Cardioversion for paroxysmal af?: My GP told... - AF Association

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Cardioversion for paroxysmal af?

My GP told me today that he is surprised I've not been offered a Cardioversion, I was surprised at him saying this as I thought they were only used for people in permanent af. Am I correct or are my suspicions that my GP knows sweetfannyadams about af incorrect?

Answers on a postcard please

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Hi Timmo

You can only be cardioverted when you are in AF Timmo as far as I know, so it would have to be during an episode if you are paroxysmal, and would be unusual I suspect

Sorry no postcard to hand

Be well

Ian

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Hiya

I suppose its a question how long you have had the current episode. If very long he is right. If you are not in AF, probably he meant ablation.

Generally, GPs know little about AF. Thats my experience. Which, unfortunately, is a lot.

Be well

Phil

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Hi Timmo,

As Ian says, you can only be cardioverted if you are in af at the time. The first time I went was when I was still Paroxysmal and the day I went, lo and behold I was in NSR, so was just "sent packing" The next couple of times was after I had been persistent af for years. Both times, it didn't work, not even for a second, so again, just, sorry and goodbye.

I think the best route is to go for ablation while you are still PAF. If you progress to persistent then the chances of success are pretty low. When I eventually saw an EP I was told the chances of success were around 20% but the risks were high, so he didn't advise it.

Wish you all the best which ever route you take.

Walter.

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It's commonly used here if you are paroxysmal and in an episode, both chemical and electrical conversion.

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Hi Timmo. Think you are right about some GPs knowing sweet fannyadams regarding AF. When I asked for a referral to an Electrophysiologist my GP told me they have nothing to do with hearts only electrical systems.

Doh! haha.

Best Wishes

Sunigirl

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Wow, did that guy even GO to medical school? He had to be making a joke!

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Hi Timmo - How long do your periods of PAF last for? I have PAF which can sometimes go on for months and on these occasions I end up having a cardioversion to bring me back into normal sinus rhythm. Like others on here have said you need to be in AF to have a cardioversion.

Best wishes and hope you're not in AF now.

Jean

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As far as I understand, permanent AF means you cannot be cardioverted or ablated back to SR.

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Not so. Permanent AF just means it's not periodic. Many of us have been "fixed" with cardioversion (not me) and/or ablation (remarkably successful) out of full-time AF.

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Just repeating what my EP said to me, that I was in Persistent AF and could be 'fixed' by cardioversion and ablation but that at some point I was likely to go into Permanent AF which would mean that he would have to look at doing something else, as an ablation would not be able to return me into SR.

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The definitions are:

Paroxysmal AF - comes and goes by itself, lasts less than 7 days and no intervention is required to restore SR.

Persistent AF - lasts more than 7 days. Can also be AF that lasts less than 7 days but always requires intervention to restore SR (drugs or cardioversion).

Permanent AF - is persistent AF with no plan to restore SR in the future.

If you have PAF cardioversion does nothing.

The definitions are often misused by GPs and general cardiologists.

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Dr Jack, I was talking to my cardiologist recently about an ablation and he said that where I have it , it is hard to get at .I am maintaining  Sr  since my cardioversion 15 months ago ,I was wondering where i might have it  . I know I should have asked him ,but he went on to something else . You are more than likely to not have time to aswer this and maybe wiser not to because you could be inundated with questions.

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If you have had SR for 15 months you have done very well and I wouldn't necessarily have anything done at this stage. 

AF generally comes from the left atrium / pulmonary veins. This is a harder part of the heart to get to compared to other ablation procedures but is routine for AF ablation.

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Thanks Dr for responding ,  and advice ,  much appreciated.

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I have Paroxysmal fibrillation which rarely lasts for more that a few hours. I ve had four ablations and tried about 5 medications but am still affected. I was in a fairly slow AF at the time of my appointment and asked him to feel my pulse (sometimes I feel that he thinks I make it up!!!) But he seemed utterly unconcerned about it and told me about the many patients he has that are in Permanent AF that deal with it and get on with their lives.

Now I take his point but I wonder how many of them work 12 hours on shift work and have a family of five that depend on them

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g'day all,

Very interesting reading all your comments on this today. I'm PAF and the last 2 'episodes' recently have for the first time for me, lasted much longer than ever before and I was diagnosed with this years ago.

Latest episode last week started at 8pm for no apparent reason and I was still in it at 9.15 the next morning. Very very scary and yes I know, I should have called NHS 24. Even my gp told me off for letting it go on so long.

I'm now due to see my cardiologist on Monday and after these recent events am really scared he's going to mention this cardioversion again. He mentioned this almost 2 years ago.

Now I'm reading here that this won't do me any good whatsoever, except send my bp sky high with terror!!!

So very confusing but what I am learning is that in a nutshell, seems to me that we AF-ers know more about this often very debilatating condition than the GP's do! And thats scary in itself.

Stay well everyone,

Blue :-)

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