, chest pain, anxiety—you should consider calling 911. These symptoms may be indicators of a more serious problem, including heart attack. But if you’re confident that you don’t need to go to the emergency room, here are some tips that may help you manage atrial fibrillation in the middle of an attack.
First, note these warning signs of heart attack:
- Chest discomfort. Most heart attacks involve discomfort in the center of the chest that lasts for more than a few minutes, or goes away and comes back. The discomfort can feel like uncomfortable pressure, squeezing, fullness, or pain.
- Discomfort in other areas of the upper body. Can include pain or discomfort in one or both arms, the back, neck, jaw, or stomach.
- Shortness of breath. Often comes along with chest discomfort. But it also can occur before chest discomfort.
- Other symptoms. May include breaking out in a cold sweat, nausea, or light-headedness.
—From the National Heart Lung and Blood Institute’s site, Act In Time to Heart Attack Signs
If you have these symptoms, be safe, not sorry. Call 911.
If you feel comfortable enough not to call 911, here are some alternative steps you can take that may help you convert to a normal sinus rhythm (normal heartbeat):
Drink a glass of water. Palpitations are sometimes caused by dehydration. Don’t drink any alcohol, coffee, tea, or soft drinks. Alcohol and caffeine can trigger atrial fibrillation, and the phosphorus in soft drinks can deplete magnesium (see below).
Eat a banana. Atrial fibrillation can be caused by a lack of potassium, usually because of too much salt in the diet. Bananas are high in potassium, as are tomato, prune, and orange juices. But read the labels; some juices have high amounts of salt. Stay away from salt! See this list of high potassium foods. Note: Most vitamin supplements that have potassium also include large amounts of calcium. I don’t recommend taking extra calcium if you have atrial fibrillation; calcium is excitatory to the heart.
Eat some pumpkin seeds. Magnesium is essential for a normal heartbeat. Try eating some pumpkin seeds, which are high in magnesium. If you don’t have any pumpkin seeds, try brazil nuts, almonds, cashews, pine nuts, or any of the foods on this list (scroll down to Appendix B-7). If you have a magnesium supplement, you can take that, but only if it doesn’t include calcium. If you have some epsom salt, you can take an epsom salt bath. Epsom salt is magnesium sulfate; you’ll absorb it through the skin. If you can’t take a bath, try adding water to the epsom salt to make a poultice and apply it to your wrists.
Dunk your head in cold water. Fill a sink with cold water and plunge your face in it. Sometimes this little jolt can help.
Lie down. Or, do some exercise. Some people find that symptoms improve if they lie down and try to relax. Others find that doing a little exercise, which makes the heart beat faster and then slow down, helps even more. You’ll just have to experiment to find out if either of these suggestions work for you.
Try some belly breathing. Lie down or sit comfortably, and relax. Breath through your nose to a count of four, slowly filling your belly. Exhale through the nose or mouth for the same four count. Breathe deep into your belly, not your chest. Make the inhalations as long as the exhalations and breathe in a circle, i.e., don’t hold your breath on the inhale or exhale. You can also try breathing into the belly and holding the breath for a count of ten (stopping if you feel uncomfortable), then resume breathing rhythmically to a count of four.
Listen to a normal heart. If you’re not alone, ask someone if you can listen to their heart. I know this sounds strange—and you’ll want to be selective about who you ask—but I have found it surprisingly helpful. The phenomenon is known as entrainment. Your heart will tend to slow down to match the slower, normal heartbeat. Try it.
If your symptoms continue or worsen, go back to the top of this post. It may be time to call 911.
When you’re feeling better, come back and read my other recommendations for managing atrial fibrillation.
Status: Draft. Last edit: 05.26.08
7 Comments, Comment or Ping
David Eidell
I am now fifteen hundred miles down in a rural part of Mexico and have A/F (resolved). I went through a week of meticulous heart inspections, and tests last December in a US medical center. No evidence of heart disease so they say.
Homegrown methods of controlling the problem include hydration, and magnesium supplements. Knock on woof – last episode occurred last December while at the Medical Center. I was put on Diltiazem, Amiodarone, and metaprolol and cozaar.
I also have both versions of sleep apnea and have been Rx’d with a Bi-Pap machine set on 14″ and an oxygen concentrator which is set to 2.0 liters.
Every so often I will get bouts of feeling ill even though my B/P machine declared my pulse to be free of irregularity. In the past while still in the USA and living near the med center the machine has been infallible in detecting Afib, irregular heartbeat, very fast pulse (to 180) and BP examples of 160 / 140.
One bout of feeling ill had me going to a local medical clinic. My B/P was 165 / 95 a pulse of 95 but my machine did not indicate irreg heartbeat.
The clinic administered a sublingual tablet of 10mg Isosorbide and within 5 minutes I was feeling much better.
This is nuts, I thought so I discontinued the dangerous amiodarone and now monitor heart and pulse several times a day. Especially at night (like last night for example) I had a difficult time falling asleep, felt wound-up and cranky, so I took a B/P 165 / 95 — I took an isorbide tab and within a half hour I felt good enough to go to sleep.
What the hey is going on here? Did I stumble upon an effective treatment for my occasional bouts of extremely high BP? Why does a high BP make me feel so bad and wound-up?
Can extremely high BP trigger A/Fib? If I continue to “treat” my occasional bouts of high BP will this reduce the chance that my heart will fall in A/Fib?
