You’re in the middle of an afib attack. You have palpitations, rapid or irregular heartbeat, chest pain, and extreme anxiety. I’ve been there. It’s no fun. Here are 8 things I’ve either done or others have done to help stop an atrial fibrillation episode. If you have something to add to the list, please share it in the comments!
1. 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).
2. Eat a banana or drink low-sodium V8.
Atrial fibrillation can be caused by a lack of potassium, usually because of too much salt in the diet. Bananas are high in potassium (422mg in a medium banana) and low-sodium V8 has even more potassium (900mg in 8 oz). Tomato, prune, and orange juices all have decent amounts of potassium as well. But read the labels; some juices have high amounts of salt. Stay away from salt! See this list of high potassium foods.
If you have potassium supplements handy those can help too. The drawback to a lot of potassium supplements, however, is they have very little potassium – usually no more than 99mg per tablet or capsule – and they are often found in combination with calcium. I don’t recommend taking any calcium as it can excite the heart. Pure potassium gluconate powder is the best type of supplement to take. I always take NOW potassium gluconate powder.
3. 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.
If you have a magnesium supplement, you can take that, but only if it doesn’t include calcium. I personally take ReMag as I can take large doses of it during an episode without any laxative effect. Another supplement that can be highly effective is Ease magnesium spray.
4. Dunk your head in cold water.
Fill a sink with cold water and plunge your face in it. Sometimes this little jolt can help. Others have said a cold shower has a similar effect.
5. Lie down or exercise.
Some people find that their 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.
6. Try 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.
7. Listen to a normal heart.
Listening to a normal heartbeat can help slow down your heart. This phenomenon is known as entrainment. Your heart may slow down to match the slower, normal heartbeat that you’re listening to. Try it:
8. Try the valsalva maneuver.
This is a safe and often times an effective method in slowing or stopping an atrial fibrillation episode. This maneuver greatly increases pressures inside the chest cavity which stimulates the vagus nerve and increases vagal tone. The vagus nerve is one of 12 cranial nerves and extends from the brain stem to the abdomen, via various organs including the heart, esophagus and lungs. Here is a video that demonstrates the maneuver:
If your symptoms continue or worsen, go back to the top of this post. It may be time to call 911.
Next: Recommendations to Help Prevent an Afib Attack
Thanks for the article Travis.
I showed this to my cardiologist and he said some of these are SVT-related versus A-fib related. For example, he said the valsalva maneuver is for SVT, not A-fib.
I think, to be clear, you need to separate the two.
Chuck:
Thanks for the clarification. However, I have heard from many afibbers who have tried the valsalva maneuver with success to end an afib episode. Doing the maneuver during an afib episode isn’t going to hurt. Worse case scenario it just won’t convert you, but if you’re in an episode it’s worth a try!
Travis
After about 13 hr in hospital my a-fib converted to sinus. They first tried 2 doses of Co-vert that did not work. They were anticipating to do shock conversion. Based on the timing of my conversion, I suspect the following:
Since I was a bit nauseous and with headache, I tried to induce vomiting. I did not bring up anything, but I did induce the stomach spasm of vomiting. I am thinking that this spasm may have converted the a-fib. The doc said that it was not the co-vert administered so many hours earlier.
I’ve had a sudden onset afib on and off for about 6 years. I tried lots of things to get it to stop: Emergency rooms, metoprolol, flecainide, etc.
I learned about 2 years ago that a modified valsalva maneuver will stop it in its tracks…
I take an extremely deep, deep chest breath, But I DO NOT bear down. Hold the breath with just my diaphragm. Hold it for about 8-12 seconds, (its hard to do that long), then let it out in its own speed. Bingo… might take one or two, but I go sinus in an instant. It seems to work better when I’m somewhat reclining on my left side.
I have made a few lifestyle changes: no beer or fizzy sodas, not eating late at night. I have an episode about once a month or so, but it only lasts as long until I can do my “procedure”. I might have to name it as I’ve never heard of it being mentioned. Maybe The “MJ Move”!
My son is an emergency room MD, and he said he’s used it on a few patients and works really well. But he still prefers to stick to the protocols he was taught.
In the early 80’s my cardiologist taught me carotid massage and it can convert your PSVT, PAT, AFIB, with little or no risk involved. Ask your cardiologist to teach you How to do this properly.
It might be wise to not discount dietary shock from triggering an afib event. Before I managed to find methods to bring my afib under control it seemed as though I would trigger an event buy eating a bag of salted peanuts o a huger brine cured pickle or consuming a very large and sweet mango. I stopped the shocks by avoiding the foods and reduced the episodes about by 2/3rds. It’s worth a try. And after a course in the school of hard knock I too am a believer in adequate water intake. At least 3 quarts a day.
I should add to my history that I lived with 2nd degree heart block (one nerve bundle branch remaining). Then, one day I showed up at the ER with a pulse of 41. My BP was taken immediately. 95/57. Difficult to stand upright and exhausting to walk across the ER parking lot. Car to car, hanging on.
It’s not reassuring to be immediately wheeled into an ER treatment slot and have someone shout “ER Crash Cart! ER Crash Cart STAT!”
But the visit brought me a 5 day stay. A dual chamber pacemaker, and a huge reduction in cardiac medications. I have noted in the 13 months subsequent — my pulse is often a 70, the setting of the pacemaker, and sometimes after a poor night’s sleep the pulse increases to 120. I do not suffer the weakness that sometimes overcame me (even with a pulse oximeter reading of a hundred or less).
But having been hospital diagnosed with severe deficiency of blood magnesium I still take a 500mg supplement every 2nd or 3rd day.
I note that I still suffer bouts of slightly thumping and irregular heartbeats but I feel much better. Without question when my BiPAP machine broke down in Mexico my heartbeat (and feeling of fatigue) fared poorly. But no Afib events and the day after I rebuilt the Positive Breathing machine everything returned to “normal”.
Active participation in controlling heart arrhythmia to me, is essential. Some folks throw responsibility entirely into the hands of their medical professional and to me that is one of the biggest mistakes an individual can make. Salt and sugar control, whining and begging for blood electrolytes to be taken and results given to me is an essential part of my modus operendi.
I wanted to add another thing to this article. First off, I’m a 19 year old male and have had random afib episodes since high school. I am getting a cryoablation next week. I just had an episode yesterday and did all the maneuvers the doc told me plus the ones on here. None worked but they did help me relax. I was with my girlfriend at the time. I say this in all respect and sincerity; try having sex. After me and my girlfriend had sex, my heart converted back to normal sinus and I felt great. It may not work every time, but it’s worth a try. This is the first time I had sex during an afib episode and surprisingly it worked. Hopefully, this can help someone else as well!
Austin:
Thanks for the tip! I’m not surprised that having sex help convert you. Some afibbers are able to convert to normal sinus rhythm with exercise. So for those of you reading Austin’s tip if sex isn’t an option simple exercise can sometimes do the trick as well.
Travis
What is your girlfriend’s name (and number)?
Just kidding!
I get exhausted from walking to the mailbox. Is coreg or cardizem better for rate control?
At 62 I went into menopause and developed numerous medical issues. Afib was one plus autoimmune diseases. For about 3 years I was on a blood thinner and a beta blocker. Then I went to a specialist. He took me off everything until I hit 70. My afib was infrequent and I never knew I was having an episode. I went on a blood thinner and had bleeding episodes and stopped.
After the last three years of severe stress I have nonstop afib. They can’t get it to stop with blood thinners multaq and shock. It will stop for maybe 38 hours. What do I do now? It’s 94 beats I don’t think they can do any more shock treatment. I will try all your suggestions before I see the doctor again.
Marjorie:
You might want to consider having an ablation since the drugs and shock treatments are not working. An ablation will be your best shot at stopping the afib. I wish you well.
