Saw my EP this morning and had a very informative chat. The outcome is that because I have had AF for over 12 years and the drugs are having

no effect now, I am now going to have a pacemaker fitted. Cardioversion and Ablation is not an option because of my age! Have many of you had pacemakers fitted? Have you felt the benefit? Will I still be on Warfarin and Bisoprolol? Any advice will be welcome. Thanks.


14 Replies

  • It sounds as though you and I are running in parallel. Could you confirm your age? I am shortly to be fitted with a 7 day loop recorder before the EP decides between ablation or pace and ablate. The thought of having my AV node abated is worrying. Having learned of its existence I've become very fond of it!

  • Hi jennydog, I am 77 and my EP told me that because of my age, the only thing he can now do is fit me with a pacemaker. He said that because I have had AF for 12 years now, this has given me a further slight complication which is a mitral valve regurgitation.

    I must admit, I did not like the idea of an ablation but as it is I am too old for that! He said that anyone over the age of 75 would not be suitable for Cardioversion or ablation. I also had a 7 day monitor which recorded very clearly what was happening with my heart, at long last. Why does it have to take so long to get this far?

    Good luck with your recording and let's hope your EP can make the right decision for you, as mine has.


  • Hi Ang31c4ts

    I have had a pacemaker for 8 years due to severe bradycardia. And PAF. I think you are due to continue on Warfarin and maybe on bisoprolol, too. But because the pacemaker mainly takes care of the rytm the side effects of bisoprolol can be less problematic. If you haven't had continuous af for long time, I don't really understand why not cardioversion is a possibility.

  • Hi Varina8, apparently I could not have Cardioversion as it is not recommended for people over 75. My AF varies in length of time, it can be from 4 hours to 5 - 7 days. Three times I have been listed to have Cardioversion in the last 12 years but each time I was back in NSR. My 7day monitor showed I had bradycardia as well as extremely fast heart beat so the EP thinks that the only way forward is a pacemaker. Added to my AF is the slight problem of mitral valve regurgitation, which they think has been caused by the AF. I assume your pacemaker is keeping you in sinus rhythm?

    Thanks for the information on Warfarin and Bisoprolol.

  • Hi ang I had pacemaker fit last June as my heart was missing beats every so often but also had to have an ablation for AF so am confused as if pacemaker can help with AF why then do we need an ablation.I was under the impression the two where completely different things.Pacemaker op no problem i,m still on bisoprolol but see my EP next month

  • No, the pacemaker doesn't control af. Paf even overrides it . So I'm in pacerytm (70 or more depending on exercise) most of the time, but very symptomatic when af is on. I had 10 mg bisiprolol for several years and had the typical betablocker symptoms, but much more mild than a lot of persons here have described. I think it was due to the pacemaker. It overrides bisoprolol.

  • Hi Ang & welcome - As I understand it age is no barrier to ablation, but will make it more difficult to obtain one. My husband has AF and bradycardia and mitral valve regurgitation and had a pacemaker fitted 2 weeks ago today and is now firing on 8 cylinders instead of 4! It's very early days but since having it he hasn't suffered any arrythmia since its implantation which took about 1 hour and was performed under a local anaesthetic, his ecg's now look better than mine. Depending upon which pacemaker is fitted and the number of settings which can be done on it, SOMETIMES it can be set in such a way that for SOME people it will prevent the AF but as Varina says, won't control it. AF is such a mongrel beast! Anyway, that is what we have been told.

    If you have bradycardia (slow hearbeat at consistently under 60beats per min) you might query being prescribed Bisoprolol as Beta Blockers slow the heart beat which could be dangerous for people without a pacemaker to regulate it. The priorities for my husband was anti-coagulation - for life to prevent stroke, pacemaker to ensure heart didn't pause for more than 5 seconds and it only kicks in when less than 60 beats per min, then Beta Blockers to regulate the AF.

    Hope that helps.

  • Good evening Cdreamer, very many thanks for all the information. My 7day heart monitor frequently recorded my heart beats as low as 29 and also several pauses then very fast at between 120 and 180. Yes, I am a little worried about being on Bisoprolol but perhaps they are more worried about how fast my heart is beating while in AF. Must remember to ask next time I see my Dr.

    May your husband continue to fire on all 8 cylinders, hope it will be the same for me!

  • Please question re beta blockers as a matter of urgency as with a pulse of 29 beta blockers are not the right meds. If you have rapid pulse at other times maybe a pill in the pocket approach would work????

  • Hi rosyG, I intend to see/speak to my Dr on Monday. All I know is I have got terrible headaches since starting the Beta-blocker. I have tried Flecainide, Sotelol and Amiodarone over the last 12 years but my body does not like any of them! Plus they did not work anyway, hence a pacemaker being offered.

    Thank you for pointing this out to me.

  • Hi again CDreamer, who did your husband see to get what sounds like excellent treatment. I cannot get my GP to refer me to EP I was initially referred due to a heart rate of 50 and awful symtoms then they found PAF, cardiologist gave me beta blocker and aspirin, so heart rate dropped to 42, all the while he knew my heart rate went as low as 40. Had to brow beat my GP to take me off beta blocker all he did was put me on a calcium channel blocker, am 2 days away from changing my GP. My life at the moment is a nightmare. As I have been off work for so long I have to go back on 3rd March or I do not get paid anymore, have had to negotiate a part time contract and I pray I can hold out and cope until I get properly treated.

  • yes part of the reason NHS hospitals decide who to operate on in the likely outcome or success rates.

    They all want to be top of the tree, so anyone that may be more difficult would be put on the back burner, as having bad odds of success.

    I would think very carefully about pace and ablate, you just never know, drug companies around the world are trying hard to find a suitable drug, after all its their business, as ablation is of no use to them at all. A med to stop af would be a world beater and worth `loadsa money`. If you had pace and ablate any new drugs would be of no use to you.

    As we are told at the outset, AF in itself is unlikely to kill you, what you are not told is that being in constant AF will probably lead to other complications of the heart.

  • Do, I had PM last year and feels tons better x

  • Thanks for that. Am having too many episodes, looking forward to it! Just getting ready to go to wedding! Had AF most of night but I am ok now.

    Stay well and bless you.


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