can any one help

[duckpopper]

hello i have been told that i can not have shock treatment as iam in and out of af , now iam to see a heart rythm specalist for abalation , irealy do hope this will work iam on pradaxa, and bisoprolol which they have just increased to 10mg aday rather than 5mg aday, irealy hope this will controll my af , as i get realy scared of having an af attack,i dont like to go farfrom home as i constantly worry of it happening all the time , i still have young children and feel awful as they can see iam on edge all the time , also can any one tell me should i always go to hospital when ithappens or just let it pass , thankyou for any advice it would realy help me

[Beancounter Volunteer]

Hi duckpopper

Well firstly I agree, a cardioversion may not work at all if you are in and out of A Fib, it is usually either for those like me in permament A Fib, or is used to treat people have paroxsymal attacks.

I remember your questions the first time about the CV so I know you are new to this, and it seems to me that you have just been given a whole new raft of things to worry about.

The pradaxa is the anti-coagulant, and it's excellent that you are on that to reduce the risk of stroke, and thje bisoprolol is a rate control drug, so that is slowing down your heart and BP to ensure that your base heartrate is not too high when you get an A Fib attack.

Now the main question about the ablation, it sounds really necessary if you are getting regular attacks, it's not an instant cure, there are various figures quoted but about 60-80% success seems to be the norm, and it does have to be repeated sometimes. Plus it's not instant, very often takes several months after the ablation for things to settle down. Many here have had ablations and I am sure they will post with their experiences. I have not had one, but people here tell me it sounds a lot worse than it actually is. And ablation techniques and methods have changed markedly in the last few years and they are getting better and better.

As to going to hospital if you have an attack, that's a personal preference, if you feel you can cope with the attack, and some say walking gently helps for example, then feel free to do so. If however it upsets the young children or you feel you cannot cope then go and make sure they understand that you need their help. Some A & Es don't like coping with paroxysmal A Fib but honestly you have more right to be there than many, so stand your ground.

You are here among friends on the forum, some of what you need to learn is just to relax and not be on edge, that will actually make things worse, and it's not easy we all know that.

Lastly remember that there are many many sufferers, and to quote Dr John, A Fib is not immediately life threatening, even when it feels like it.

Good luck, good health and I wish you the very best

Ian.

[bulworth]

Very nice post by Beancounter, a lot of good info. I will echo his sentiments that it's not the a-fib itself that presents an imminent danger, it's the stroke risk that a-fib produces and since you are on Pradaxa you are out ahead of it, so take a deep breath and chill out, there is no use running to the hospital if you get an episode. I was in a differrent boat than you because I had persistant a-fib, not just episodes like you. Last year on July 11, I went in to NYU for an ablation after two failed electro-cardioversions and I have been in Normal Sinus Rhythm ever since so if your doctor recommends you to an electrophysiologist for an ablation I would be the first one to say go for it. Dr Chinitz is the man.

[Offcut]

I agree with the above you must be in charge of it not it in charge of you. I had it for years before it was diagnosed and becuase I was told by one of my doctors many years ago not to worry about it, I did not and thought I managed and did not die before I took tablets etc. Live with it. I have limits due to other problems but try not to let it get me down. Enjoy your family get them to do the running about for fun. Become the circus master not the clown.

[TheStand]

duckpopper,

I saw your question earlier and saw that Ian had answered but I just wanted to pop in and pass on a few thoughts. As Ian said AF is not a life threatening problem. The real danger from it is a stroke risk and as bulworth said, you are on a anticoagulant so your risks are greatly reduced from that.

You were asking about a cardioversion when you were here a while ago and from your statement I'm not sure that they have actually explained a cardioversion to you. It is normal that Drs will throw out terms and not tell you what they mean.

A Cardioversion is a procedure that is designed to shock you back into NSR (normal rhythm). They use either electrodes or chemicals via an IV to do it. The cardioversion works for most cases and will bring you back into NSR But it has no effect of keeping you there. They can only do it while you are having an attack and it will only last until the next attack. Some might go a year before it happens again and some will have an attack a few minutes after the cardioversion. If you have attacks once a month then hopefully you will remain in NSR for a month but then when the next attack happens you would need to do it again. Its like your battery in the car is dead so you grab some cables and jump it (the cardioversion) but the next time you try to start it you will have to jump it again (another cardioversion). This will continue for ever until you do something to fix the battery. Then you won't need the cardioversion because you won't be having attacks. So a cardioversion does not fix AF, it only stops it until you have the next attack.

