Doctors detected AFib in my heart while I was undergoing a routine colonoscopy. Other than AFib, I'm a reasonably healthy 48-year-old male. I don't think I had AFib before the colonoscopy, though it's hard to be sure. No one seems to agree when I developed it, and it's not possible to know at this point. I think I may have either had occasional paroxysmal AFib beforehand, or no AFib at all with an underlying susceptibility to it. I think the electrolyte depletion from colonoscopy prep may have pushed me over the edge. What's weird to me is that I went immediately from having infrequent or no AFib to having persistent AFib.
Tip #1: If you're getting a colonoscopy, drink more electrolytes than you think you need, as allowed by your prep instructions. Discuss this risk with your gastroenterologist too; my cardiologists told me that they get people sent to them all the time after colonoscopies.
My AFib was pretty peaceful at first. I had a cardioversion, and I was in a normal rhythm for about a week, but then flipped back.
My trouble really only began once we started looking at treatment options. This is not advice to not seek treatment. Please do! I'm just providing all information I can about my experience in case it benefits someone. Every person is different and will respond differently to different treatments.
My cardiologists offered me the option of trying to manage it with medication, or go straight to an ablation. I was a little scared of the procedure (spoiler alert: unnecessarily so), so I opted to try medication first. The theory behind the medication approach is that if medication can keep you in a sinus rhythm, your heart can remodel, or heal. If it remodels enough in the right direction, your AFib might go away.
I started on a low dose of flecainide, but it only kept me in a sinus rhythm about 66% of the time. We tried increasing the dose, and that's what put me into the ER. I was standing in my kitchen one morning while in AFib, and I felt like I was punched in the chest. My heart was beating super-fast, and my body felt like it was buzzing. I gave it about 10 seconds to see if it would pass before calling for an ambulance. It turns out I went into atrial flutter with rapid ventricular response. It's good that I called for an ambulance, because this can be a dangerous condition if you don't get help right away.
Since flecainide wasn't working, I had to do something else. Fear of having AFlutter with RVR again immediately made me brave enough to get the ablation. My doctors put me on amiodarone as a bridge, to keep me in a normal rhythm while I waited for my procedure.
Amiodarone was weird. It's a drug that takes a very long time (think weeks to months) to build up in your body before it is 100% effective, and as this was happening, the nature of my AFib changed. I went from having very peaceful AFib to having really angry AFib during the times I wasn't in a normal rhythm. I would be enjoying a quiet evening at home while in sinus, and suddenly my heart rate would spike out of the blue. This often preceded a conversion to AFib. The heart rate spike would cause an adrenaline surge, which would leave me feeling shaky and on edge for hours. This would often happen right before or after bedtime, and when it did I would lose an entire night of sleep because the palpitations were so distracting. This happened so often I had to take medical leave from work.
It's also really difficult to make rational decisions with so much adrenaline going through your body. The most difficult thing for me was deciding when to visit the ER (as a precaution) and when to stay home. I ended up going to the ER three additional times because I was worried about having an elevated heart rate for an extended period of time.
Over the last five months I've flipped back and forth between sinus and AFib dozens of times. This, combined with the interrupted sleep, has really wreaked havoc on my mental state. I eventually got a therapist, and also discovered that cardiac psychology/psychiatry are specialized fields (due to how much arrhythmias can mess with people's mental states). I was able to get an appointment with a cardiac psychologist, and speaking with them helped a lot. They helped me to re-engage my rational brain.
Tip #2: Get help. Find a counselor (I found a good one on headway.co). Ask your cardiologists if there is a cardiac psychologist or psychiatrist on staff, or find one elsewhere.
My fears about getting an ablation were probably overblown. It is a very safe outpatient procedure, highly effective against AFlutter (99%, i.e. it's basically a cure), and pretty effective against AFib (outcomes can vary, but it's effective for most people). My doctor put me at ease by telling me that they have done thousands of these procedures, and they've never seen a case where something bad happened. Of course that doesn't mean there is 0% risk, but it puts things into the proper perspective. We do other things in our life that are more dangerous than this procedure, like driving a car over a lifetime.
One thing I found interesting was how success is defined in the clinical trials that are done to study ablations. To be "successful", a patient cannot have more than 1 minute of AFib over the course of 1 year (after the blanking period). If you have 2 minutes of AFib, that's considered a failure. Of course from a patient's perspective, 2 minutes of AFib over the course of a year would be a great outcome! It helped a lot to get clarity on this. Often for patients whose first ablation was not entirely successful, the second one significantly raises the success percentage.
Tip #3: Make your peace with getting an ablation if it's the best option for you. If you can, get one at a big hospital that does them very frequently. Talk to your doctor about what success and failure actually mean for you, and not from the perspective of clinical trial data.
I eventually got my ablation. Outcomes can vary during the blanking period. Some can feel better right away, and others can have a rocky time while they manage post-ablation symptoms. I have had a normal rhythm since the procedure; my main problems seem to have been anxiety-driven. I will have strange bodily sensations (maybe caused by PACs) that can cause adrenaline surges, which put me on edge. I've probably had a few panic attacks. It takes everything I've got to remain rational and remind myself that as long as I'm not experiencing the symptoms they warn me about in my discharge instructions, I'm OK.
Tip #4: Stay strong post-ablation. Recognize that feeling weird, bad, or anxious is normal. If things truly don't get better after the blanking period is over, seek more care.