Waiting in Persistent

On Feb.2, 2016, at 73, I was diagnosed with atrial flutter. My GP, for three months, put me on Metropol (which did not agree with me) and Riveroxaban . Due to miscommunication, I came off those meds and remained only on Rampril for high blood pressure and aspirin (My GP, due to diagnosis, immediately took me off hydrochlorozide), On April 5, 2016, I had an echocardiogram recording no valve problems. From May to September I had one irregular heartbeat episode a month lasting 2 or 3 days. On September 27, my EKG recorded atrial fibrillation. Beginning October to present, I have spiraled down rapidly with 5 episodes in October, 3 in November, 7 in December, and 3 in January , most lasting from 3 to 4 days , and with the last one beginning January 13 to today marking day 34 in persistent atrial fibrillation. Despite being prescribed Verapamil 120mg on Oct. 6, I began taking it on November 28. When I met with my GP a month later stating I was alarmed that I was 3 ½ days in afib and 3 ½ days in sinus rhythm, his answer was that it was the Verapamil working but he did not refer me to a cardiologist. I did ask to replace Rampril with Lisinopril since I had been on the former for years. On my last appointment on January 23, and in persistent atrial fibrillation, my GP has finally referred me to a cardiologist for an evaluation and upped my Verapamil to 180mg in the hopes I may convert to sinus rhythm, plus he wonders whether the blood pressure medication switch may have triggered persistent atrial fribrillation. Just to see the cardiologist will be day 54 in afib. My questions are did I spiral too rapidly and how much damage is being done to my heart as I wait in persistent fibrillation?

4 Replies

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  • Are you still not taking an anti coagulant? You mention stopping Rivaroxaban.

  • I am taking aspirin 81mg. My cardiologist appointment is March 7, 2017, so I will see what happens then with regard to other anti coagulants.

  • Many people are permanently in AF and provided the rate is controlled the heart should not suffer too much. I am appalled at you lack of treatment which borders on negligent and do think that you should be assessed for stroke risk and probably put back on anticoagulation. Why not do your own CHADSVASC score. Look up AF Association website, search CHADSVASC and work it out .

    By the way you have not been given any rhythm control drugs so only rate is been attempted .

  • I have been resistant in welcoming afib drugs and anti coagulation drugs on top of my hypertension ones. But, out of necessity, I have grown to accept afib. since the disease has gotten worse. Only rate control has been attempted by my GP, who feels rhythm control is for cardiologists to prescribe. I have read that rate control drugs restrict the ventricles from beating too rapidly in trying to catch up to the fast beating atria. Since the atria are not being controlled, do they not then continue to become more haywire in their electrical beats? So, my question was more about the rapidity of atrial degeneration in terms of lesions and fibrosis. March 7, 2017 is my cardiologist appointment "for an evaluation." I intend to be directed to an electrophysiologist for the purposes of an ablation because I do not want to go the rhythm control drug route. It is probable that the cardiologist will prescribe one of the new anticoagulant drugs during the ablation waiting period. Thank you for pin-pointing your stroke concern.

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