the thread of ATRIAL FIBBING

Hope this goes smoothly!

ok so i went into barts cardiology on monday at 10am and smoothly is how it went and i am now out and in day two of recovery post-cardioversion (which i called a "repeat fibrillation above lol: not its name no, fibrillation is the name of the monster) -- in fact despite lots of boring waits* i was out by 6.30pm same day

i: barts was eerily calm and unpeopled compared to any other time i've been there -- never more than two other ppl on the ward, waiting either for cardioversions themselves (very quick procedure) or pacemaker box changes (longer op tho perfectly routine)
ii: nurses etc all cheerful and professional, not at all a stressed environment -- i was due to be sorted super-quick but apparently then bumped by an emergency post heart-op arrival who'd fainted at newham and been transferred… most of my entertainment all day was listening to phone discussion which of newham and barts needed to hold a post-op bad for this person
iii: also eavesdropped: that barts had not had an actual official COVID patient since the bulge in march, tho of course they were testing everyone on entry
iv: thx to newham fainter i wasn't seen till 3ish having arrived at 10 but as noted the procedure is p quick: wheel me to a lab, sedate me, zap me -- sedation wasn;t full anaesthetic, so i was conscious but very far removed from anything going on. my memory of the actual electric shock is a comically cartoonish silent bump in which every item in the room flew up the air and settled again. i suspect this is not what happened.
v: one zap and my heart was normal sinus waves again, first time in 18 months i think. they told me before that they'd try three times before giving up: but it was just one and worked, so hurrah! the first cardioversion i had -- possibly discussed upthread -- i was fully asleep, they tried it three times and it didn't work ("you have a stubborn heart mr s") and i also got a mild red iron-shaped scorch mark on my back from a shock-paddle lol, tho a bit of savlon sorted this out quickly. this time i dodged all of this and was back on the ward and fully awake (no driving or heavy machinery** for 24 hrs!) by 4pm.
vi: so now we just wait and see how long before it reverts to weird shit, 3 days 3 months 3 years? it may not revert! but i suspect it probably will -- something in my structures pushes towards it. but fingers x-ed…
vii: anyway i am back and beefing calmly as i normally do, hullo ilx

*yes i took in a cpy of the LRB to while away the time, no it never left my bag
**what does heavy machinery actually mean in this context? (i will never google "heavy machinery")

nice to have you back, sir :)

that heavy machinery in full

https://d2rd7etdn93tqb.cloudfront.net/wp-content/uploads/2017/05/ripley-power-loader-aliens-051617.jpg

👍

I read this thread a couple days ago and was hoping they weren’t re-fibrillation you!

genuinely feeling better since the cardioversion: less tired and sluggish, much less sense that my heart is like skittering and bumping. i'm off caffeine again (my choice, the consultant says it's not relevant but for all its benefits it makes me jittery and anxious)

the arrhythmia may come back (it may already be back, i often wasn't aware of it) but the flutter seems to have been banished for now

i'm on one less med (no DIGOXIN) and wd like to be on lower BISOPROLOL tho this probably won't happen till after my next review (by phone app! tho i think i'll imagine i'll need an ECG leafing up to it, which will be hard to do over the phone)

the one downside is that i've had a near-constant headache for a week now -- really bad on monday till i dosed up with anadin extra (paracetamol aka acetaminophen, aspirin, plus caffeine). so the headache might just be caffeine withdrawal (plus weather pressure effects), or a med side effect (RAMIPRIL is mildly head-ache inducing) or maybe my increased heart power is pumping too much blood into my head lol

aside from monday it's tolerable though -- meaning i can work through

(meaning i am staring at a screen all day: also famously headache-inducing)

i'm sorry about the headache, mark, i really sympathise with you there. on the other hand... BISOPROLOLOLOLOL

seems to be fine today tbh, i think it's weather exacerbated by caffeine withdrawal

so it turns out that six months on my heart is still in good sinus rhythm (per an ECG last week) so my arrhythmia nurses are happy for me to reduce my beta blockers -- which with luck will mean feeling less tired day-on-day.

this is excellent news! i was somewhat resigned to the arrhythmia returning -- it always has done before -- NOT THIS TIME, SO FAR