Travis
Hello Travis, Just wanted to asked a few questions in regards to afib. I,ve had this for about 1.5 years; I have messaged you before about afib. I don’t know what kind of afib I have I do know it’s not from a heart damage or a valves. I used to get bouts of it very often when first dignoised lasting anywhere from 4 to 6 hours and many times during the week. I am on xaltro blood thinners once a day and metoprolol 25mg twice a day. I have sleep apnea; a digestive hernia and need to loose over 100 pounds. I use my sleep apnea machine every night, hired a wholistic dietitian. I have lost about 15 pounds and take magnesium daily now and did some live style changes in my eating. I have not had a afib episode in 6 month with the exception of 2 times. One when I was on holidays and we were on a tour bus on very bumpy roads and bad shocks I went into afib, lasted 10 minuets and stop about 5 minutes after the bus stopped. The second incident happened when I was bending over and not bending my knees for an extended period of time, as soon as I put myself upright and relaxed for 10 minutes it reset and was beating regular. The only other thing I noticed now if I do get irregular heart beats. But my heart rate is low… my resting heart rate is 54 bpm. Is it normals to have arrhythmia/irregular heart beats. Second question is could my Afib be caused by my digestive hernia? I have done many life style changes in regard to what and how I eat that have been positive for no afib issues. When I brought this up to my cardiologist he says no, my digestive hernia is not a factor but I do believe it is. Do you know of any research in regards to this. Thank you
P.S. My cardiologist sent me to an EP to discuss ablation last March. I am still of mixed minds about it. The health style choices seem to be working really well for now. For as I said in my previous post, no episodes for 7 months.
But, what concerns me a lot is that here in Canada that if one goes to a teaching hospital to have an afib ablation, the resident(s) will also take part in the catheter work, too. “After all, we are a teaching hospital”, the doctors all say.
And yes, residents must learn, but must they learn on me? How does one get that highly skilled and experienced EP to solely do the actual procedure, someone who has done many hundreds? Here in my area (close to Toronto), the best EP’s are associated only with teaching hospitals. And thanks, Travis, yours is a super article.
Helen:
I always tell people with afib to try lifestyle changes first. It only makes sense to do so. The truth is, MOST people will get relief from their afib burden just by losing weight, eating better, sleeping better, etc.
However, I have found that most people do not experience a lifetime of relief from lifestyle changes alone. That is where I disagree with Dr. Mandrola. He seems to think you can cure afib by just losing a lot of weight and being “healthy.” It’s not that simple. Afib is far more complex than that.
What I tell people to do is spend 6-12 months making hardcore lifestyle changes and see how things go. If you’re able to significantly reduce your afib burden as a result, stick with it for as long as you can. But if your afib gets worse despite those efforts, then it’s time to consider having an ablation by an expert EP!
I feel for people that live in Canada because they have limited choices in who they can be treated by. And as you’ve pointed out, a lot of the hospitals in Canada are teaching hospitals so finding an elite EP is next to impossible to find. Truth be told, most Canadians I talk to that want to be treated “by the best” come to the U.S. and pay cash for their ablations. If you pay cash for an ablation in the U.S. it’s about $40,000.
I wish you the best!
Travis
I have paroxysmal AF. Healthy, active 77-yr old woman. I like these suggestions and they do work. I also have been wearing a Fitbit for the past several months and when I feel myself rushing around too much, or with my “foot on the gas” too much, I check my HR. Sure enough, often well over 100.
I stop – take a deep breath in through the nose, breathe out slowly with pursed lips, and relax my shoulders. I basically use it as a biofeedback tool. As well, I NEVER become dehydrated, no matter how rushed or busy I am. I always have water with me. I have stopped all alcohol. At least I can have coffee (half high test)!
I have read a great deal by Dr. John Mandrola, cardiologist and electrophysiologist. His articles and blog have helped me a lot and I feel much more positive and empowered. He pushes healthy lifestyle choices as the 1st line of defense for afib treatment. He and others have stated that if we lose just 10% of our current weight, that AF symptoms might fade or go away. I have slowly lost 15 lbs in the past few months. No episodes in 7 months. Touch wood!
I am 83 and other than my HEART, I am in great health. HA!!!!!!!!!!!!! I am in Mexico all winter each winter and we have a ambulance group called, rescate. I think it is rescue in Spanish.
I went there on my own when I had my last episode and they let me lie there on oxygen for about an hour then it went right back into rhythm. I am not always that lucky. They even went to the store and bought me a banana and they had potassium pills. I now carry potassium pills and a couple of Magnesium as well. Putting a banana in my purse when I leave the house also. Thanks!
Beth:
Glad to hear they were able to restore your heart rate! Potassium and magnesium are definitely an afibber’s best friend!
Travis
I was looking for a response by Karl dated May 16, but did not find it posted as yet. I wholeheartedly support what Karl said. I have had paroxysmal A-fib due to hypothyroid since 2014. I have not had an attack since last September after I started the recommendations of Dr. Sherry Rogers, MD (renowned and highly respected author on heart health and environmental toxins), eight months ago.
I have been on D-Ribose, Taurine, Arginine, Acetyl Carnitine and Glycine Powders, CoQ10 and natural vitamin E with all 8 parts. For 6 months now and I feel a tremendous improvement in my heart function. I have had no A-Fib. I think A-Fib patients, as recommended by Karl, should first work on improving their heart nutrients before going with ablation. There is extensive research that show the combination of d-alpha tocopherol and gamma tocopherol , two components of natural vitamin E, work extremely well together to stop A-Fib.
Travis: Although I personally do not like the concept of ablation for myself, I will stay informed by reading all updates on it on your site. At the moment, I am not a candidate for ablation. Everyone is different. I am very grateful for this web site. Thanks again, Travis, for all your work.
Low magnesium is the leading cause of A Fib. A patient MUST have an RBC magnesium level checked, not SERUM level. The higher the serum level, the lower the red blood cell level is. Only 1% of magnesium is in the blood. The rest is cellular. I meant to add this to my post above. I recommend a fib patientg read Sherry Rogers MD Is Your Cardiologist Killing You, available on amazon.com for about $10 used. Wonderful book.
Karen:
Thanks again for your contributions to this blog. I appreciate you sharing your experiences and perspectives.
I agree with you that all afibbers should work on diet and lifestyle factors first and foremost. However, if after 6 months or so of adhering to a healthy diet (with the appropriate vitamins and supplements), moderate exercise, and various lifestyle changes you still have a-fib then it’s time to strongly consider having an ablation. For many afibbers, particularly in the early stages of afib, these changes can do wonders and can keep afib at bay for a while (for some that might be many years). However, for those people with advanced a-fib or those who have a genetic predisposition to afib, these changes often times aren’t enough.
Travis
Even with my success with a nutritional / lifestyle approach to managing my AFIB, I completely concur with your comments on ablation. I was seriously considering having it done until I went on my current drug and supplement regimen. Prior to that my AFIB episodes all terminated on their own in typically about eight hours. Afterwards, however, I was completely wiped (shortness of breath, fatigue, sleep) for a day afterwards. Given that my episodes were becoming weekly events, there was no way that I was going to live with the risks when ablation was an option (especially since I am still relatively young – 60 – and in good shape). So, yes Travis, I completely agree that if the supplement / lifestyle / medication route doesn’t work, find a good EP and have the ablation. The improvement in quality of life is worth the risk and inconvenience.
I have had ASTHMA my whole life but about 7 years ago my asthma got so bad and was diagnosed of EMPHYSEMA/COPD which was most likely due to the asthma. I was on double antibiotics and steroids, still didn’t feel any better. My lungs were constantly wheezing in all four chambers. I already used Advair, Spiriva, and Albuterol in my nebulizer. They just didn’t do much.
April 2016 my sister in-law told us about Rich Herbs Foundation where she ordered herbs that effectively treated her arthritis. We ordered their COPD herbal treatment after reading a lot of positive reviews. I am happy to report this COPD herbal treatment reversed my lung condition. My quality of life has greatly improved and every one of my symptoms including difficulty breathing and wheezing are gone.
I will be 52 soon and have never been healthier!
I am 52 and have had afib for about 1 year. I was put on metoprolol 50mg. I take this at bedtime. I am averaging about 1 attack each month. I take another metoprolol and can get out of it in a few hours. My new EP cardiologist wants to put me on 50 mg of flecainide. I haven’t started this yet because the side effects look terrible. I wonder if I just need to suggest that I take 2 of the metoprolol instead?
Awesome! I had a 2nd episode that started yesterday. Beta blocker at 25mg currently (was at 50mg for a few weeks after first episode) and baby aspirin are my regimen. I just now took another beta blocker (starts with M) and aspirin in hopes that it will get rid of this episode. On my way to the store to get the food items indicated in the article. So glad to find you! I bet lots of folks are very grateful for the info :)
Mary:
I’m glad you find the site helpful! I wish you well.
Travis
Hello Everyone,
I’ve discovered this site a few weeks ago and it brings so much closure. I was diagnosed with a-fib 3 years ago. Since I’m young I haven’t really paid too much attention to it and thought it was an “ehhh” thing until recently. I’ve had several a-fib attacks, 2 which I was hospitalized for.
