Here We Go Again

Oh well, it looks like a second shot at a cardio version. The first lasted 18 months and came to an end two weeks ago on holiday on a tiny Greek Island!

I felt palpitations following a morning swim, and my pulse had become irregular! I had slipped back into AF.

Did I overdo the alcohol? I don't think I had and neither does my wife. I have been very cautious because I am aware that alcohol can tip the heart off balance.

If alcohol was the cause I'll just have to give it up!

I went to my GP first thing on return home (two weeks after reverting to AF) and was admitted to A & E! My pulse rate was 140+ and apart from intermittent palpitations I had no other symptoms and felt fine.

I was kept in overnight until my pulse and BP reached a safe level. I am back home and back on Digoxin, expecting to hear from my cardiologist soon regarding a date for another cardio version. It's a huge disappointment but I'm hopeful that a second chance at a cardio version will last longer than the first. Statistically, the likelihood is it won't, but I'll give it my best shot!

25 Replies

  • Cardioversion does nothing for AF except to end the current episode. The condition is progressive so episodes will come more frequently and last longer as time goes on. Further cardioversions will do nothing to change that progression but I'm sure you know that.

    However, on the up side, a successful cardioversion does reveal that you have a good chance to put the condition behind you should you go down the ablation route. Something for consideration perhaps Hazel?

  • Took the words right off my key board. Nothing more to add.



  • Cardioversion is carried out to stop the current AF episode and bring the heart back into normal sinus rhythm. It's either done with drugs such as flecainide or electrically, in hospital, with the two paddles over the chest. It 'shocks' the heart back into normal rhythm. I'm sure you will have seen this on Emergency Room centred TV dramas or documentaries. It works for most people Jansang but because it is not a 'treatment' for AF you could be back in AF by the time you get home. On the other hand, some people can remain clear of AF for a very long time but though the cardioversion initiates the AF free period it has no impact whatsoever on how long it lasts.

  • Thanks for the answer - I am on Flecainide with very severe side effects - including extra muscle & joint pain, & weakness.

    I had a catheter oblation to bun out the extra av node I was born with but it could not correct other faults connected with that fault.

    Blessings JS

  • Stay optimistic! I've had a huge number of DCCV s & even had one which kept me in SR for 4 - 5 years. It gives time for the whole ablation business to be improved on. Meanwhile I would stop the alcohol !


  • "It gives time for the whole ablation business to be improved on."

    It can also give time for fibrosis to form in the chambers at levels which might make ablation - even those improved ones you're waiting for (!) - much less effective.

  • I think too many people rush into ablations.

  • On the contrary Yatsura. Too many people delay this straightforward and comparatively safe procedure because of bad advice from cardiologists who are not EPs supported by confused scare stories that bounce around forums like this.

    And just like so many other progressive medical conditions, waiting is definitely not the best option.

    What is it that you are actually waiting for?

  • You have been lucky and had a successful ablation. I've had two and now suffer worse than ever. Of course we all speak as we find, please allow others to say what they feel.

  • Are you not doing that Jean? How is AN stopping you or others say what you feel?

    You say you have had two ablations - perhaps the next one will do the trick. We should look at ablations (plural) as a 'course' of treatment. Not condemn the procedure as a failure when it doesn't work straight away. Some people are lucky and find one does it, for others two, three or more are required. For yet others it doesn't work at all - perhaps because they left it too late!

    You say you now suffer worse than ever. I'm sorry to hear that but AF is progressive so wasn't that almost inevitable? It probably wasn't past ablations that caused your current difficulties but it could be that the next one will resolve them.

  • I've been told by my EP that I can't have any more ablations due to the amount of scarring in my heart. My first ablation took three hours and the second 6. I was recently told by a cardiologist that the scarring has probably made my heart stiff, hence my problems now.

  • Firstly, ablation IS a big deal.

    I cannot see why anyone who is not experiencing debilitating / life changing symptoms with AF ie asymptomatic, would want to subject themselves to general anaesthesia , multiple burns ( 50+ ? ) to the Atria plus the risk of very serious complications.And then the possibility that this may have to be repeated again & again. & still need to take drugs!

    I think there is alot to be said for making lifestyle changes first. I wish I had realised this 23 years ago But never too late.

    We are learning more about AF & treatments available as time goes on but it seems to be a very long process.


  • Sadly, AF is found in athletes and couch potatoes, vegetarians and carnivores, Muslims and Christians, Tories and Labouristas. I'm not certain that lifestyle changes will achieve anything.

    Correction. I'll get off the fence. They won't change anything at all!

    If 'asymptomatic' lasted forever then perhaps yes, why would you bother to change anything? But it doesn't I'm afraid Yatsura. Nasty, progressive AF, always forgets how to be nice. Eventually.

    And finally, I do not believe (only my humble opinion of course and you are entitled to yours) I do not believe that ablations are as scary as you assert. They'd be done in a full operating theatre with the chief executive present if that was the case, not in a side corridor! Sorry, I'm just denigrating the catheter lab for effect. But seriously, ablations can stop AF in its tracks, possibly for life, and at the moment and into the foreseeable future, nothing else can do that.

    Anyway, it's an interesting little debate - thank you for your involvement.

  • I've had ablation and did not have General was done with sedation.

    I wasn't a pleasant experience....but nowhere near as bad as I thought.

    It did keep me in sinus for 4 months..and it was shear bliss!!

