Not sure of the future plan of action

I have touched on my problem in ealier posts. At present I am having two or three attacks of af a year it seams just as I have managed to put af at the back of my mind wallop!! It's back lasting up to two hours . I know a lot of you on here are amazing in dealing with symptoms a lot worse and I feel a little fraud. But I have only had af for three years and at 56 years old I need a plan of action . My problem is I am a vegetarian and I have a rest heart rate of 46 to 52 so I just don't think tablets are going to work for me. I have asked about having an ablation but it's seem you have got to exhaust all other treatment first . Which to me is crazy if you stand a better chance of success if done early. Very worried about the future

20 Replies

  • Well yes under NHS and Nice guidelines you need to try two drug regimes first before being offered ablation. And yes many EPs think ablation should be the first line of attack. Being a vegetarian should not affect what treatment you get. Not sure why you think it would? Low heart rate may well contra indicate beta blockers but that goes for those with asthma as well so there are several rhythm control drugs which could be tried.

    My best advice would be to go an see an electrophysiologist (EP ) even if you need to pay and see one privately but do ask you GP first to refer you. It is your right to be treated by whoever and wherever you wish. Check out patient information under the main website (AF Asociation) for a list by area. That way you will be speaking to an expert on AF and can make that treatment plan.


  • Cheers Bob!! will certainly take on your good advice

  • Bob. It is in the NHS England publication that you can now (from the last year or so) be referred straight for an ablation - you no longer need two failed drug treatments.

  • About bloody time too. I stand corrected.

  • Hi, I too follow a plant based diet and while that is phenomenal for being heart healthy, and healthy in general, it does not affect the treatments offered. Everyone reacts to the medications that you may try a little differently; some work, some don't. You may or may not have side effects. Maybe you are thinking about the need to go on an anticoagulant, and you've heard people avoiding greens on warfarin. As long as you are consistent you can eat anything you like, and there is no such worry at all on the newer anticoagulants. Good luck as you sort it all out.

  • Thanks Grandma

    I am just trying to look ahead . At the moment I am on a pill in the pocket treatment. And if what I read on here I can expect it to get worse as time goes on. I just need a plan of action or at the least some options. So I can get on with life I know it's not that straight forward. But I suffer with aniexty which for those who know getting my head around af is not easy there are more black days than good days in my mind

    Thank you again

  • Sending you hugs, I understand the added burden, keep strong!! Doesn't get worse for everyone! I went from age 39 with paroxysmal AF to recently (now 68) before any significant

    change. Best wishes

  • Hello. I'm 42 and in a somewhat similar position in that I was diagnosed with AF this year which got worse quite quickly over a period of months and after 4 days solid of AF I started taking 2 x 50mg of flecainide. My heart rate is low around 50bpm as I was a runner. Touch wood flecainide has been a Godsend for me so far. I've been offered ablation but have decided to continue on the drug for as long as I can. I too suffer from anxiety and have taken escitalopram since 2011. Who knows what the future holds for any of us. One day at a time... Good luck!

  • Hi yanbart

    I am a keen cyclists and all through I have cut down the long treks I still love to cycle. Just wondering are you also taking warfarin

  • No I'm only on Flecainide at the present time. I think Bob's response is great by the way. I should also add that after a long break I am back running with no obvious problems. I too am from Wales!

  • Glad things are better for you and good luck in the future yanbart.

