Can a cardioversion work for persistent AF?

[puppywalker]

I went to see the cardiologist last month to get the results of the heart ultrasound and 24 hour heart monitor that were done in November. When the tests were done I was in NSR but went into persistent AF after that, at the end of November. I told the cardiologist that I was now in persistent AF and he sent me for an ECG to confirm it. I had been expecting him to suggest a cardioversion but was taken aback when he said that as I was in AF all of the time a cardioversion would not work and if it did my heart would almost certainly flip back into AF almost immediately. He said my heart was contracting well and to come back in a year's time and to continue with the medication prescribed by my GP i.e. 1.25 mg Bisoprolol and an anticoagulant.

Apart from getting breathless if I walk uphill or go upstairs I feel fine. I do get tired more easily but it is not too bad. I am happy to stay as I am if that will not do any damage to my heart but worry that at some time in the future I will be told that I should have had a CV but that it is too late now and I have missed my chance!

I thought he would have suggested another ultrasound as to me it seems obvious there has been a change in the way my heart is working. Have you any advice please? E

[Hidden]

Hi Puppywalker, please bear in mind that I'm not medically trained and your Cardiologist may have good reason for his comments, but as I understand it, cardioversions are generally given to patients in persistent AF to see if they can be reverted back to NSR. Although the patient may flip back into AF, it helps establish if they feel better in rhythm and often helps indicate whether or not an ablation is an option. If that is the case, then generally it is best done sooner rather than later. If I were you, I would ask to be referred to an Electrophysiologist, a cardiologist who specialises in arrhythmia for a second opinion......John

[Hidden]

Hi again Puppywalker, I have just read your earlier posts and it seems that your AF is well controlled on a low dose of Bisoprolol and that you are anticoagulated. This may be the reason why your cardiologist is happy to monitor you before making any changes to your treatment. As I'm sure you know, many people in your position are happy to carry on without intervention because their condition is being controlled and their heart function is less likely to deteriorate. I would, however, opt to see an EP just to be sure. Best wishes, John

[puppywalker in reply to Hidden]

Thanks John.

[azriverrat]

The longer you wait the less chance of success on an ablation.

[puppywalker in reply to azriverrat]

Thank you all for your replies. I am seeing GP on Tuesday for medication review so will ask what he thinks. He may have had information from cardiologist. E

[TonyRands]

I have had 2 cardioversions, one kept me in sinus for around 4 years, the second for 2 months. With the second I carried on taking a low dose of beta blockers, which appears to be an accepted method of keeping in sinus after DCV. However I wasn't aware of this approach, the GP was not keen on me taking beta blockers, so I stopped them and shortly went back into af. I am due for a 3rd DCV, but this time the cardiologist is prescribing beta blockers to increase the chance of staying in sinus and I shall remain on those. Page 11 of the AF society booklet mentions this use of beta blockers.

Like you my af doesn't cause me any symptoms other than a slower time on my 10k runs, so should the beta blocker approach not work, I am happy to stay in af, which you seem happy to do. It may be worth pushing for a DCV plus beta blockers just to see if it works, you don't have anything to lose. I am nearly 78 yo.

[seasider18]

Does a ten second ECG show what type of AF that you have?

[Dadog]

Hi puppywalker. I was in AF continuously for over a year (new cardio section being built and hospital forgot about me!). I had the CV when they remembered me and it worked perfectly for 13 months. Second CV has lasted for two years now. Not same for everyone - but it can work for persistent AF.

[puppywalker in reply to Dadog]

Thank you Dadog, that is encouraging. E