Could this be a way for you?

[Travellingrandad]

Am I cured?????????????????????????????????????

I am a seventy-seven year old male and I have suffered A/F for quite a long time, over fifteen years.

My life became more sedentary than usual as I settled into an English winter at the end of 2012. My bouts of A/F increased from the normal once a month to three times per week and so I made efforts to see the local A/F hotshot, in Poole Hospital

Getting an appointment to see a specialist takes time and I went skiing and then to Spain and resumed my normal routine with the mountain walking group and I noted that my bouts of A/F had decreased, I set about a personal keep fit regime and walked (preferably uphill) every day. I cycle down again!

That was early in 2013 .

I have since seen the Doctor at Poole Hospital and done all the tests including the 24 hour heart monitor and she could find no fault, in fact she had to check the records carefully to make sure I wasn't joking about having A/F.

I live a normal life, drink my fair share of the Costa Blanca wine but do take regular exercise and I rarely have an A/F event and even then, it is minimal.

You can imagine how delighted I am.

I take aspirin once a day and Angitil 90mg capsule twice per day and at the suggestion of the Spanish doctors, I also take propafanon. I am also prescribed statins for high cholesterol and I feel that this may also be part of the answer.

Perhaps the medically inclined among you can find some form of answer to this but if exercise is all it takes, the answer may lie in your own hands or perhaps, feet!

Arthur

[Hardjuice]

I'll be interested in replies

As I haven't an answer to why you came out of AF

[BobD Volunteer]

I suspect the Propafanone (Arhythmol or Rhytmol) is probably doing its job which is why you do not experience any symptoms. It is an anti-arrhythmia drug. Lucky person!

Don't approve of the aspirin unless you have other heart problems as it does sweet f. a. for stroke prevention in AF whilst still having the capacity to cause stomach bleeding.

[Tricia239 in reply to BobD]

Bob, why do you say 'lucky'? I don't seem to tolerate any meds, but, this one has not been offered to me - any idea why? I'm on two Nebivolol per day, don't like taking them but they do seem to minimise the frequency of my attacks of PAF.

[BobD Volunteer in reply to Tricia239]

Lucky as in not having any events. The first line of treatment is always beta blockers as GPs are not supposed to prescribe anti-arrhythmic drugs in UK. Things ending in lol are beta blockers which just slow the heart during events, not attempt to stop them.

[PeterWh in reply to BobD]

Bob. Alan Williams has asked you a question below. Jean pointed out correct way but Alan hasn't redone. Please see.

[Hidden]

I took propafenone and it completely stopped my AF. I was on it for about 3 years, and I can't remember having a single bout during that time. I had a terrible memory when on it though , but other people don't seem to get this problem hopefully.

Koll

[AnticoagulateNow in reply to Hidden]

You probably had many bouts Koll - you just didn't remember them!

[Hidden in reply to AnticoagulateNow]

Ah ha, you could be right

[CDreamer]

Very interesting and pleased for you. I am sure diet and exercise will help, personally I found all drugs have side effects and for me made me feel worse and stopped me exercise so you are one very lucky person. Could also be the stress free life? You enjoy..........

Having lived in Spain I found the Spanish doctors great, having said that cannot understand the asprin - why?

[Travellingrandad in reply to CDreamer]

Yes! I could believe that a stress free life is a major contribution to my current health, I could also believe that my very stressful live prior to retirement was a major cause

[Alanwilliam]

Bob D

I am confused when you say that GP's are not supposed to prescribe anti arrhythmic drugs. Can you explain what you wan by this. Thanks

[jeanjeannie50 in reply to Alanwilliam]

Just to let you know that Bob won't get any notification, or be aware that you have asked this question unless you do a reply under one of his comments on this page.

[Alanwilliam in reply to jeanjeannie50]

Hi Jeanjeannie. Many thanks for your interest in my reply to Bob. I wad beginning to get paranoid that I was being ignored. I will look at your tip and will try again. Many thanks again

[BobD Volunteer in reply to Alanwilliam]

Hi Alan . Peter alerted me so here I am.

Drugs like felecainide, propafanone, amiodarone etc are anti-arrhythmic drugs which try to prevent the arrhythmia at source by changing the chemistry in the heart.