You are on bisoprolol. That is a rate control drug and will do nothing for stopping the attacks. It does slow down the heart beat so that the AF attack is not as bad but it can not stop it from happening. There are also drugs used for Rhythm Control. These drugs help to hold the heart in rhythm and stop the attack from happening. They are not 100% but most find them helpful. A person who normally has 1 attack a week might drop down to 1 attack every 4 or 5 months on them. It a very individual thing. They effect everyone different and some of them have some nasty side effects.

About the ablation, I will only say that I had mine done 13 weeks ago and am AF free now.

About the trips to the hospital. It depends on how you can deal with the attack. If you are feeling faint or having chest pains then go... I have had AF for 13+ years and have only went to the hospital about 3 times. The good thing is that you state you are in and out of AF which means you are converting back to NSR on your own. Normally a cardioversion is only done when an AF patient is not converting back on their own. Only you know how long your attacks last and how bad they are so it has to be your choice. I knew mine would last 6 to 8 hours and if I took it easy I could just ride it out and I would go back into NSR and be alright.

[squiffy]

I too go in and out of AF and am on a low dose of Bisoprolol and also on warfarin. When in AF, I rest as much as possible and have gone to hospital on two occasions when the episodes have lasted longer than usual or are more severe with high blood pressure, headache, and/or feeling dizzy. I used to get very scared and wondered if I was going to have a heart attack and die. I never realised so many others have to cope living with AF and some have if permanently. I have recently been put on warfarin as I was previously just on aspirin but have now accepted that it is best to be on the warfarin because of the risk of having a stroke. I am more likely to get an AF attack when I overdo things or am stressed. Please try not to worry, enjoy your family and make sure you get some 'ME' time to rest and relax. I have been encouraged by reading the questions and answers here and knowing I am not alone in the way I feel. It has been good to share. Bless you and your family and be determined to enjoy and live life to its full.

[BStanding56]

When we first experience Af and dealing with the beast is very frightening I don't think The medical professional take that on board. When I first experienced Af 4 years ago, I did not know of these forums and could only dwell on negative thoughts I was truly frightened. I have learnt to some extent to cope with it and pace myself and listen to my body, that is not so easy when you have the demands of a young family, Fortunately I am retired I must have been in A&E loads of times and to be fair have always been treated extremely well. I was/am very symptomatic, I would almost fall flat on my face when in Af, my Dr has always said if you feel unwell and in Af , call an Ambulance, couple of times hubby has taken me in . I have never been sorry that I went into A&E. This is a brilliant Forum, you are amongst people who understand what you are going through, never feel alonex Beth

[BobD Volunteer]

Hi there duckpopper. This AF thing is a really mongrel condition and about the only common thread form patient to patient is the fear and anxiety it causes and as has been stated this is the one area doctors seem not to deal with. This and other such forums try to but not always as successfully as one might wish.

I think the general bench mark advice would be that if you have chest pain, collapse or breathing difficulty then go to A and E but be prepared for not a lot to happen. Being in a controlled environment may well help the fear but few A and E departments do much other than monitor the patient. Maybe if they are not awake then a cardioversion may be done but this depends on how serious is the condition at that time as to do so carries risks unless the patient is already on anticoagulants and within therapeutic range.

The only time I ever went to A and E was for something else when I went into AF whilst being assessed and since that time always rode out the attack at home as best I could. Remember we are all different so whatever makes YOU feel O K is what matters and don't be put off by sniffy young doctors.

BobD

[lizwright]

I have had three ablations and numerous cardioversions but my af is under my control now and as long as I don't over do things, get plenty of rest and don't get too stressed I am ok. I have a full time and a part time job, one of those consists of stressful deadlines. I only called the ambulance once when I had an attack in 8 years and that was because I couldn't actually stand, the only time I was like that. Usually I go to bed and after sleeping, it sorts itself out. I rely on the anti -coag to prevent any nasties like strokes. It feels pretty uncomfortable and the breathlessness is frightening. I wish I had made hugely more fuss before diagnosis but now I am with Papworth hospital, Cambridge and everyone is aware of it, it is much less of an issue. My chest feels very tight today because I have had a nasty cold and ideally I would like to sleep all day now but its not possible so sometimes I just have to potter through it. Don't push yourself but do carry on with life as you want it to be as well. You manage it, not the other way round!

[skary]

hi duckpopper

all the above posts contains loads of info from people who have been where you are now ,When you see your cardiologist ask him to explain everything you don't understand. I write all my questions down in case I forget any ...which I always seem to.

good luck

Nikki

[Jfarreast]

This is an especially helpful thread. Is it possible to make it available in a more general way so everyone can see it.

Thank you all.

[Alandrea]

Try sotalol