I recently started paying more attention to it and following up with my cardiologist after the last episode I had that came randomly. It lasted about an hour I want to say, which is the longest it’s lasted. My heart rate was so high, about 190 and I could feel the fluttering. It’s such a nerve racking feeling in the moment.
I stopped eating junk food, cut out my sodium intake by a lot, and stopped eating out as much so I make my own meals with no salt added. I carefully watch what I eat now. I was diagnosed with Paroxysmal a-fib so it comes and goes. Right now I’m taking Metoprolol 12.5Mg since 25MG lowers my blood pressure a lot. I’m also on Aspirin 325MG both once a day in the morning.
My life can get sometimes stressful and I am an anxious person so I know those two things I need to work on. I have had some fluttering for about 3 seconds here and there after my discharge from the hospital but I believe my stress plays a role in that. I’m so glad I ran into this site.
I also started having afib episodes when I was quite young. Maybe my second year of college and then they stopped altogether for years. I’m 33 now and the frequency and intensity of the episodes peaked a couple of years ago. I started seeing a cardiologist then who gave me metoprolol to take on an as-needed basis, and ordered that I come in for a check up every six months.
Shortly after this I started running and doing yoga very regularly and my episodes spaced out from every four to six weeks to now maybe two to three times a year.
The last two episodes I had I took a few deep breaths and then started doing some basic yoga…cat/cow, child’s pose, downward dog, and the episode stopped both times within two to four minutes. Absolutely incredible!
My episodes lasted 10 minutes or so in the very beginning and at their peak over two hours with my HR reaching well over 200bpm. The yoga seems to stop them almost instantly.
I discovered this after a terrible morning episode. The episode ended but my HR stayed slightly elevated all day until I got on my mat and did a yoga practice that evening. I checked my HR after finishing my practice and it was finally back in the 70s, so the next time I felt an episode come on, I tried yoga and it worked. Now, my last two episodes have been six months apart and both were stopped by yoga. Never even had to take the metoprolol!
I’m not sure if this is a thing, but nothing I’ve ever tried has been this effective. Hope it can help someone else!
Shayne:
Thanks for sharing your experience with yoga in managing your afib. That’s so awesome to hear it’s working so well for you.
Can you share the specific type of yoga you practice? Better yet, can you also share the specific yoga poses/exercises that you do?
Travis
I’m a 62 year-old female with A-Fib. I usually never know when I’m in it but these last 2 days have been nonstop and I’m getting nervous. I’m on coumadin, toprol xl and digoxin. I’m just hoping this will stop. I don’t believe I need to go to the hospital since I do take these meds. I called my doctor and he just left. I will try him again tomorrow.
Carol:
How are you doing today? Were you able to get a hold of your doctor? I hope you’re doing better.
Travis
Listen, I AM AFIB FREE NOW! I was in AFIB every other day lasting 8 to ten hours a day. I TOOK DILTIAZEM when needed for them. Was on Pradaxa and getting ready for ablation. Nothing helped or stopped them. I found my key and believe this needs to be shared. I am now med free and only take a low dose aspirin daily with no AFIB in weeks. I am on the keto diet, which is delicious and I have cut out all sugars and ALL sodium and anything that has it. I eat fresh meats, veges, nuts after I cut out salt I have been AFIB free! Please experiment for a few days eating unprocessed foods with zero sodium, you will be amazed! You can use seasoning with NO SODIUM
Thank you, I am at my wit’s end with this afib! I have had my heart reset 4 times and I have had the ablation surgery and still have major episodes. I have got to make major changes to my diet and soon. I’m 57 and still have at least 10 years before retirement. I have to keep on keeping on.
William:
Regarding your comment about having an ablation and still having “major” episodes after the fact, you may be interested in this article:
https://www.livingwithatrialfibrillation.com/3137/successful-afib-ablation/
Travis
It costs almost zero to try and straighten out electrolyte imbalance. Magnesium is inexpensive, a banana is cheap, and eliminating excess salt is crucial. Somewhere I seem to recall reading an article that suggests the average diet contains 10x the amount of sodium needed. If you’ve ever been on a treatment table for afib you’ll notice your blood sugar is checked. I am convinced a person can shovel down an ounce of medications and a combination of electrolyte imbalance, massive quantities of salt (electrolyte) and out of control blood sugar would negate 90% of the benefits of the medications. Secondarily, strokes are unforgiving. At a minimum get a pulse oximeter and regardless of how I feel a racing pulse in combination with an abnormally low O2 saturation means get to an ER fast. One slug of coagulated blood and the fat lady might start singing. It just isn’t worth it. For me, stubborn AF meant dosages of Amiodarone and that is one medicine that may take a week to start working. Controlling AFIB is just as much the patient’s responsibility as it is the cardiologist’s. I was fortunate and stopped AFIB with cheap magnesium. But it was not enough. I tossed the sodium, tightly controlled the glucose, and surprise of surprises — heart arrhythmia has now went the way of the passenger pigeon. Yes the pacemaker helped. Yes diet control helped even more.
My first AFib attack was last April in the middle of the night. I went to the ER and after about 1 hour I converted on my own. I saw my cardiologist (I live in Minneapolis) and we decided to do nothing at that point.
I have seen an EP at the same practice before for palpitations etc. and I have an appointment with him coming up in February.
Today I woke up at 6:15 and had my 2nd A-fib attack. I wasn’t as nervous but started to prepare things around the house in case I had to go to the hospital. I have a dog that needs care. I took a short walk. I took an atenolol 25mg (I usually take 12.5 mg at bedtime for palps). Then I laid down and did some deep breathing.
At around 8:15 a.m. I was out of afib. I felt awful all day from the meds and my heart was pretty irritable (lots of little palps and runs). Previously the cardiologist had said if I had another afib bout I could stay home for about 4 or five hours in a-fib before going to the hospital. After this bout today, right now, we are going to stay the course and keep my appointment in Feb with my EP.
2 questions: First, do afib bouts keep getting closer together or are they truly random? Second, I’m nervous about going to sleep as both events happened at night. I am pretty sure there is absolutely nothing I can do about that. I have stopped laying on my left side. I don’t know anything else to do at night.
I am racking my brain to figure out what caused the episode last night just like the first episode. I cannot come up with anything. I do have anxiety and my life is pretty stressful most of the time but there was not anything usual before either of these bouts. Last night I had a lot of sugar as my sister sent me Christmas cookies! That is the only thing out of the ordinary that could have caused this. Is it worth wasting the time trying to figure out a cause?
Thank you so much,
Linda
Linda:
Hello to a fellow Minnesotan. I live just North of Minneapolis!
To answer your questions afib is unique to everyone but the randomness of afib is its hallmark. That’s what’s so nerve wracking about it. It’s often unpredictable. The frequency of the episodes can be random as well. You may have a period where you have several episodes over a period of days and weeks and then total silence for days and weeks. And for many, afib progresses to persistent afib where you are in an episode for a week or more at a time and can’t convert to normal sinus rhythm on your own. When does this progression happen? Again, it’s random. Some may will progress in weeks – others in years (and yet others never).
I totally understand your fear about going to bed. Getting afib at night is totally common.
There are a couple things you can talk to your doctor about. Since you mostly get your episodes at night you likely have “vagal afib” which is afib that mostly occurs at rest and/or at night (or after eating). This type of afib does not respond well to beta blockers. In fact, beta blockers can make it worse (for some people – not all). As such, I would talk to your doctor about NOT taking a beta blocker. Here are some links on the subject:
http://www.afibbers.org/atrial_fibrillation/rhythm_control/B79a.htm
http://a-fib.com/faqs-understanding-a-fib-5-adrenergic-vagal/
Instead, I would talk to your doctor about Flecainide. This is usually the best drug for vagal afibbers. Furthermore, I would ask about taking it as a “pill-in-the pocket” – meaning you only take it when you have an episode.
Finally, if you have undiagnosed sleep apnea that could be an issue. Many people with afib have sleep apnea. If you have it and you treat it you can often times reduce the frequency and severity of your afib episodes. Here is an article I wrote about the sleep apnea/afib connection:
https://afib.newlifeoutlook.com/sleep-apnea-and-atrial-fibrillation/
I wish you well!
Travis
Boy, you got that right they are totally unpredictable and you can be in the best of health and still have A-Fib. I had been having episodes maybe 1 or 2 a year for the last few years. My episodes got closer which prompted me to mention it to my doctor in August when I went for my yearly physical. I wore a monitor for one month.