(rewarding myself with a cup of coffee, living dangerously with that caffeine bump which the experts says is unrelated to all this)

(ok it's more like four months than six i guess)

I have Wolff-Parkinson-White syndrome and may have to have this fibbing thingy done at some point, it may go away though, and I don't feel like I've experienced any real symptoms for more than a year, and the tachycardia used to be pretty bad, so idk, maybe it went away by itself, have heard that happens. I do have one coffee first thing every morning which seems to be ok, but any caffeine at all after midday and I will not be able to sleep until maybe 4am.

best wishes CaAL :)

this last week i have been a bit puzzled that i seem not to be dropping off to sleep easily -- eg much late-night scrolling of random wikipedia pages to no evident purpose (the somewhat arbitrary list of unsolved murders since the bog ppl to someone earlier this year, the tale of the michelin man, did you know he once sued ilxor user MOMUS)

well as i finally drop my beta blockers to one quarter what they were three weeks ago as suggested by my my arrhythmia nurses above i just realised this is the reason: i am currently on half and will soon be on one quarter my beta blockers! i assumed i would be less physically tired but wobs is a bad week to judge that perhaps. needs less sleep feels a less handy improvement at least initially and it will probably wear off before i find a way to harness it (im not actually getting younger) but it is mildly exhilarating, like that first time when i went onto the atkins diet and more or less skipped sleep for a week without blowback! (a thrill never recaptured)

in conclusion the human body is weird, don't have one if you can avoid it

(adding: the sleeplessness predates the two whole bottles of red wine i consumed one on eve one on day so it's not that despite the rosso being a stimulant for me at least when i haven't had much in a while)

very palpy last night, and tachy today -- resting pulse 140-ish just now? beta-blockers prob too low too soon, upping them a bit again >:(

(this after six months of being nicely steady, which is annoying)

ffs! best of luck with the beta blockers, mark

my doctor in china put me on beta blockers then my doctor in the UK insisted I come off them. alcohol seems to lead to more palpitations than caffeine for me for some reason, I will admit the more I find out about this stuff the more I realise I know nothing, suppose most things are like that.

i've gone back to half-dose from quarter-dose of my betas (half that is of what i was on for a year+) and wll stick at half-dose for a while i think

my pulse-rate still seems a bit up (116) but tbh i never know when a sensible time to take it is (eating always bumps it up for a while for example)

anyway i feel much better and more energetic again

tapering seems like a good plan

flutter is definitely back lads >:(

i had an ECG -- a tale in itself lol -- in advance of my heart review this coming monday and they were briefly p keen to keep me in (as happened before upthread) (heartrate fast tho not as fast as it was upthread): anyway luckily they relented when (a) as always i have no other symptoms (no chestpains, no difficulty breathing) and (b) they knew i'd be talking my specialist v soon

i p much knew it was back -- i could feel it skipping around at night and i've woken up a few times w/it racing (tho everyone gets that and i've always had sleep paralysis issues) -- but i crossed my fingers and hoped self-diagnosis was inaccurate (which tbf it is). i put my beta blocker dosage up again -- not to full wack -- so i'm mildly feeling fatigue effects (a mix of beta blockers, heart flailing away needlessly, being 61 in a month's time lol)

upside: flutter is considered less severe than the fibbing of the thread's original title, so we have in a sense progessed -- during the ablation of two years back they couldn't tap out all all the misfiring spots and i suspect the ones left untreated are combining to cause the flutter. flutters are more likely spontaneously to self-correct and the cardioversion zapped it back into behaving well for at least six and i think more like nine months

my specialist insists that caffeine is not an issue (i'm back off it but every time i have a demanding editing job i will be back off the wagon)

anyway i'm a bit fed up obviously but symptomatically it is fine tbh (some tiredness, but def not as bad as two years back) and on monday i guess we will know what ways forward there are (upside: i just got my second vax yesterday so i wd be reasonably safe for further procedures if this is what they suggest, and more to the point unanxious abt them)

(the ECG tale is that basically i had to organise it myself and i am not my own GP so this involved a *lot* of boundary-busting pestering and checking) (including being given someone's direct email -- i think by by mistake -- which i immediately exploited with vigour)

(in the end this all worked and i was lucky in the admin ppl i reached out to)

(including being given someone's direct email -- i think by by mistake -- which i immediately exploited with vigour)

First Boris' phone number, now his email, what are they playing at at No. 10? All the best, mark!