  • Hi, I was first diagnosed with AF more than 25 years ago, and was in a similar position getting 2 or 3 attacks a year. I did go for the medication as ablation was still in its infancy back then and not considered a good option for an otherwise healthy 30 something. I also managed my lifestyle to reduce the attacks and lasted quite well until 12 months ago when the frequency of attacks and risks reached the point where an ablation became the right option. Whilst I am very happy I had the procedure, I'm not sure you should see that as the immediate answer, especially if there are other options. Obviously, much depends on the dose and extent of the medication you might need to take. I have a low heart rate and am also a vegetarian, but with an anti arrhythmia drug , such as Flecainide and more recently warfarin, I fared quite well for a long time and was well controlled in terms of symptoms. I even tolerated a low dose of a beta blocker for a few years when the symptoms did get worse. I still feel that medication for some time might do the trick for you, and an ablation if that does eventually fail, but some time in the future, is still a decent plan. I always knew that ablation was an option as the procedure became more widespread and effective, and I was comforted that if the drugs did eventually cease to work, then this was a road I could go down. There are many options to consider and exhaust, so you shouldn't worry unduly about the future, especially as treatments are being improved and refined all the time. There is life with and after AF!!

  • Cheers Bob

    Makes me feel a lot more re- assured

  • I'm a similar age (58) and also having two or three attacks a year, but lasting a bit longer, five to eight hours normally (though the last one was about 28h). Doctor is just taking the route of increasing the biso, pretty soon I'm going to be on a horse-sized tablet lol.

    I myself am happy to try out medical routes before ablation because it's a big procedure. Plus I'm in Wales and all the rules are different, not so much proactive care as prodding you every now and again to see if you twitch :)

    If it works better the earlier it's done, I guess I would ask an EP and get all the facts together to make a decision. If there isn't a hard and fast rule in England any more that's great, it puts you in more control.


  • Thank you lis

    Something to think about. I am also from Wales and I know what you mean

  • Thank you all for your replies. I know we all must stay positive . The more I read about af the more I see how modern medicine and techniques are improving leaps and bounds hopefully to the point where af is a thing of the past. Fingers well and truly crossed . Wishing you all a merry. Well Christmas

  • At the end of the day there is no perfect answer because we are all different and both the AF and the medicines affect us differently and also affects us differently from day to day. The optimum time can never be accurately determined either thinking in advance or looking back!!! As to developments in the future in reality how much that is new will they deliver? It may be quicker and more accurate. For instance with PVI (pulmonary vein isolation) it appears (as a non-medic) that cryogenic is possibly more effective in many cases but not all. Being philosophical don't wait around for utopia for procedures or operations because utopia in all fields (not just medicine) never exists and and in any event we may not be around to see it or benefit from it (eg maybe in 50 years time PVI will be a 30 min procedure and patient only there for a couple of hours and a 99% success rate. However most of us won't be around to see that (being realistic not morbid). What we have to do is go for what is available now and what can help us now. It is vastly better for AF now than what was available 20 years ago!!! Yes we individually don't like being Guinea Pigs but if no one had been we would have been stuck in the Middle Ages!!!!! My father was one of the Guinea pigs for some RF treatment when his cancer spread to his liver and he gained about three extra years that way so it was worth it!!!!

    Philosophical thoughts over!!!!!

  • My feedback would be to stop the drugs.

    You're having arrhythmias 2 or 3 times a YEAR and they last for up to 2 HOURS each. That's nothing. Relax and get used to it. Nothing's wrong. You don't need any drugs, just good nutrition and the discipline to keep track of your symptoms.

    While you're at it, learn to meditate. It stabilizes the mind. With practice, when you experience something that would otherwise be upsetting, such as an AF episode, you won't get stressed out. You'll watch it, just as you watch your mind, and you'll be stable enough to see it for what it is, which is not the end of the world.

  • I don't agree with stopping outright and certainly NOT without consultation first. What you could do is talk to your EP and then look at reducing for a period and step by step to see what happens. For many lifestyle changes don't cure, though they may help. Also medicines affect people quit differently and also for each individual differently from time to time.

  • Whether one should stop quickly or slowly depends on more medical knowledge than I have. I understand that flecainide loses its effectiveness over time, which may be why so many people have to bump up the dosage. Age 56 seems like awfully young to start that process.

    In any case, 2-3 bouts a year lasting a maximum of 2 hours each is next to nothing, and IMO certainly not worth taking drugs. Unless, I suppose, those bouts are so severe as to be truly medically hazardous.

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