I had an episode at 11 pm the first night I wore the monitor. It lasted 11 hours and I didn’t have another until the day I took the monitor back. The monitor showed I had paroxysmal A-fib. I went to a cardiologist in October 2017 and I was diagnosed with A-fib. It just so happened I had an episode in the doctor’s office. He order a stress test for Dec 14. The test showed no blockage anywhere, heart looked good.
The cardiologist put me on 25mg metoprolol twice daily to slow heart rate and 325 mg aspirin daily. Mind you I had 2 CHADS against me. I was female and 65. No other issues. I had a physical done in August. My stats were excellent. My cardiologist cautioned that people who have A-Fib are at risk for a stroke. Jan 1, 2018 I had a cerebellar stroke. I am blessed it only affected my balance. I am in therapy for my dizziness and vertigo issues.
While in the hospital my metoprolol was cut down to 12.5 twice daily due to taking my blood pressure way down and a blood thinner was added (Eliquis) 5 mg twice daily. Since having my stroke I have had short bouts of A-fib which didn’t seem to concern my cardiologist or primary care doctor. Today, early morning I went into a-fib and as I write this I still am. I couldn’t have therapy this morning because of it. I go back to the cardiologist in April. I will see what he says.
For those who say cut out sodium and processed foods, I don’t eat processed foods, salt, sugar and eat only healthy fats.
Donna:
Thanks for sharing your story. I’m glad to hear you survived your stroke and are doing o.k. Keep us posted on what your doctor says in April. Be well in the meantime!
Travis
Cut out SODIUM!!! I am now AFIB FREE! I had very severe AFIB! No meds helped, I was on pradaxa a blood thinner and diltiazem when I had an episode. I follow the keto diet, cut out sugars, and SODIUM from your diet. Once I stopped eating sodium, I have not had another episode! It’s been weeks! Nearly everything has sodium. Try it for a few days!!! It’s a trigger for AFIB
Marla:
Thanks for sharing your experience! I appreciate it. However, I want to caution anyone else reading this that we are all different so what works for Marla may not work for you. In other words, for some of us simply reducing sodium may not make a difference at all. In fact I think there is more going on with Marla’s success. I doubt it’s just the reduction of sodium that is helping. Her overall change in diet is what’s working right now.
I want to point this out because I don’t want someone reading this to think all they have to do is reduce sodium and they’ll be cured. It doesn’t work that way.
Travis
P.s. Marla – I’m going to make a copy of this comment and put it on my blog post about diets for afib as I think your story will be inspirational. Thanks!
On Metoprolol 25mgs (2x daily) and 15mg Xarelto once daily. My afib symptoms are not relieved by this protocol. I feel worse now than I did before meds were prescribed. Metoprolol seems to control my heart rate and my blood pressure doesn’t rise too high during episodes (around 150/80) at times. Sometimes BP and HR are quite normal during an episode, but I still have frequent episodes.
I believe I definitely have vagal nerve involvement and must convince my dr. since beta blockers shouldn’t be prescribed for this kind of AFib I’ve learned. I stopped taking all my former supplements because of the limitations of the blood thinner. I’d like to know what supplements are most compatible with Xarelto.
I’ve started taking Magnesium again which I took before going on Metoprolol and Xarelto. I’d like to add vitamin D, omega 3, potassium, but Xarelto does not mention the use of any of these supplements as beneficial or detrimental with respect to a blood thinner, and I’m afraid to take them but fear I’m possibly missing out of any benefit I may derive with respect to my AFib.
My age makes me hesitate getting ablation since I’ve had it many years and apparently it is not as successful in my age group and for those who’ve had it for several years. Possibly risky as well?
Christime:
As far as I know (and you’ll want to do your own research to confirm this), there isn’t any contradictions of vitamin D or potassium with Xarelto. Omega 3 (i.e. fish oils) does thin the blood and that one you’ll want to be careful with. When I was taking Eliquis I cut my omega 3 down to two capsules per day, which was about 2g of fish oil per day. My good friend, Steve Ryan of a-fib.com, wrote a brief article about taking krill oil (a type of omega 3) and Xarelto together. You can read it here: http://a-fib.com/faqs-minerals-supplements-krill-oil-with-eliquis/
Eliquis and Xarelto are the same type of blood thinner. They are a NOAC (Novel Oral Anticoagulants), a Direct Factor Xa Inhibitor.
As to your comment about being too old for an ablation, that’s not true at all. However, you’d want to make sure you go to the most experienced EP you can find. Less experienced EPs will probably tell you you’re too old because they don’t have the skills and confidence to help you! An experienced EP, one that has experience doing ablations on complex cases of afib, will have the skills and confidence to bring you relief!
Travis
Hi Travis:
In your response to Christine on 12/19/17, you stated “when I was taking Eliquis….” Do you still take Eliquis? I am on the drug, and I really wish not to be. The expense is outrageous, and I feel the same way now as when I was just taking an aspirin a day.
How did you stop taking it? A gradual weaning, or an abrupt quit?
My GP won’t support my request to drop Eliquis. I think it’s a matter of not contradicting another doctor’s prescription (cardiologist). Maybe I’ll have to just see a different cardiologist.
My afib episodes are every one to three months, 8 hours per event. Thank you for your posts. They are very informative, and it makes me feel there’s an actual A-Fibbers Club that I belong to!
Janis:
I don’t take Eliquis anymore. I was only on it a short time before my ablation and for a short time after my ablation. All told, I was only on it for about 3 months.
When I stopped taking it I just stopped. I didn’t wean off of it at all. I just quit immediately when it was time to stop.
Having paroxysmal afib like you have makes it tricky to decide if you should be on a blood thinner. Given your age and sex gives you a CHA₂DS₂-VASc score of 2. That is the hardest score for a doctor (and patient) to determine if blood thinners are appropriate or not. It’s not an easy decision to make.
Travis
Another one – stopped afib episodes…
Mexico is the land of sweet and salty. In August, Eduadro’s mother went 190 miles yet again to the hospital. 10 episodes in just a couple of months. He relayed a bottle of magnesium 500 miles to her and after taking 250mg day, she had one recurrent episode in early October. The episode lasted 10 minutes not hours.
Next step. NO SODIUM. No prepared or canned foods with added salt. Strict avoidance. Now, 2-months, and she reported yesterday the infrequent awakenings at night which she suspected were threshold events have vanished.
There is a relationship. Even with a pacemaker, I continue to have irregular heartbeat. With magnesium supplements no afib events for six years. But when I become foolish and eat salty food, my heart arrhythmia becomes very pronounced. Shame on me. I know better. Before the magnesium, say ten years ago, a single salt-cured pickle would trip an event. Now, I think and look at labels before I chomp.
It costs nothing to try and may reveal a drug-free way to improve your quality of life. Ask your doctor about adding a banana a day to your diet for potassium.
My pacemaker was installed because of repeated Bradycardia events including one that happened in a medical center ER. That and a 2nd blocked bundle branch were enough to tip the scales in favor of a cardiac metronome.
I had chronic very high blood pressure before the implant, even with low salt and magnesium. After the implant, BP was dramatically reduced. Yesterday, and for 40 tests* before that 125/70 with no cardiac or BP medications. The cardiac surgeon told me “I see this quite often”. Since my labs indicated very low mag levels I continue to take 500mg every other day.
*different MD’s using mechanical BP apparatus.
YES!!! I was days away from an ablation and starting a very dangerous arythmia medication. I CUT OUT SODIUM and I am now AFIB FREE!!!!! I now follow the keto diet (no sugars) and eat fresh meats, green leafy vegetables, and some dairy. But I now eat NOTHING with sodium and I am AFIB FREE!!! I am so thankful I found that trigger!
It would be great if you had an article to explain all the acronyms being used. EP? LAA?
Lots of others I can’t think of right now.
Teri:
Great suggestion! I’m going to work on that next. Be on the look out for it. In the meantime, EP is short for “electrophysiologist” (a cardiologist that specializes in the electrical system of the heart). LAA is short for “left atrial appendage” (a small pouch found in the left atrium). Thanks again for the article suggestion. I love the it!
Travis
I have been recently diagnosed with A-Fib after years of unsuccessful tests. After being diagnosed, I purchased the Kardia Mobile. In my opinion, that was money well spent. The medical staff at the hospital was very impressed with it.
I absolutely hate the feeling with A-Fib. I am scheduled for an echocardiogram on 12/18 because the last visit to the ER determined that I have an enlarged. I had to call and ask my cardiologist about having the test done. The ER doctor was surprised that I haven’t had one since being diagnosed in November.