They can have a negative effect in some circumstances and as a result should only be initially prescribed by tertiary not primary care i e by a consultant in a hospital. Although amiodarone is supposed only to be used as a last resort due to the many side effects , flecainide is commonly prescribed either as a pill in the pocket (PIP) or as a regular dose. It is normally started in a hospital after checks on the general condition of the heart (echocardiogram) and the patient should be monitored to ensure that it does not introduce other arrhythmias. Flecainide is the commonly used anti arrhythmic and although propafanone works in a similar way it is not so commonly used.

NICE guidelines are that GPs should at presentation prescribe a beta blocker to help lower heart rate during events to reduce symptoms but that if this fails to improve QOL (quaity of life) then the patient should be referred to a specialist within four weeks.

Hope that helps explain.

[Alanwilliam in reply to BobD]

Bob. Many thanks for your comprehensive reply and for taking the time to put it together. I was not aware of many of the details you describe regarding anti arrhythmic drugs. I am much clearer now. Keep up the good work. Alan

[Hidden in reply to BobD]

Bob, my first and last PAF episode was 12/16, I was prescribed low dose sotalol and aspirin. Im working on getting healthy. My question I cannot get my cardiologist to answer, is why do I have to take sotalol after 3 mo of nsr. What would b the problem

with watch and see? I have major fatigue and short of breath with exercise. Echo, cardiac cath, ejection fraction all good. Bp good just obeisity(BMI 36 , Im female and 63.

[BobD Volunteer in reply to Hidden]

Far be for me to criticise but both aspirin and sotalol are no longer recommended for treatment of AF under 2014 NICE guidelines. So you see you have almost zero stroke protection plus are taking a drug which can actually cause harm.

What I would say is that unless you are wearing a monitor you may not know if you are having AF events. Not everybody is aware of them. Most AF related stroke victims only find out that they have AF AFTER the stroke hits.

Please speak to your cardiologist after you read all about this condition and treatment from AF Association fact sheets.

[Hidden in reply to BobD]

I am thinking I need a new cardio, prob is in our area, one large group all partners. My question I guess is wondering if its medically acceptable to ask for no meds but pip?

[Coco51]

First of all it's great to hear your good news. The fitness regime is a good idea but as a cure for AF didn't work for me. My bouts occurred 6 - 8 times a year over 10 years despite regular dog-walking and Zumba. Then after a six week period of 2 - 3 hours a day of very enjoyable walking in France including uphill my AF went persistent - ie didn't stop. A cardioversion has worked so far for 5 weeks. Ablation is scheduled. But I will carry on with the walking come what may. Hope it continues to work for you.

[SRMGrandma Volunteer]

Diet and exercise are the key to being heart healthy. They don't, however cure arrhythmia's, but when you are healthy, the AF can stay at bay. In many ways AF is a reflection of one's general health. As Bob says, you are on the propafenone so that is working to keep you in rhythm so it's all good!

[Craggy]

Well done. A positive attitude really helps and fitness of the mind (and lack of stress) can be as important as physical fitness. You appear to have both.

Are you cured? Well even though I have managed to avoid AF for nearly a year, I won't consider myself cured until I stop taking my drugs (flecainide and bisoprolol) and still remain AF free.

[Travellingrandad]

Thank you everyone for your comments. I feel great but I know very well that as I get even older, the exercise regime will start to melt away and the dreaded AF will return. I also expect that the NHS will be more reluctant to do an ablation, preferring to spend resources on younger folks. After all I have read on ablations, I do not feel very confident regarding the success rate and so I will avoid this course as long as possible.

Has anyone got any statistics re success of ablation?

[Buffafly in reply to Travellingrandad]

Statistics keep changing as EPs become more skillful and equipment improves so hard to say what the present ones are. If you consult an EP he can tell you what he considers your chances of success are, which are really the only ones that matter! However it also depends on the skill and equipment of the EP......

It is generally recognised that if you are going to have an ablation you have the best chance of success if you have it while in PAF, once you go to persistent it is much harder. I was told when Propafenone became less effective for me that I should have an ablation asap.

As for age we have people of 80 on the forum who have had or been offered ablations, it depends on general and Cardiac fitness although even that need not rule you out if an ablation is expected to improve your QOL or avoid a pacemaker.

Hope that helps.