any advice appreciated !

Hi, I'm a 49 year old man who has recently been diagnosed with AF. The diagnosis came as a complete shock, my daughter is studying to be a nurse and while practising her blood pressure/ heart rate techniques on me she realised I had an irregular heartbeat ! A trip to the Dr resulted in an ECG and an appointment with a cardiologist. I had no symptoms and am generally in good health with healthy blood pressure/ cholesterol and weight. My AF is constant and until my daughter pointed it out I was totally unaware of it. The cardiologist advised that since I have no symptoms I should carry on as normal, that surgery wasn't a good option and that ablation tended to be temporary solution to AF anyway. I have been prescribed beta blockers to bring my heart rate down and they seemed to have worked but my heart is still beating irregularly. I wondered if anybody else was in the same position and what folks thoughts were on ablation v medication ? Thank you ! Oliver

12 Replies

  • You are one of the lucky ones aren't you with no symptoms! Ablation has less likely hood of success when you are permanently in AF so the cardiologist does have a point. And that from a great fan of ablation!

    That said, long term untreated AF can cause problems such as enlarged atria and even heart failure so it is best to keep an eye on things. Make sure that you have regular check ups to monitor your condition.. I presume that you have had an echocardiogram to check the general condition of your heart.

    Regarding your drugs. beta blockers will do nothing to stop the AF, they merely help keep the rate down when in AF. I hope that stroke prevention has been discussed as AF does make us five times more likely to have a stroke. At your age and with low BP then your risk is quite low, but again a watching brief is important. As you get older or should other conditions intrude then anticoagulation may be needed .

    The AF Association main website has a huge range of fact sheets which I commend to your attention as knowledge is power and will help you to live with this condition.


  • Thanks Bob. You've basically said and confirmed exactly what the cardiologist said to me. I've had an echocardiogram, just waiting for the results. I guess it's like you say, keep having regular check ups and be as informed as I can be about AF.

    Thanks again for your advice/input, much appreciated. Oliver

  • You could enquire about having a cardioversion (stop and restart) to put you back into normal sinus rythym? As Bob says I would also ask about whether you need to take an anti-coagulant. If you are in permanent (silent) AF might be a good idea? I would also question the need for Beta blockers buts that's just a personal view they make me feel like 'driving a car with the hand brake on!'

  • Read all you can from john mandrola.

    Read all posts from srm grandma, who has improved her situation by diet changes.

    Adopt a low glycemic index diet, no sugar or stimulants.

    Good luck


  • Love posts and links from Dr. John Mandrola. His writing about the tough facts of post-ablation recovery has given me confidence that these complications will pass. He just seems to skillfully and compassionately explain the pertinent information and provide updates on new research or ideas.

  • Agree with Bob. My untreated AF led to dilated cardiomyopathy

  • HI Oliver

    I am 73 and my AF was also discovered by chance when my wife (nurse) checked my pulse one day some seven years ago. I had, and still have, no symptoms and after one day for checks in hospital I was discharged and put on the anticoagulant warfarin and my INR checked by my GP. I had two cardioversions which eventually failed - one after six months but ablation has never been suggested in my case. Now instead of going to the GP for checks I monitor my own INR levels and regulate my dose accordingly, sending the results to my GP every few months. I sometimes wonder what might have happened if the AF had not been discovered and how many people out there have AF and do not know.

    Good luck

  • There is a movement in my country to make afib screening routine for certain high-risk groups because so many people do not feel the episodes.

  • I also concur with Bob. I have permanent AF and have tried Beta blockers - because the GP said they may cure it - and he is the surgery specialist (pah!) I now know different. They are just to slow your rate down - but usually with matching tiredness/lethargy. So you may have to tune the dose. Listen to the forum and educate yourself so when you have choices presented you can have a view. But loads of people have it and you're not going to have a heart attack! You can still play squash etc. I think that if you're in permanent or persistent (look up the difference) its better than those who have attacks of it which I can see here can be disconcerting or worse. One personal view: the NHS (assuming you're British) tend to focus on AF as a stroke-related issue, which of course it is, so there's a focus on preventing strokes rather than 'heart-health', as I say just a personal view.