Yeah, best of luck, man.

hope they can come up with a good treatment plan on Monday, and that you don't feel too rough after your second jab!

Best of luck, d00d!

had my six-month review with my heart specialist (45 mins before the appointed time, #ffs dude)

his definition of fibrillation (vs flutter) is "there's a riot going on in yr hart" -- well i don't have that any more, which is a guess one step foreard, the issue now (flutter) is much more organised (=basically it sometimes just beats much too fast). his proposal going forward is One More Cardioversion this summer, to thump everything back into shape for Good This Time, plus of course toning my well-being by losing weight, regular but not too strenuous exercise and maybe fully giving up coffee :( :( :(

i mean some of those are things i shd probably do (exercise can once more become a thing now i've had the double jab)also give up personal and globally induced stress and anxiety but that was my gloomy and resigned suggestion -- he agreed that they weren't helping and also that there was nothing anyone could do about them.

he now has moved on from filing me as a music teacher to believing i am a professional songwriter who loves the beatles -- i guess this is how he remembers which one i am. but i will always be grateful for the phrase "difficult heart architecture" so this is merely a tiny and weird price to pay

also he was effusively grateful that i organised my own ECG and got it sent to him. tbh i could do with a strong coffee right now but

he now has moved on from filing me as a music teacher to believing i am a professional songwriter who loves the beatles

LOL

i raised the sleep paralysis thing (viz is there any knwon connection) but as the last question in a longish consult over the phone it didn't get much discursive attention, i will ask again when i next see him face to face

apparently there is a link with sleep apnea but im p sure i don't suffer from that

a thing happening a fair amount is that i'm being woken from very-mild-peril dreams by the racing of my heart

i know this can happen to anyone -- ie is not necessarily a symptom of the condition -- but does indicate to me how much stress i'm probably processing unconsciously, and how much (if it hadn't been for the flutter as a fact) i would be saying serenely to myself that i'm neither stressed nor anxious

ie i am very good at hiding my anxiety from my conscious mind, setting it in the background somewhere -- but it is churning away still

new cardioversion on 22 june, maybe this one will take and also keep

my dad has some afib experience following heart attack at 60. ablation, cardioversion, etc. he's read extensively about it and has also had some occasional sleep paralysis - but doesn't connect the two (I asked him) and hasn't heard of a link. doesn't mean it isn't connected in your case of course! he reckons his afib recurs mainly due to posture and the vagus nerve, an idea that medical people apparently refuse to discuss.

crossing my fingers for 22 June btw!

I have palpitations sometimes and also get sleep paralysis when I nap - never wondered about a connection but this is interesting.

best of luck to you mark, hope it all goes well.

Yup, best of luck!!

update: in and out in hours, cardioversion successfully returned heart to proper sinus rhythm for the time being, everything very routine and straightforward, sorry not to report sooner but i was still quite tired yesterday and basically just looked out of the window all day lol

my p-waves are back baby (for the time being)

glad you're back in rhythm and hope you're less tired today?

https://www.youtube.com/watch?v=8WG118J4XlU

(note trumpet playing cowboys)

so i had a phone appointment with my consultant but as they had failed to organise an ECG beforehand there was literally nothing to talk about (i also attempted to organise the ECG -- as i managed to get one last time by battling for it myself -- but this time no dice)

i expressed my irritation abt this in the appointment and got a long lecture abt we're in a pandemic and nothing is working properly but also an acknowledgment that i was basically right to be frustrated: he suggested we switch the appointment to the royal free (where he also gives clinics) since they are now opening up to face-to-face, and since i am gong to be in the building i will be able to get a walk-in ECG beforehand (the same way it used to work before COVID)

i just got my appointment date from the royal free: it's in december (fine, i'm not really in a hurry i guess) and… it's a phone appintment

royal free's contact structure includes me being able to send emails to change appointments -- which barts does not -- so i have done this