    I will be having it done again so fingers crossed x

  • The other replies are spot on but in answer to your musing on the possible causes of your last "attack" I always felt I was at greater risk on holiday. It is as much to do about the general change in diet and behaviour as it is about one single factor such as alcohol. However, I had to admit to myself that I did drink a bit more when I was relaxing on hols, and eventually I just decided to give up completely. If these sort of measures buy you some more time then that's worth considering (coincidentally a swim has triggered my AF before !) . When I ended up in a Spanish hospital after a couple of days in AF I was also prescribed ranitidine to help regulate any dietary indiscretions and always made sure I had a supply when I went away. Having said all of this, eventually the AF episodes increased in frequency and started to seriously impact my social life I am sure your own cardiologist will explain the options based on your particular circumstances but mine felt that repeated cardio versions would only be a temporary fix and after due consideration I accepted the suggestion of going down the ablation route. A few months on so far so good!..

  • To be honest Bob...I think if it's going to come back it will regardless.

    I was at home just woke up in fact still in bed feeling wonderful when mine came back. 2nd ablation here we come. x

  • Thanks to you all for your words of support and encouragement. Interesting that Bob56 mentions holidays and diet etc...One month before our holiday I was diagnosed with Coeliac disease, which complicated matters when ordering meals in remote tavernas whose owners had little or no knowledge of the disease!

    Life is throwing some challenges my way right now! Bob56 and Yatsura - I think alcohol has to go; as for swimming? I love swimming in the sea. Oh well, more to think about.

  • Hi. I would never suggest stopping the swimming. It's one of the best exercises you can do, but I have a feeling my breathing pattern when swimming can sometimes upset my already sensitive heart, even more so if the water is a bit cold. As for the alcohol, remember the first law of AF is that it only makes you give up the things you enjoy !

  • You poor thing. i KNOW HOW IT FEELS.

  • Hope your second last a long time, Ive had one cardiovertion lasted less than 2 hours

    good luck

  • What an interesting discussion and so many divided opinions.

    Is AF always progressive, probably I would say, but certainly not 100% definitely as there are people who have been in AF persistent and paroxysmal for 8 or 9 years without it getting any worse. Will they (I) get worse? no idea hope not. And of course we should always remember the forum is somewhat biased, it's only a minority (and a welcome one) that come back and tell us good news usually.

    One of the challenges we have is the lack of data, because as Bob will tell you up until around 15 years ago AF treatments were almost unknown and doctors either diagnosed a "fit of the vapours" or sent you home with an aspirin and a pat on the behind. Of course that has changed dramatically, and we think (but do not know) that the incidence of AF is increasing alarmingly, but why? Is it just more diagnoses or is it an environmental or lifestyle change which is behind this? And if so then why cannot lifestyle changes affect AF?

    Interesting post earlier in the week about AF and being over-weight I thought, and that's not the first time it has been linked. I do agree though no evidence yet that losing the weight will affect the AF, but as a preventative?

    Re ablation, of course I have not had one and won't until such time as the risk/reward balance is in my favour, and yes of course that means the ablation is less likely to be successful and also more fibrosis etc etc. It's still not in everyone's interest to have an early ablation it so much depends on their individual circumstances and especially their symptoms. And of course ablation really is changing fast, in the 3 years or so I have been on the forums we've seen what 4 or 5 major changes? what's coming next year? I agree those of us at the conference usually ask that question and at the moment there is nothing on the horizon (that they know about) but we really don't know as our condition is on the "cutting edge" of medical science for treatments currently.

    My overall agreement is with both sides of this discussion, both are correct, and may I say that we seldom ever can be 100% certain of anything (except taxes)

    My two farthing worth


  • Excellent post Exellent ; )

  • Hi there, Exactly the same thing happened to me. I went for 7 months after my first CV last October, woke up on Voting day 8th May!! Palpitations, nothing sinister just felt all over the place, rang the arrhythmia nurse who did my CV, ( this was off the record but he said I could ring if I needed a chat), anyway, he said go to A and E where they might do a 'quick' CV and convert back. No such luck, referred back to the GP, who referred back to the cardiologist, a three month wait and then a second CV. I am back in sinus rhythm now and have been since August 20th. I don't think it's the wine, I have had the odd couple of glasses and a few beers, (not all at once!) and it's been ok. My GP has quite a common sense attitude and said that 'you have to live your life, but don't go mad), I think it's one of those things, my cardiologist said that if I do go back into AF it's the ablation route and I really don't fancy that but people who have had it say that after the initial problems they feel fine so it may be worth it. I am off on hol tomorrow and intend doing some walking, eating chocolate and having a few beers!! Hope my CV lasts as long as yours did, I know that you feel 'gutted' when it fails, we all wonder why but it can be anything, why did we get AF in the first place? I was (am) a fairly healthy 65 year old, 64 when I got it, walked a lot, had just come back from cycling in Spain, I don't smoke, eat healthily and my only vice is real ale, (or was as I don't drink much of it now but still enjoy a few halves), mine just came one evening as I was preparing tea, no warning, a very fast HR, palpitations and irregular pulse, Bang, permanent AF.What's that all about? Hope you get sorted soon, good luck and stay on this site, people offer great support and advice and you don't feel half as bad knowing there are a lot of people like you out there. Cheers. Elaine

  • 18 months is not bad at all as they state normally last 12 , I would suggest to get strict on diet more veggie and fish just give it a go ,I would research about Digoxin too .

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