I am very concerned about what is going on since my paternal grandmother has A-Fib and has had four strokes. My cardiologist, in my opinion, isn’t as concerned as I am. Am I over reacting? I’m new to this and have questions.
The medicine I’m on doesn’t seem to be working since I am still having symptoms and have been on meds for a month now. I take Metoprolol 25 mg twice a day. The ER doctor said I could take as many as four pills in a 12 hour period. Some days I have no issues all day long. The next day I have problems all day long. On A-Fib days, I’m exhausted, which gets really old!
Jenny:
You’re not overreacting at all. However, don’t let your grandmother’s experience with afib get you down as the treatment and management of atrial fibrillation has come a long way in recent years. By getting on this early, you are significantly reducing your risk of having a stroke!
Having the echo is a great first step but I would also encourage you to get a heart monitor from your doctor – either a 24-hour Holter monitor or a 14-day event monitor (ideally the latter option). The echo will tell you how structurally sound your heart is and the heart monitor will tell you how often you’re in afib. With this information you can work with your doctor to come up with an effective game plan.
If you are in a-fib a lot, or your episodes last several hours, and medications aren’t working for you, then there is always the option to have an ablation. Some people have a lot of success with drugs (at least for a while), while others don’t do so well on drugs (i.e. they either don’t work or the side effects are too much to handle). When drugs don’t work for whatever reason, the ablation is the best option.
I had a successful ablation back in March 2015 and I haven’t had a single a-fib episode since!
If you have specific questions for me, feel free to contact me.
I wish you the very best!
Travis
Jenny, can you clarify this, “ER determined that I have an enlarged”?
Interesting you were prescribed the least aggressive med for afib. Statistically, Metoprolol will NOT keep you out nor convert you from afib, only control your HR. However, Metop is critical to use with an anti arrhythmia such as Flecainide, which most likely would convert you back to NSR. I would mention that to your ER to at least have some relief from this condition until you make some difficult decisions about afib.
Travis and I have known each other in the virtual world for several years. We know each others trial experiments with this condition pretty well. His degree of attacks and severity of episodes vs mine were certainly more egregious. I believe we have tried just about everything there is to treat this including ablation.
We’ve both had many tests. Mine include all the medical ones and even a catheter scope. Blood tests for all the usual suspects, Mag, B12, etc. Always normal and even above the ND vs conventional levels.
I have tried most of 1-8 and more with no success but have self converted with supplements and a few maneuvers such as a short sprint or neck adjustment twice.
I had 2 years of zero afib with PVCs several times per week by using no less than 10 different supplements. The big 3 were Magnesium, C, and COq10. But then in Jan this year, wham, back with a vengeance. By May I had more episodes than all the 6 previous years of about 8. One ND had given up and suggested ablation. A new one also, but first a new test.
I also converted several times using 300mg of Flecainide with Metoprolol. I did consider ablation and was one month away, waiting for an EKG which was scheduled. I had considered Natale but chose Boston because Stevenson has a 97% success rate and is a 3 hour drive for me. Plus, my degree of afib was very simple according to Dartmouth EP.
Of course that never happened. And since July, stopped all supplements. Very little Mag or Vit C and just some basic seasonal ones unrelated to afib. The last test was a saliva adrenal for cortisol levels. The results took forever, 2 months, but just before EKG. Off the charts high at night, most episodes occurred then, surprise, very low during the daytime, constant fatigue.
Two supplements in the morning, two at night and no afib, PVCs virtually gone and changed absolutely nothing in diet or life style except zero alcohol for 1 and half years. Worth a shot for everyone with a-fib to check their adrenals. With that said, this will be my last natural attempt to cure this condition.
I have thought of the high cortisol at night issue ever since I was in the hospital two times in August with no success at stopping my A fib until the end of the second visit. On the 4 th day of that 2nd visit I finally got a cardiologist. I was given digoxin and within five minutes my heart rate went down to the 60s from 115-129. The next day I was released. But no one told me that was not a permanent fix. If I stop the digoxin, the A Fib will come back. If I stay on .25 digoxin, it does go into normal sinus rhythm. But the side effects of digoxin are awful.
I will pursue that now, thanks to your comment. I am positive I have a problem with high cortisol. I asked to be checked for that often, and my cardiologist said it was not necessary, the hospital drs said it was not necessary, etc. Why don’t they listen to me? Do I have to get all my degrees and credentials out for them to see? It is frustrating as well as life threatening. I am so grateful for this Web Site.
“my cardiologist said it was not necessary, the hospital drs said it was not necessary, etc. Why don’t they listen to me?
That’s a great question. It is your heart and life after all. Yes, those pesky side effects. That may be the least of your worries. The fact is most meds stop working after a time. The ultimate goal is to get you to the gold standard of ablation. I’m not against that procedure, Travis had a successful one, but when you get into my age group and older, the success rates aren’t much better than med protocols.
James:
I would just add that the “gold standard” exists. You just have to go to the right EP. If you go to an experienced EP, and admittedly they are far and few between right now, the success rates for older people is just as good as they are for middle-aged folks like me.
Travis
Travis, I hope youre right. Im way past the unknown dangers long term vs the nightmare of dealing with afib on a regular basis.
We all know Natale has the rep for it, but no one lives forever. There has to be a way to better equip all EPs to rock star status.
James:
And that is the key – getting all the EPs across the country “up to par” with the likes of Natale. Dr. Natale actually spends a lot of his time training EPs and traveling across the country at various conferences educating the EP industry as a whole. For example, Natale and his group were pioneers with LAA ablations. Slowly but surely the busier EP centers across the country are implementing the LAA ablation as part of their standard procedure (only when a LAA ablation is warranted of course).
Prior to Natale (and other rock star EPs) educating the EP industry about the LAA ablation, EP centers would just ignore the LAA. They either didn’t know about it or they didn’t have the skills to touch the LAA. Again, with time and education from the likes of Natale and other “rock stars” in the industry, the LAA ablation is becoming more and more common (which is a good thing since approximately 30% of afib cases have triggers coming from the LAA).
What people don’t understand is that “successful” ablations aren’t due to equipment and tools. It all comes down to the skills and knowledge of the EP. We already have the equipment needed to perform successful ablations (although there is always room for improvement). What we lack more than anything right now is skills and knowledge. EPs have the tools, most just don’t have the skills or knowledge to perform durable and long-term successful ablations.
Travis
Travis, agree with training if there is a direct correlation due to varying degrees of experience as PVI has some serious limitations with LAA. As you know I’m neither against or for ablation, or any specific procedure for curing this condition. I’m hopeful for something better. Right now, ablation is still a procedure of treating symptoms vs finding the cause. Some are left with daily PVCs, higher HR and fatigue issues, but no afib. That’s the good news. Though better than daily meds, I believe there is little difference when comparing mortality rates. The issue becomes quality of that life with varying degrees for afib. Mine is quite manageable right now and ablation is the furthest thing from my mind. Yours, ablation was obviously the best choice.
James:
Thanks for the reminder to check adrenals. I still have to have mine checked. The darn saliva kit is still collecting dust on my desk (literally). I don’t know why I keep dragging my feet.
Glad to hear correcting your adrenals have helped so much. That’s so awesome to hear!
Travis
It’s been 9 months since being diagnosed with A-fib but I do believe I have had it for a few years not knowing what it was. I was diagnosed with sleep apnea and my cardiologist believed my A fib was cause by that (I have a machine and use it every night now). I am on blood thinners (xarelto 20 mg and apo-metoprolol 26 ml).
I was doing real well for about 4 months then I was having some digestive issues and was sent for a barium swallow x-ray. Since that test (about 4 hours after that test I went into Afib for a long time with irregular heart beats), I have been having a-fib attacks at least 3 times a week and having arrhythmia heart beats regularly.
My x-ray showed I have a small digestive hernia and gerd. And when I have these a-fib attacks now, I know when they are going to happen, it’s tied directly to my digestive system. If I eat anything that upsets my stomach, or I have heart burn, I go into Afib. I am terrified to eat now (I’ve lost 5 pounds).
I have an appointment with a gastroenterologist specialist in December. I just don’t know what to do now. Could my digestive system now be causing my Afib? What are my options? Is having 3 to 4 episodes a week excessive? Do I bring this up with the specialist? Do I go back to the cardiologist? Is this common?
Darlene,
From several experiences I have had, I think our systems can be set off by a variety of events from Treadmill stress tests to what you went through for testing your digestion. You probably had a heart monitor with leads while they made you drink that awful stuff. Your system was stressed, your gut was already off, drinking barium, then getting zapped with xrays all the while you have leads sending minor electric current going through your heart for monitoring. When you think about it, there is plenty of reason for your afib to kick in.