so to catch: they caught my request abt the december appointment needing to be face-to-face and changed it -- but then at the last moment the pandemic clamp came back down and it was postponed

four months later it has not been rescheduled -- tho i am copied into to a request earlier this week from one dept to another to action this (i will chase it up next week)

i also went into my health centre last week for my various routine yearly tests: blood pressure was high and everyone went scrambling, the nurse said i had to talk to a GP. well i did -- but it was a GP who i've had before and liked (very thorough and matronly) but this time she seemed scattered and flustered, a mixture of bossy and distracted, asked me questions but only half-listened, did some hurried tests which were all fine, and eventally agreed that the best thing was to up my BISOPROLOL to see if that had any effect and to check in with my actual real GP (who i never see) if it stays high.

she also quizzed me about coffee. well the consultant has always said coffee is nothing to worry about (re the atrial flutter) but maybe BP is a different matter? so i said actually it's time i took a break from caffeine and/plus also i shd maybe shd some of my extra lock-in pounds vcz they probably aren't helping.

i don;t even drink much coffee now but this has been the toughest caffeine withdrawal i've ever been through, i'm still achey (head and muscles) eight days later and have the mildly feverish hot-eyes thing -- tho i am sleeping better. (i did a lateral flow case just in case but at least it's not THAAAAAAT… )

plus it took me ages to find my BP meter, i'd put it in a dumb place and i then kind of wanted not to test it until the caffeine was out of my system, so i waited until yesterday. BP still higher than it should be -- which of course immiedately started making me anxious, like every twinge is thet start of a heart attack. a couple of years back a nurse identified that i have "white coat syndrome" with regard to this procedure -- as if the electronic hum of the BP monitor secretly stresses me and drives up my reading. she always did it with an old-school hand-pump monitor and got "better" (lower) readings. but i don;t have a hand-pump monitor plus i always find it a bit of a scuffle getting the stupid in the correct position on my arm, which is ANNOYING and probably also raises my BP lol.

anyway today my pulse was a little lower -- below 100 -- but too high still for calm and normal. the thing is, this is the first time it's been checked for at least six months and it may have been high for AGES (i'd stopped checking bcz of the white-coat thing and just assuming i had an upcoming appointment and so on). when i was talking to the GP last week i was basically feeling absolutely fine. i'm feeling a bit rough now but i think it's 2/3 caffeine withdrawal to 1/3 ramped-up anxiety.

it's a bank holiday tomorrow, i will take it easy and then call my *actual* GP (who is good but i never actually see) on tuesday. maybe she will send me into A&E like happened in sept 2019 -- i thiiiiink i am fine (“heart rate ain’t nothin but a number” per the cardiologist in the hospital i wd be in, see upthread) and i am not keen to be on a ward at all (i am double-vaxed and boosted but the boost was five months ago)

cant have symptom w/o typos

mm typos

i was off caffeine for a lot of last year after my last procedure (which was successful for a while then reverted)

but over xmas i had two big editing projects and i just always cave and start the day with coffee when i'm editing: the upside we all know and love, the downside is ambient headaches and sluggishness first thing, combined with mild fatigue from the beta blockers (tho i was only only a low dose of beta blockers most of last year)

a second downside -- it belatedly occurs to me -- is that i tend to dose my headaches with paracetamol (acetaminophen), not in vast doses per day but pretty regularly, and i believe long-use paracetamol is sometimes asssociated with high BP? if cutting out caffeine also means cutting out paracetamol (as it generally seems to) then that's probably a good move, tough as it always is

(actually tbh i've stopped finding the fatigue from the beta blockers such a problem, so that's something i guess)

Did any med tell you to cut caffeine? I've never had one do that, never found any studies to support the idea, more like this just now (usually minus the weasel disclaimer at end):

Research suggests that caffeine isn't a cause of abnormal heart rhythms or atrial fibrillation, and drinking four to five cups of tea or coffee a day shouldn't increase your risk of developing coronary heart disease either. However, the effect of caffeine will vary between people.

Drinking caffeine with atrial fibrillation - British Heart Foundationhttps://www.bhf.org.uk › ask-the-expert › af-and-caffeine

And sodium of course, which is one sneaky ingredient.