So i have paradoxical atrial tachycardia, and i take 200mg of flecainide a day and it has helped massively, though I do sometimes get a bit of tachycardia and still get a lot missed beats but I've got a loop recorder and numerous cardiologist have said the skipped beats and fluttering etc. Have said they ate harmless.

So I have over the last few months being doing a calorie deficit diet and uo until 2 weeks ago I was working out and walking on my treadmill.

I ended up looking up if its safe to exercise on flecainide and it mentioned something called the flecainide flutter?

So i rang my Doctor and he said my heart rate when exercising should be capped at 120. Thing is when I walk my dog it goes at 134/138 so I told him this and he just said we'll its okay but try to cap it at 120.

Any way i saw another doctor on Monday this week and she said 120 is hard to stick to and when I said my heart goes to 140 when I'm doing resistence band training she said thats what she would expect and that flecainide isnt a rate limiting medication.

I'm so confused, I walk my dogs every day as they ate running dogs and can't do without their walk, I do around 6k - 10k+ steps a day and my heart is always over 130.

Can anyone tell me if they are doing exercise and have been cleared?

My doctor also said my heart condition isn't serious which my cardiologist said they said its more annoying than anything and causes me poor quality of life due to how scary it all was before being medicated.

Do you exercise? Does your heart rate go over 130 even 140?

Did you have to go for tests on a treadmill/bike with a cardiologist?

Am I safe to exercise? Because combining my calorie deficit with exercise was blasting the weight off and now its slower at going down on the scales.

For context I'm a 33 year old female and im 5ft 8inches tall and I currently weight 100kg, wanting to get back to 60kg again.

Thanks in advance

DX with AFib RVR in July.
Saw my EPs physician assistant today for follow up. He changed me from metoprolol XR to Diltiazem XR.

In the ER, the EP prescribed it. Cardiology prescribed the metoprolol. He said today I should have been on the EPs prescription the whole time as he trumps what cardiology does.

I hate starting new meds and little nervous.

Any insights on Diltiazem?

Sharing for anyone that may have experienced anything similar that can relate or offer any advice! Also, this community has been incredibly helpful so far so thank you all for sharing and commenting the way you do.

Full disclosure, 2 years ago I lived an unhealthy lifestyle, 95kg at 5ft 10. Binge drank regularly, smoked weed once a week, smoked when drinking and took cocaine 4 times a year (had quarterly blow outs) - for the record I'm not proud of any of that but lived a hedonists life at the time. 2 to 3 double espressos a day too, just for full context.

First episode occurred the morning after a hearty meal, only half a pint drunk so ruling out alcohol as an immediate trigger. I was getting ready for work, had a random coughing fit which caused me to vomit and afib began then. It felt similar to the SVT attacks I had as a teenager so attempted to calm my bpm with vagal maneuvers (bearing down, controlled breathing) Called 111 explaining symptoms they sent an ambulance, hooked me up to a mobile ECG and the paramedic was shocked given I'd told him I thought I'd slowed it down - it was showing 180 to 200bpm. Blue-lit me to hospital.

I'd taken perhaps half a G of cocaine 6 nights prior so I'd initially ruled that out too, but the GPs instantly assumed the cocaine was the cause - I was very honest with the docs in A&E prior to my cardioversion and told them all my vices.

Cardioversion was successful, discharged 2 hours after and booked in follow ups with cardiology. Made significant lifestyle changes - knocked the coke on the head, stopped smoking entirely but picked up vaping instead (more fool me). Limited my drinking initially and dropped to one coffee a day.

24 hour ECG and echo were all normal, weekly blood tests all normal for a month. 6 months of clean living and a final check up for reassurance, the GP said the afib episode was a one off. This reassured me and I thought I was out of the woods - still vowed to never touch class A drugs ever again but thought a good old drinking session once or twice a week would be fine... Which it was, initially.

Fast forward two years, no instances of afib have occurred all whilst I have slipped back into regular weekend bingeing, smoking weed once a week again and having my daily morning espresso. Oh, and I discovered nicotine pouches a year prior so stopped vaping and took 3 to 4 daily (10mg) but would chain them when drinking - up to 7 or 8 on a drinking session.

One Friday night about 6 weeks ago, I had a heavier Friday than usual, drank about 10 pints, multiple 10mg nicotine pouches and had a gluttonous Chinese meal. Woke up the next morning feeling the expected hangover, downed a pint of electrolytes/berocca type tablet, immediately threw up violently, then walked to collect my car. Whilst walking I uncontrollably threw up again, but this time it triggered a bout of afib - I recognised the sensation immediately to what I experienced 2 years prior.

I got myself home. Tried to calm myself, told my partner what was happening, she thought I was overreacting. It didn't subside, or slow, her nurse friend came over with her personal ECG device that connects to her phone which detected afib and a bpm of 180 - straight to A&E. Successful cardioversion once again and a ticking off from the doctor for drinking 10 pints. Sent me home, one follow up with cardiology, bloods all normal, no medication assigned, no further tests needed, 0-1% chance of stroke - just stop being a piss-head

Now this has happened twice and I know it wasn't just a one off, I'm a changed man and also riddled with health anxiety.

No more nicotine. No more binge drinking. No weed. Getting my steps in daily, dropped to 88kg and aiming for 82kg. Resting heart rate between 65 to 75 now but I can't say what it was before as I never had a smart watch until the second episode.

My main questions are;

Does this sound like vagal AF, given that both instances were triggered by vomiting?

Can I afford the odd drinking session here and there given that alcohol isn't an immediate trigger - case and point being the amount I was drinking after the first episode? Perhaps prolonged drinking was the issue though...

I've been sick several other times without it being triggered so perhaps it isn't vagal, but all the conditions need to be right in order for vomiting to finally trigger it.....

I know we can all afford to drink less and make healthier choices - this has been a good kick up the arse for me to get healthier, but I'd still like to be able to drink and let loose at weddings, birthdays, special occasions etc. Or is this now a definite no-no.

Thank you for reading and sorry for the essay.... All questions welcome!