Failed CV

[John67]

Hi everyone, I had my first cv last Tuesday which unfortunately didn't work. I'm waiting for an appointment to see the cardiologist. I'm in persistent af with no real symptoms. My question is should I stay on the meds or go for ablation if offered?

[PeterWh]

Don't worry about cv failing. The first thing is that you were returned to NSR so an ablation is an option.

Did you feel better in NSR?

The fact that you don't have real symptoms is a little vague. If in persistent AF you won't get sudden attacks in the way that someone with paroxysmal AF gets. However given time you probably will get issues and attacks. I was diagnosed in persistent just over two years ago. Had an ablation but went back into persistent AF less than 72 hours later. Now 18 months on I am definitely getting worse and can do less and QoL has gone down. I can expand more at a later date.

AF can do other things to the heart and your circulation will be reduced because of insufficient pumping.

Personally I would go for the ablation sooner rather than later based on my experience and reading other subscriber's posts. It can only get worse not better. The unknown is over what period. Also you don't know what else will pop up.

I am guessing from your user name that you are 59.

[John67 in reply to PeterWh]

Thanks Peter, the cardio nurse said that the the first 'shock' appeared to work but after a a short time I went back into af. I had two more 'shocks' but it didn't work. I'll update once I have seen the cardiologist.

John

[BobD Volunteer]

Just to clarify one thing. Did the DCCV ever put you into NSR? You say it failed which to me means that you never went back to normal rhythm. If that is the case then ablation may not be an option and in fact a bad idea as you would be facing a procedure which does have risks for no real purpose. I doubt that any EP worth is salt would want to attempt ablation when cardioversion had not worked even for a few minutes.

Regarding long term medication there is no doubt that leaving the AF untreated can lead to other cardiac issues such as cardiomyopathy or even heart failure. Again you say that you are asymptomatic but do you know what your heart rate is for example? Some people have relatively low rates of AF say 80 bpm but for most it is up in the 140 upwards range which can damage the heart long term if not reduced by drugs.

Read all you can from AF Association main website and make sure that you see a specialist to discuss your future treatment plan. AF is a long journey remember and no quick fixes I'm afraid.

[excalibur in reply to BobD]

if the cv didn't get you into NSR at all, ask whether it's possible to do another cv using the internal method via catheter. This has a much higher chance of succeeding. My first cv was the conventional type using external paddles, and failed. Subsequent cv's using the internal method always were successful.

lance

[John67 in reply to excalibur]

Thanks excalibur

[John67 in reply to excalibur]

Hello excalibur, how long had you had persistent af before trying the internal method and do you feel better for having it?

[excalibur in reply to John67]

I had had it for at least a year. They had tried 3 attempts at an external cardioversion - the 3rd attempt they placed one paddle on my chest and one on my back and all it did was give me burns. Then a year later I had an internal one which worked 1st time. I have since had to have 3 or 4 more internal cardioversions after I reverted to AF, though these were spread over 8 years. For the last 6+ years I was on Amiodarone which kept me in NSR and I felt better than in AF, but had to stop the Amiodarone due to side effects and the replacement - Dronedarone didn't prove effective. So now I've decided it's best to stay in AF - my EP wasn't keen on an ablation.

Generally I would say that I felt better in NSR, but I've just learned to live with my AF. I don't get major symptoms, and I don't get fast AF - I just have a very irregular pulse which affects my ability to breathe rhythmically when exercising.

But I think that it's important to have been able to try both approaches so that you can compare the difference.

Lance

[John67 in reply to excalibur]

Many thanks for this. Once I've seen my cardiologist I will update with his recommendations.

John

[John67 in reply to BobD]

Thanks Bob, apparently after the first 'shock' I was in NSR for a short period and then back into af. Next two 'shocks' didn't work. My heart rate is around 80 and bp 130/ 90.

John