I get your panic. I too was going crazy with the symptoms and when it was too apparent to deny, I had to start asking… no telling my doctors that it came on from my stomach. It was not until we (hubby and I) learned about the vagus nerve and then it was obvious I had a vagus trigger.
As for what to do, my opinions are just that but you need to have some idea what to do or it will just make you more scared. Having your heart doing the jig in your chest is disconcerting to say the least.
Anyone that has additional/different ideas, speak up. This blog has been the best thing on this planet for me and other afibbers in limbo.
Your questions (Q) are here with my comments/opinions (MO)…
Question (Q) -Could my digestive system now be causing my Afib? My Opinion (MO) – Yes, a major nerve is right there where your heartburn comes up, called the vagus nerve. This pup is great for a lot of things but can cause a whole lot of problems if it is sensitive. For me, really cold food, or really hot food would set my heart off on an afib episode for hours. It would set me off before I even knew my stomach was upset. The gas building up put pressure on the nerve and off I went into afib land, generally for hours.
Q – Is having 3 to 4 episodes a week excessive? MO – It depends on how long it goes on. If they are a couple of flutters, then it can be typical but if it goes for hours on end, you need to take action.
Q – Do I bring this up with the specialist? MO – Yes, but don’t ask about it, most of the time you will have to educate them on your symptoms and triggers and don’t let them explain it away with some pigeon hole answer. This stuff is out of the box for way too many Dr.s.
Q – Do I go back to the cardiologist? MO – Since this is something to do with the body’s electrical system, see if you can get a referral to a Electrophysiologist that deals with both the nervous system and the heart. They are cardiologists but will be more familiar with the vagal trigger. Just don’t let them talk you into something that may be too advanced for your condition. Also, vagus nerve trigger afibbers can be further exasperated by beta blockers so don’t let your dr prescribe them for you.
Q – Is this common? MO – From reading this blog, this is much more common than I thought. If you are in the USA, doctors do not believe in the European studies that recognize a vagus nerve being a valid trigger. In my situation, I had to educate my last cardiologist and still got so much resistance that I moved on to someone that seems to know more about it.
Q – What are my options? MO – Read the points at the top of this blog. The important ones in MO are the hydration, the magnesium and potassium, and then while you are in episode, try the maneuver they talk about. Magnesium is/was big for me. BUT too much (450 in one pill) will give me cramps and the runs. I do 250 2x a day. That has helped a lot. Drink as much water as you can gulp at a time. It helps get more volume down. Don’t eat things that you know will set you off until you know that you have it under control. Last breathe deep. Lack of oxygen is big. If you have sleep apnea, lie on the side that won’t set you off. If you have heart burn, sleep slightly more propped up. Don’t cross your arms over your stomach when you sleep, the pressure would set me off.
There are a lot of helpful tips in this whole blog…
Good luck, stay sane, it will be okay if you don’t stress over it.
Thanks very much Dannie. Your explanation of the situation and the way you take care of it exactly how I do it. Excellent summary of the Afib.
I have so called pill-in-the-pocket and use them when I get into a AFIB, but I strongly believe that digestion and gas have to diminish for me to go back to normal. I take organic apple cider vinegar in a warm cup of water, 1/2 hr later small amount of Manuka Honey, digestive enzymes, and for sure Magnesium. I had it for 10 years. I started with fermented foods lately, Kefir and Regulat also provides friendly bacteria and good for digestion. Regards, S.A
MSG is recognized by many people as producing afib along with other food spices and salts. I would say be aware what are you eating and how your heart reacts after!
I have afib 36 female no other health issues when I have episode I put my thumb in my mouth and I blow and lay down I can break it. Hr 170-200 I hate it it’s awful. Always starts with a run of pacs. I take no blood thinners. Doctor said low risk just Xanax and propranolol when needed. I just hate living my life in fear.
Barbara:
I hear you. Afib stinks – plain and simple. And while it’s easy to tell you to live in faith and not fear, I know it’s much easier said than done! Still, though, I encourage you to strengthen your faith.
God Bless,
Travis
“You can’t have a shortage of magnesium, it’s the most common element on earth” A letter per letter verbatim quote from an ER doctor, Sebastopol, CA. I argued, blood was drawn, two hours later he showed up with an Rx for Magnesium 400mg. You are responsible for doing your own homework – not an ER doctor. A friend’s mother down here south of the border was having one episode occasionally two per week. Nowhere to turn to — so I gave my friend bottle of 250 mg magnesium tablets. A week later, she had it in her hands. She started off on 500mg day and a week later reduced it to 250mg.
That was last JUNE! Afib for three years continuously, then nothing more after taking a maintinenance dose of magnesium. I recommended further she DRASTICALLY reduce her intake of not only salt but any product containing sodium. She asked “me” if she should discontinue her Rx of Diltiazem. I told her absolutely NO unless her cardiologist whom is 260 miles distant round-trip, specifically directs her to. She lost 40 points diastolic and 17 points systolic simply by cutting back on sodium intake.
Patients need to take a more active role when working WITH their physician. It has been 6 years since my last Afib event and that sole event was caused by me packing magnesium in the trunk of my car so deep I did not take it for two months. Before that, I had gone years without an Afib event.
Here are a few questions for the good doctor :)
I had pains in my chest and was treated for it in multiple USA hospitals. The only thing that seemed to work a little was Rx Isosorbide Mononitrate. Then one day an Rx presented me with office visit paperwork and quipped “By the way, did you know you have severe anemia?” An hour later I found myself at a supplements counter purchasing iron and folic acid. The next day the 24/7/365/7-years chest pain disappeared and I felt turbocharged. Gee, don’t red blood cells carry oxygen to the heart muscle? I have been chest pain free for eight years now. And my CBC’s are normal. So is my magnesium
This gets better…
I suffered terrible inner ear infections for five years. I am now deaf in my left ear. Suddenly the chronic (treated with Augmentin) infections ceased. What did I do? Anything? The tiniest thing? No. Wait. YES! I had gotten a pneumonia inoculation. WHY? WHY did they cease. It was up to me to research Journal of American Medicine articles to note COMMONLY UNDERSTOOD INFORMATION that an inoculation against pneumonia commonly CURED frequent inner ear infections in adults. This stuff is all based on USA accredited Medical Center exams, and specialists whom have proved subsequently that they knew nothing of the JAMA study and conclusions.
After being at odds with various cardioligists for several years over my 24/7 irregular heartbeat and the need for an evaluation so see if a pacemaker was “indicated” I showed up in the ER in Chula Vista California when an attack of Bradycardia was underway. A pulse of 42. They got to see it in person. After 5-years. After showing them with images the ridiculous events recorded on my cellular.
This was in August. I was evaluated for two days. The surgeon decided a dual electrode atrium/ventricular pacemaker was the best way since I had two of the three bundle branches blocked to the A/V node. Was it worth it? The pacemaker? My blood 02 went from 93 average to 99-100. I felt better. When I got home I could not believe my eyes. My fourteen years of elevated hypertension had VANISHED. The cardiologist had eliminated Diltiazem from my personal formulary but RX’d metopralol on a PRN basis. Taken as needed. Now three and a half-months later, the 180/110 BP values are gone, replaced with 130/80. I continue to take Lisinopril to protect my kidneys. But no other BP medication. I strictly control salt and supplement with minor potassium and moderate zinc.
If you suffer from Afib I recommend this: Enlist the services of an INTERNAL MEDICINE doctor. Even though you may have a regular MD and cardiologist. I have suffered medicine by rote cardiologists and medicine by rote internal medicine doctors. I changed doctors. If they act bored treating you it is a BAD sign. Find one with a little enthusiasm for your health and well being, even if you have to drive to another town.
Ask the internal medicine doctor to do a full workup on your blood and urine. Include all electrolytes. If you suffer no liver or kidney diseases and show borderline electrolyte results, get an OK from the internal medicine doctor then try elecrolyte supplements. If they work they work. Nothing ventured nothing gained.
Much of my inner ear issues were and are are now caused by acute blockage of the Eustachian tubes. They have had blockage issue for decades. So I did research and uncovered a medication that had never been discussed with me – Montelukast, So in 10 days this gets discussed with my internal medicine doctor.
Just showing up in a doctor’s office, does. not. cut. it. A patient should actively participate in their healthcare. Note that the words “participate” “over ride” and “ignore” bear little resemblance to one another. Do the studies. If you find provenance with a possible treatment (AMA, FDA, Mayo Clinic, JAMA) print out that article and take it to your next visit.