If I don’t get a satisfactory answer here, I suppose I should pack up and drive six-hundred miles to the nearest Mexican hospital with cardiology dept. Otherwise I am planning to remain in Mexico for several years.
my email is
[email protected]
Thank You For Any Help!
Aug 11th, 2009
Carlene
Max I to have atrial fibrillation for 9 years now. One ablation on the 9th of July 2010. I am still in and out. The E.R. is tired of me. I have been in the hospital 4 times since July 9th and this is Sept. 9th. Any suggestions you could give me would be highly appreciated I am afraid to do the second ablation I.had so much trouble after the first one. I am 56 and in good health except for this.–Thank You! God Bless!–Carlene
Sep 9th, 2010
ANN WYATT
Hello Everyone.
I still have not had an A-fib episode and it is a long time now since I had the last one. I firmly believe that apart from food additive triggers, that the fear of having an episode is just as responsible.
David, I noticed that you referred to being ‘wound up and cranky’. I think this can also be a trigger and that the tablet you took calmed you down. I used to worry about having a night time episode every night before going to sleep and sure enough I did. Now, I don’t even think about it and I have lost the ‘fear’. Now I have about one episode a year and I don’t let myself become stressed. Can you try meditation or even some slow breathing before you go to sleep. Tell yourself that you are going to have a restful, uninterrupted sleep. I know this sounds too easy but I really think we can wind ourselves up to the point that we actually programme our brains to act in a certain way. The brain then sends the message to the heart and off it goes. It’s worth a try. I wonder also, if all the medications fight with each other and then act as a trigger. After all, if you have a heart problem and have to go to hospital, don’t they give you magnesium? It supports and strengthens the heart muscle and helps to lower blood pressure.
Good luck.
Ann W
Sep 20th, 2010
anneh
Hi Ann, I was dx with LAF in March because of a Dr overdosing my thyroid meds (for low thyroid) sending my hyPERthyroid and into AF. I had another episode 3 months later but converted it with a 40mg beta blocker (they had put me on it in the ER but I weaned off). The cardiologist wanted me to stay on the nadalol so I chose the lowest dose (10mgs) and didn’t like the way I felt and am just on 5mgs (they don’t even make it that size, I have to cut them up). I take hawthorn/mag/CoQ10/taurine/alpha lipoic acid/fish oils etc. Also walk daily and am not overweight, do Tai Chi and yoga. I am wondering anyone here has found using a beta blocker really helps and would prefer not to take this drug, perhaps just take a larger dose at onset of an episode? Thanks for your thoughts.
Sep 30th, 2010
Laurel
Regarding plunging your face in cold water – DON’t! It can make your BP drop so low your heart stops.
I have long term a-fib, and used to manage sudden episodes by putting My forehead on any metal or ceramic surface, because they are cool. Refrigerators doorknobs; dinner plates ; there is always something metal or ceramic around. A nurse told me this is extremely dangerous and furthermore, it is dangerous to be the sort of person who responds to cold in that way. She said if I ever go to the ER they can accidentally put me into arrest if they don’t know I have this. It is a form of vasal vagas syncope.
That discussion made me more aggressively pursue stabalizing my heart so I don’t have these episodes to begin with. I had micronutrient testing to find out what nutrients I don’t absorb and found I have serious absorption problems. Specially formulated supplements and flecainide helped tremendously, but there was one oth thing. I am particularly sensitive to glutamate (not to be confused with gluten) which is a neurotoxin and excitotoxin and implicated in a-fib, and a leading cause of obesity, which can’t help.
Jan 30th, 2011
Andey
Sunday morning woke up with a racing pulse, extremely high blood pressure (monitor read 196/169 – pulse was 161 and the irregular heart beat symbol was flashing on the monitor). I waited for about an hour to see if it would pass and finally and VERY reluctantly drove myself to the ER – i sat in the car for another 1/2 hour trying to talk myself out of going inside. Once i made the decision to try and bring down my blood pressure with the ER’s help, everything changed. They asked me if anyone had ever told me i had A-fib. I didn’t even know what that was, i have experienced these crazy symptoms many times before, though only twice as extreme as this episode. Both those times i waited it out and a day or two later things went back to normal. The first time it happened, i made an appt with a cardiologist. He told me i had high blood pressure and to take BP meds and buy a BP monitor. I was sure that a high BP was the cause for all this craziness.
Once inside the ER, after they dropped my BP, they did a cardioversion (a unique experience i must say) when i asked why they wanted to do that since nothing really hurt (all i kept seeing in my mind were those medical TV shows where the body violently jumps up in the air(charge!!)) they said my heart was very unstable and they needed to bring it back to sinus rhythm.
Since this is my first expereince with A-fib i would really appreciate any help understanding where to go from here and how i can prevent or at least deal with A-fib-
i guess my biggest question is: how do you know when to wait it out vs seeking ER help? thanks so much
Mar 1st, 2011
Tarja
I also have recently been diagnosed with this. I am in denial, im an ex gymnast and i now coach fulltome. I taught aerobics for 15years. Ive never smoked never been overweight always have exercised and eaten healthy, so i feel ripped off that i have this. I too need to know when am i to go to the hospital. I am having surgry in december but this last week i have had my symptoms worsening, especially the dizzy spells and i keep yawning its very strange
Sep 21st, 2011
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