CV Next week

[maxred1]

Ok, the call came through, although allegedly there is a letter from the Cardio, written 6 days ago. I have not seen this as yet. CV next Friday, with a pre check next Thursday. No appointment with the EP, until 2nd November, which will be four weeks after my CV. I actually requested to see an EP before the procedure, but no one seems to want this to happen. The nurse specialist?? when I questioned this, came back with, ''All this is really common, there are no issues whatsoever. If you cancel it may go back several weeks''...given my Meds level, this cannot happen, so to boldly go, and all that. Keep you posted.

Persistent AF, with current arrhythmias, 300 Dabigatran, and 15mg Bisoprolol per day.

[BobD Volunteer]

I never saw my EP for any of my DCCVs. They are usually done in the anti room for the lab where they have access to an anaesthetist . Only takes a minute or two but at least you will know if you can be put back into NSR which the EP needs to know before he sees you really.

Bob

[maxred1 in reply to BobD]

Thanks Bob, yes, the nurse quoting 80% success rate......

[RobertELee in reply to maxred1]

Here's hoping for a successful CV. You'll be seeking an ablation after that I guess?

[maxred1]

Thanks Robert, yes I share your confidence!!!!! It goes something like - CV 2/10, They are keeping me in overnight for this one, down London Heart Hospital on 7th, how did that go? then an EP,NHS, on 7th November. I am confident that at both post meetings the conversation may well be, So, what do you know about Ablation..........

[PeterWh]

I also was in persistent AF. I saw my EP and he said that a CV is an important first step for three main reasons.

1) Determines whether you can be returned to sinus rhythm (some people can't).

2) Sees how much [I believe energy and times] it takes to get to sinus.

3) Sees how long you remain in sinus.

From that treatment options and timescales become clearer though not fully defined especially as AF is a mongrel situation.

I went back into persistent AF within 24 hours though not confirmed until I saw GP five days later. When I saw EP again a week or two later he stopped the Flecainide as he said it was almost certainly not doing anything. EP told me the only realistic option in my case was an ablation and highlighted the pros, cons and risks. AS I had read AFA info and other sites I asked him realistically what the chances of success were. He told me that in my case due to extent / severity he thought that there was no chance that an ablation would work first time and that it would be 2 or quite probably 3 ablations.

[maxred1]

Peter, thanks, yes I understand the process, and therefore the dilemma. I feel my current issue, 1) Will I, can I, get back to SR.2) Due to the high meds, where will I be headed if I cannot get back to SR. 3) What meds will be required, both type and quantity, to keep me in SR, if, hopefully I get there. All will be revealed, I trust, by Friady afternoon. Assuming that I do not flip into NSR, Friday night......

[PeterWh in reply to maxred1]

This may be teaching you to suck eggs so don't be offended and it is based on experience and knowledge gained (I am not medically qualified), particularly bearing in mind AF is a mongrel situation. There are multiple sub-questions and subsets. In work we used to map out decision trees for some aspects / analyses!!

It IS very worthwhile (and good) thinking about the various scenarios and generalities as to "what if" before the CV and seeing the consultant. However some of the DETAILS and OPTIONS will have to left until you arrive at that point (ie junction). You won't have / get all of the answers now. For instance re (1) you may very well get back into AF but how long will you stay there? Some it is only a few hours others months or even years.

Hopefully some of my own situation and AF journey will help you. Not included everything - I don't want to write a chapter!!!

I was already in persistent AF. Consultant saw me, arranged ECHO, got the results and then saw me again to discuss next step(s). He said about a CV because that would show him whether I could revert to SR or whether I was in permanent AF. If I reverted to SR was it a case that I felt better in SR or did it make no difference (with various "greys" in-between)? If I reverted to AF he didn't know whether it would be for a few hours or a few weeks. In his view CV was definitely not a permanent solution!!! He hoped a few weeks so as to see what affect the AF had on the slight abnormalities that were apparent on the ECHO. After I saw him again following reverting into persistent AF he told me that in MY case the only realistic option was an ablation. Drugs were not the solution (and he took me off Flecainide there and then). I had done research, etc and had my questions ready. I asked him to give me an honest assessment as to the chances of success with ablation. He said the first time zero percent!!! Just a question as to how long I stayed in SR afterwards. He hoped 8 weeks to allow stabilisation (and he arranged for follow-up for 8 weeks rather than the normal 3 months) but was not optimistic I would get there. After 3 ablations a 70% to 80%. I am waiting for my second.

Worth noting that at the time of the ablation I was on Bisoprolol and Warfarin but both were increased after the ablation because of changed affects and reactions of my body (putting it succinctly) and then three months later started Digoxin.

Try not to worry too much, either now or in the future (easier said than done I know). Some aspects are out of our hands in relation to AF!!

[maxred1]

Peter, a question. How did you feel/know, you were back in NSR? Did you feel it, or was it the GP check?

[PeterWh in reply to maxred1]

No I definitely knew it !!! (Both after my CV in Nov last year and this year after ablation). This was not only just at the time but in the hours and days afterwards. I actually felt the heart going back into AF and felt very unwell and then I could tell afterwards.

After my CV I just went back to the GP for confirmation (as well as for something else). She felt it from my pulse and then had the practice nurse to do a full ECG there and then in the surgery to send to the consultant (confirming back in AF). Two months before my ablation I had bought an AliveCor so I was able to send the AliveCor ECG to the consultant EP as soon as and he started the next stages in the process (and brought forward my follow-up appointment) without even seeing me as he could use the results of the AliveCor.