I did exactly that with the JAMA / Middle Ear Infection / flu inoculation issue. “A GP read the article: and remarked “I find this very interesting. Thank You”
David:
An excellent comment. YES YES we all must do our research. I learned a long time ago that lack of magnesium is the leading cause of A Fib.
And in today’s medical world they are using the WRONG test for it. It shoud be RBC magnesium, not serum magnesium Only 1% of the magnesium in our body is in the blood, the rest is cellular.
A great book to read on heart health is by Sherry Rogers, M. D. “Is Your Cardiologist Killing You?” Did you know that magnesium is nature’s natural calcium channel blocker?
Also that natural vitamin E with all 8 parts of tocopherols and tocotrienols is an excellent anti coagulant. I have taken natural E for at least 30 years now, and my mother and her brother took it starting in the 1940s. I have researched heart helath for the past 13 years( when I had by pass surgery). My PT levels(the indicator of how well our anticoagulant is working) is 16+ well within therapeutic range.
I am very impresssed with this Web site – it is very well written and I have learned a lot from it. Travis has gone to a great deal of work and expense in maintaining this site for only ONE purpose – to benefit others who have the issue.
And thank you for elaborating in the types of labs necessary to determine levels of magnesium in the body. There are a lot of scoundrels hawking supplements these days. I call them scoundrels because on one forum after I mentioned magnesium they started a kumbayah about the need for “special” types of magnesium “optimum balances of the multiple available types” and one foolish individual had the gall to state “You did not take the right ‘balance’ of magnesium, therefore your experience was nothing more than a coincidence.” These are the kinds of charlatans that give truthful and helpful information about medical issues and nutrition supplements a reputation bordering on witchcraft.
I do not need to spend sixteen dollars for gel cap magnesium sulfate. I purchase mine at WalMart or online. Magnesium Oxide. For one-fifteenth the cost. Normal lab results magnesium level is normal level.
I cannot stress hard enough the need to drastically reduce salt intake. My kitchen contains salt in only one seasoning mix. Costco sells a Kirkland signature salt free seasoning that is a favorite of mine.
Blood sugar control is vital. Which means diet is vital. I can eat a gigantic bowl of ice cream or a merely large bowl of rice or corn and the numbers peak out the same — astronomical. For myself, fat and fatty foods acts like a coating on glyburide rendering it ineffective. Sugar coated, fat saturated and hair raising salty bacon has got to be one of the worst foods for mature folks in the world.
Blood coagulation: Afib comes in forms of rather light, a middleweight or heavy slugger. Severe a-fib needs to be attended to quickly. My symptoms are extreme weakness and feeling ill. That happened only a few times long ago. The longer afib affects blood flow the more chance there is of getting a coagulation in the bottom of the heart chamber. So intense afib that lasts longer than an hour is incredibly more serious than a lightweight ten minute episode.
And the issue is complicated by the response time of an individual’s blood to coagulate. If I cut myself I bleed like a stuck pig. I use aspirin, long term NSAID therapy for a herniated disc and Ginko. The cardiac surgeon demanded “No aspirin, no NSAIDs nor Ginko for two days before your pacemaker implant — they may love coumadin but they respect my personal choice of blood thinners.
Many folks have problems trying to sort this all out. I recommend, painting by the numbers — chop sodium, control blood sugar, try 500mg of magnesium daily OXIDE for a week. Then it’s off to the doctor for lab electrolytes. The individual who suspects gastro-intestinal influence should follow her instincts — and ask the doctor to check for the H. Pylori bacterium in her gut.
GERD is one heck of an irritant and irritants can sensitize the heart to malfunction. Even with a pacemaker if I get too little sleep due to old-codger-insomnia, my heart beat gets irregular. I know what causes it and I would be a fool not to do something natural to correct it. So I nap (with my BiPAP).
All that I have is genetic. So much so it is ludicrous to think otherwise. I have already lived longer than my father (knock on wood). And my mental process has not degenerated. He contracted macular degeneration 10 years before he died. That scares me into being religious about blood sugars.
Take charge of your part of the health care program and live a better life!
I usually go into afib once a month and it lasts for about a day or so. One thing I have found to help get me out is a hard sneeze especially if I can hold my breath a little bit. I have used pepper to help induce the sneeze but sometimes breathing the pepper doesn’t produce a deep hard sneeze.
Mike:
I never thought of a pepper-induced sneeze. Thanks for the tip!
Travis
Try tickling inside a nostral with a Q-tip or feather.
I see this is nearly a year old, but I thought I’d share how I discovered that I can make myself sneeze. I run my finger down the side of my nose just past the bone. Then I push the cartilage sideways. Hold it there for a little bit and I can almost always get a sneeze out of it. I don’t know if it works on everyone. My husband can’t do it.
I’ve been diagnosed with AFib for 11 months now, but I believe I’ve had it for about a few years. It started out once every four to six months (my last cardiologist was not good) and then it got worse.
Now I’m on bystolic 5 mg, htn meds, and eliquis 5 mg 2 x a day. This works well for me. I’ve done research and found out holding your breath and bearing down as if you’re having a bowel movement will reset your heart. It works for me – plus a cup of strong hot or cold chamomile tea. I keep plenty of that in my house and on my job. I will try liquid magnesium vitamins because liquid absorbs faster.
Thanks Travis and T.Ford for your comments and suggestions. While that episode lasted much longer than I liked (about 8 hours) I can happily say I have not had one since.
T, thank you for the new tip. I will try it next time I fib!
The two things that make a difference for me is to stay hydrated and taking my pills at the same time everyday. Magnesium is a biggy as well.
Here is my next question… What I have read in this blog so far sounds like nearly everyone has the vagal trigger. How many of you that have a vagal trigger, has a Dr. that is knowledgeable about it?
I ask because, as I understand it, while this is a big diagnosis amongst afibbers in Europe (30%) it is not recognized in the US. The medicine prescribed is different too for this type of afib.
My cardiologist told me that he was not familiar with it and wouldn’t recognize it because it was not done here in the US. I had to show him an article to educate him. Needless to say, he is not my cardiologist anymore.
Lastly, I have read the article that aspirin is the worst for afib which I have been on forever. Soooo what is best? Least amount of side effects is what I am most concerned about. I have low blood pressure and am really sensitive to meds so all of you that are out there on a blood thinner, which works best for you and doesn’t cause other issues?
Thanks everyone! I am glad to have found this blog. Like Kathy, I can finally talk about this to others, and learn things from your experiences!
Please look into natural vitamin E with 4 tocopherols and 4 tocotrienols. I have been on this for 15+ years. It is anti clot, anti coagulant, anti cancer and has no side effects. It must be NATURAL. There is a synthetic version and it is worthless with negative side effects.
I have had paroxsmal A-Fib for four years. I have never needed Heparain or other big pharma anticoagulants. My PT levels are 15.00+ which is in the therapeutic range.
I also just had a terrible experience this weekend I would like to pass on. BE AWARE that eating too much (for me it was only 8 sticks) black licorice candy as it can cause an irregular and rapid heart heart rate. For some, it is a trigger for atrial fibrillation. Fortunately for me it did NOT trigger an attack, but I went through a difficult night dealing with the symptoms. Finally took an extra 25 mg Coreg and I was able to go back to sleep.
Yes, black licorice can definitely be a problem for people with atrial fibrillation but it can also be a problem for the average person. This article discusses the “dangers” of eating too much licorice:
https://blogs.webmd.com/breaking-news/2011/10/black-licorice-dangerous-candy.html
Travis
Chamomile tea is a natural beta blocker – not surprised that it helps! Do you know that magnesium comes also in patches? However, I have yet to find any in 100 mg+ doses. ( You can Google “Magnesium patches”). You can make a paste of the magnesium powder and put it on your skin and it will absorb or better yet, get a magnesium oil spray and it absorbs well through the skin.
Lastly, Travis, when you have a chance, can you tell us what places in the heart the doctors ablate when they do the ablation process? Thanks.
I listened to the heart beat tonight again, and it is so calmingl Fortunately my heart rhythm is normal the 60’s and am praying it will stay there. Am pumping my magnesium!!
Karen Williams (Berardo)
Thanks for the tips.
I use the Kardia that has a ECG or EKG feature with a finger monitor. It is great. It helps me see how bad my heart rate is.