  • Hi,

    I was diagnosed with intermittent Afib 20 months ago. The periods I am in Afib have been getting longer with the last being 3 weeks. I take Bisoprolol 3.7 which is a beta blocker and suffer no ill effects or lethargy from it. I also take medication to lower my blood pressure and an anti coagulant. I saw a consultant Electro Physiologist in Cork last week who seemed surprised that I had been left in Afib and prescribed an anti arrhythmia drug which I am to take at the onset of a Afib to return my heart to normal rhythm. This is known as 'the pill in the pocket' and if that doesn't return my heart to normal rhythm he said I should go to hospital and have anti arrhythmic drugs intravenously and then take the tablets daily to prevent another attack. He said he expected that one of these options would stop my Afib, but if not I could have an ablation.

    I wonder if you should get referred to an EP so that you can be properly assessed and offered the most appropriate treatment to keep your heart in a normal rhythm. I understand that there isn't much risk to the heart with short term Afib, but long term it can cause damage to the heart, so try not to worry about being in Afib, but seek specialist advice would be my suggestion.

  • Hi Oliver

    I wanted to reply because I was you just about 3 years ago, except that I has an episode which brought the diagnosis rather than finding out through a routine check.

    And by the way I completely agree with everything Bob said.

    So like you persistent AF, with no symptoms, probably like you scared to death when I found out thought my life was shortened and probably just waiting for the heart attack.

    Took me nearly 6 months, and a good verbal kicking from Bob D to actually start thinking positively.

    OK you're in AF, Well what's the worst that can happen, Stroke to be honest. so ensure that your doctors are monitoring your risk carefully and prescribing any anti-coagulanted which might be needed.

    Next risk, enlarged atria (one form of Cardiomyopathy) as it's beating faster it can become enlarged, get too big and you have heart problems. BUT you should have had an "echocardiogram" if not ask for one, and ask them to measure the size of the atria and then you have that as a marker as the years go by.

    Treatments?, Well they may try a cardioversion to shock you back into rhythm but be aware this is always short term and really only done to see if you can go back, it's a good indicator of the success of any other potential intervention.

    They may try drug therapy, and it you are recently persistent then this could work. Be aware these are not nice drugs however, in fact, real stinkers in terms of side effects.

    Catheter ablation for us "persistents" has a lower chance of success the longer you have been in AF, so if like me 6 or 7 years then it's around 20%. Now for me and this is a personal opinion, that's too low an outcome especially when the risk is not so much complications, BUT the risk of actually making the AF worse.

    Surgical Ablation, is a much more serious operation, but has a higher chance of success for us persistents, but again you need to weigh up the risks of major surgery against you current lifestyle.

    There is also a new method of doing both catheter AND surgical ablation, which has some great feedback, but again you need to think about risk and reward.

    Completely disagree about ablation being a "temporary" solution by the way unless you call 10 plus years temporary which for many people here would be fantastic.

    So Living with persistent, well it doesn't really change me much, I'm writing this from Hong Kong having spent the last 3 weeks travelling around China alone. (and bear in mind it's hard to buy aspirin in China let alone any other Western Drug)

    It effects your lifestyle to the amount that you allow it to to be honest, I don't ignore it, but neither do I allow it to change what I do, it just means that sometimes I do things differently. (Like take the cable car up the rice terraces and walk down, not the other way round :) )

    It's a pig of a condition, but it's not the end of the world, and you are going to be fine. You will need to stop your daughter fussing :) live as healthy a lifestyle as you can and carry on telling us all about your journey through AF for the next 10 or 15 years on here.

    Be well


  • Thanks for all your replies and advice, they've definitely been a great help and given me lots to think about. I'll be seeing my GP on Thursday with the results from my echo cardiogram so fingers crossed ! I now have a much better understanding of the condition and the sort of questions I should be asking.

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