I will get afib every few days that will last for hours. The only known trigger is my stomach. If I eat something too cold or too hot, or my stomach does like something I ate I can get afib and it will last for hours. The Kardia marks my heart rate at 120-145 bpm. I had a horrible episode where I could not function and by the time I got to emergency I was at 180 bpm. That was the only time I was so bad I had to go to the ER. I was way over stressed on that one for weeks prior and I had a stress (treadmill) the day before that was normal. All was too much for me and I woke up feeling horrible.
I am on flecainide now with diltiazem, a calcium, blocker as kicker if it goes on too long.
My question is with a vagal trigger like mine, what is the best way to make it stop? I am in afib now, going on 5 hours at 138 aver BPM. I have taken 2 flecainide a while ago and just took one. I have done your suggestions short of the breathe into a syringe thing. Any other tips besides going to the ER? This is a typical episode and would like to find a way to stop it from going on so long.
Thanks in advance for your opinion.
Dannie
Dannie:
I’m crossing my fingers that you’re out of afib by now and that you didn’t have to go to the E.R. You’re taking all the drugs I would suggest you talk to your doctor about when you have an episode (i.e. flecainide, diltiazem). How long did this most recent episode last? How long do they typically last? I know you said “hours” but what does that mean specifically? Is that 6 hours, 8 hours, etc.?
Given how often you are having these episodes, I would strongly encourage you to consider having an ablation. If you have any specific questions about that, let me know.
I hope you’re doing better by the time you are reading this!
Travis
Your symptoms are very similar to mine. I will let my afib go for two hours. If it doesn’t stop I will take one 25mg senna laxative (Wal-Mart Equate brand). My afib will stop within one to two hours. For me, this is 99% effective.
I have had great success with listening to a slow heart beat to slow my heart rate down. I have not been in A Fib at the time, but two times now when my heart rate was up to 95(from normal of 72) I listened to the heart beat on this Web Site and within an hour the rate went down to the low 70s. I keep the Web Site a click away on my computer so I can get to the heart beat sound! Thanks for putting that on there!
I had several attacks of A Fib 2-3 years ago and I was diagnosed as having severe hypothyroid. This is not as well published as A Fib due to hyperthyroid. Since my thyroid has been normal, no more A Fib. However, it has occured two times when I was dehydrated, and all I needed was 500 ml of water to stop the attack which lasted about 10 minutes.
I was told by two ER doctors and my cardiologist that if your A Fib (over 120 HR) goes to two hours, get to the ER. It takes at least two hours for the blood to accumulate in the atrium to a point where a blood clot can form and go into your bloodstream to your heart or brain.
Karen:
I’m so glad to hear the heart beat track has helped you! That’s awesome!
And you bring up an important reminder to us afibbers – get your thyroid function checked. A “malfunctioning” thyroid can definitely be an afib trigger.
I wish you well!
Travis
I have just been diagnosed with Afib 6 months ago. I am on a blood thinner/heart pill to regulate my heart rate and high blood pressure pill. I have a blood pressure monitor with a heart rate. I am a 52 years old female. I was getting episodes about once a month.
I was recently diagnosed with sleep apnea and I have a CPAP machine now. I am not doing well on the machine and finding it hard to adjust. I am having episodes about 3 times a week and not sure if it’s the sleep apnea machine or something else.
I also take my blood pressure when I am having an episode and my pressure goes crazy – up way too high and then 5 minutes later, way too low. My heart rate is about 155 beats per minute. My episodes last from 2 hours to 8 hours. I am not sure if I should go to the ER when this happens. It wipes me out. My highest blood pressure was 159/120 and lowest was 80/50 within 8 minutes of testing. Is this normal? Is this what my life is going to be like?
Darlene:
It’s definitely not “normal” to have such wide fluctuations in your blood pressure. It could be a combination of many things – your afib, the meds, sleep apnea, etc.
The first thing you’ll want to do is address the afib. Fifty-two is relatively young so I wouldn’t rely on drugs as a long-term solution. I’d strongly consider having an ablation by a highly qualified and experienced EP. An ablation is your best shot at a long-term cure but only by an experienced EP. If you decide to go this route, contact me directly through my website here as I can give you some additional information about this.
I’d continue to work on managing the sleep apnea with the CPAP machine and try to eat a diet that will help lower your blood pressure naturally. You may also want to look into various supplements to help manage your blood pressure as an adjunct to your blood pressure drugs.
If you have any other questions, let me know!
Travis
Hi Darlene,
I recently underwent an ablation in Feb of this year and it was the best thing i ever did. I was diagnosed about 4 years ago with Afib put it did not become a serious problem until last fall. Like you i was unsure when i should go to the ER. I have had 3 cardioversions between Oct-Feb before my ablation.
I asked the question in the ER on one of my visits when do I have to get to the hospital. The answer was: if HR is over 120 and you are asymptomatic – i.e. no chest pain, no palpitations, no sweating, etc. and it continues for 2 days – get to the hospital. If HR is 120 and over and you are symptomatic do not wait -get to the ER immediately. The ER nurse advised they used to say if HR was 100 go to ER now they say if it’s 120. Trust your gut, if it doesn’t feel right it probably isn’t so get to emerg. Hope this helps. Good luck.
Hi Travis,
Just a update I want to post… I was diagnosed with severe sleep apnea and would have 28 stop breathing in an hour and sometimes it would last about 2 minutes. I received my machine on June 6…. and was having Afib episodes often (heart rate over 150 bpm , throbbing in my chest and blood pressure crazy) in the First 2 weeks on the machine. I was having episodes daily until June 18 (my last episode). I have been episodes free since, I am off my high blood pressure pills and only taking the heart pills and blood thinners… I see the cardiologist in September so I am hoping for even better news.
Darlene:
Thanks for the update (and sorry for taking so long to respond to you). I’m so glad to hear things have improved for you. I look forward to hearing what your cardiologist says this month. I hope it’s nothing but good news!!
God Bless,
Travis
A new quest for me, checking my adrenals. I can list the results of this $120 test but basically, my cortisol levels are high at night, low in the daytime. Not a good thing for our condition. After no episodes for over 2 years, then 8 this year, ablation talk was about 25% on the table.
So, I did the saliva test for the day, stopping all caffeine which I’ve since curtailed dramatically, and the results provided ND with a protocol. I started in April so it has taken some time and 4 episodes of afib. Since that time I’ve dropped nearly 20 lbs and 4 inches off my waist combined with a 30 min workout each morning and no episodes this month, nary a skipped beat either.
For adrenals I take some pretty strong supplements. I stopped the T, it was raising Estrogen levels too much and moved to 10 mg DHEA and 2 caps of HPA adapt. At night, “Cortisol manager” and Phosphatidyiserine reduces stress levels. It makes sense because I am 90% nocturnal when it comes to my episodes.
James:
Wow! You’ve made some serious lifestyle changes to drop 20 lbs. Good for you! That’s awesome.
What specific adrenal test did you take? Do you recall the name of it? My ND is encouraging me to do a similar hormone test. I don’t sleep very well at all and he suspects my cortisol might be messed up.
Are the supplements you are taking correcting the cortisol issue?
Travis
These are very helpful. I am beginning to suspect lack of Potassium as a trigger. My AFIB usually lasts 2-8 hours. My pulse rate will be pretty normal. De-hydration and exercise are usually the triggers but not always. Alcohol does not seem to be a trigger for me. If I suspect it is de-hydration I sometimes have a lite beer. I know this is wrong but beer hydrates at least temporarily. I tend to have some anxiety and a beer tends to calm me down a bit. The carbs help a bit if my blood sugar is down. I admit this is very likely all in my head but it has worked within 20 minutes more than once. I’m not recommending just saying.
Doug:
A beer to convert into NSR…interesting. That’s a first, but hey, if it works for you that’s great. Although as you’ve pointed out, I suspect it’s more of a placebo effect.
I wish you well!
Travis
I have found a cold glass of milk stops the pacs you get before going into afib.
Raymond:
Thanks for sharing your experience. Milk has calcium and calcium is an electrolyte so I’m not terribly surprised that it works for you.
Generally speaking, however, calcium can excite the heart. Many afibbers actually go into afib after too much calcium.
These electrolytes need to be “perfectly” balanced for us afibbers so when one gets high or low, afib can be triggered (or stopped).
Travis
pacs?
Alison:
PACs stands for Premature Atrial Contractions. These are premature heartbeats that originate in the atria. They are a kind of heart palpitation that you might feel. Generally they are harmless but for some they can lead to an afib episode.
Travis
Thank you Travis for sharing your understandings. I’ve found this site incredibly helpful. Noticed you haven’t been around for a while. Hope you are ok.