Managing afib without ablation?

[Arveno]

Are there some persons with afib who can manage rather acceptable life with change of life style anticoagulant, some medication and without ablation? Would be encouradging to know that it is possible. Thank you all for sharing.

[Hidden]

Hi, everyone is different and the only person who can answer that is you. Some people have a lot of symptoms, some have none and some have a few. Some can control the AF with medication, some cannot and some have side effects from the drugs. The question is what quality of life you can achieve if in AF or in sinus on medication. Having a cardio version to get you into sinus (hopefully and maybe not for long) can give you a glimpse of life in sinus.

[Arveno in reply to Hidden]

Thank you Richard75. Yes, you are right and of course I know all what you are mention as I am reading a lot. We (my husband 76) are managing with Sotalol, Xarelto, LCHF diet (he has diabetes) and aggressive modification of life style. He is asymptomatic, felling rather OK except tiredness (probably consequence of Sotalol) and some limitations. I would be happy to keep him alive with me in this (hopefully little better) condition without risks of problems during and after ablation. Therefore I was asking whether there may be somebody who suceeded with that. May be yes but those people are not here.

[songbird74 in reply to Arveno]

I have AF every fourth day and it used to last 48 hrs. After being diagnosed pre-diabetic I went onto LCHF diet, lost 2 stones and now my AF still starts every fourth day but only lasts 12 - 24 hours. Interestingly my blood sugar is down to 5.3 on days I don't have the AF but 6.8ish on days I do so the AF is driving the diabetes. I felt very lethargic on bisoprorol and flecainide and they didn't help so am now on flecanide which has much less side effects and I have reduced dose to 5mg as above that didn't improve the Af and I'm told makes losing weight harder. Also started taking magnesium at 150 twice a day - dont know if this has helped too.

[Arveno in reply to songbird74]

Hi Songbird. Thank you for sharing . I tried to copy reference of Dr Mendrolas article: "Insulin, Not Cholesterol, Is the True Culprit in Heart Disease". According to the article it is insulinresistance, diabetes or pre-diabetes which is driving afib not the oposite. You can read yourself. Try google it as I did not suceeded at copiing the reference.

Concerning supplementation with Manesium. I do not know which are you using but we are using Magnesium taurat as the quantity of Tauring in the body/heart is decreasing with age. My husband is 76 years so it can help.. Anyway it cannot danger.

[Hidden in reply to Arveno]

My mother had persistent AF that was discovered in her 80's, probably had it long before diagnosed. She got a pacemaker because her heart rate would drop very low in her sleep. She was a very perky woman and lived pretty well until she died at age 97.

I have had AF almost 21/2 yr now. I did some major life style changes and am getting along with just pill in pocket method so far. My last episode was 11 months apart, I have not been in hospital or needed ER since diagnosis. Im hoping to avoid ablation but if my AF gets more often and bothersome, I would consider it.

[CDreamer]

I can only offer personal experience - when AF was occasional I coped very well. As AF progressed to having 2-3 episodes a week, often lasting over 24 hours and leaving me weak, breathless and exhausted and after drugs stopped working - I felt there was no reasonable life for me without ablation. I needed 2 and am very grateful for the AF free life since.

If I had my time again I wouldn't wait nearly as long.

But to answer your questions - yes there seem to be quite a few people who have found that changing their lifestyle through diet - changing to mainly plant based diet, eliminating alcohol and exercising have stopped their episodes. It is worth a try before but didn't make slightest difference for me.

[Arveno]

Thank you CDdreamer for sharing.

[Finvola]

Yes, I decided - in consultation with my EP - to stay with drug therapy for symptomatic PAF and other arrhythmias. I have no co-morbidities, except my age, which is nearly 73. I have taken Apixaban, Bisoprolol and Flecainide since 2014 and have had no AF in that time but have very brief runs of tachycardia and bouts of ectopics.

My life is fairly normal, except for having to pace myself due to breathlessness on exertion - probably caused by the Bisoprolol and Flecainide.

I have made lifestyle changes since diagnosis - no alcohol, artificial sweeteners, colourings or flavourings, processed food or takeaways. I limit caffeine, sugar, red meat and do my best to avoid adrenaline (as in dental injections) and rarely use over-the-counter medicines without a major investigation into ingredients and interactions. I eat masses of vegs, fruit, fish (sea, not farmed). I've always been an avid walker, so that continues - as does moving the weeds around (which I call gardening). Good quality sleep is important as is stress reduction and relaxation.

If/when things worsen, I have the option to consult with my EP for ablation but at the moment, that is not an option I wish to consider - for a whole variety of reasons.

[Arveno in reply to Finvola]

Finvola, nice to hear that we are not alone with our type of considerations. We are doing simillar life changes as you, but no sugar or carbohydrates. As husband has diabetes we started to use LCHF diet and with that keping blood sugar close to normal 5,5-6,7 mmol/l. Blood pressure is also OK (about 135/72 at morning can be 105/60 at evening, puls between 60 -70. He also lost 20 kg. We do not know whether he has some afib incidents as he does not feel them. As far as I know (reeding a lot..) there is the same risk of stroke or whatever (sudden death) with or without afib or ablation. There is risk of ventricular fibrilation with Sotalol. Which we are carefully observing trying to avoid ( salt ballance and other) potential triggers.

[Finvola in reply to Arveno]

That's an impressive weight loss - well done to your hubby. As any therapy for AF, drugs or intervention, is all about quality of life, I'm fairly content to stay with drugs - whilst they do the job with minimal side effects. Like you, I'm aware of the potential risks of drug therapy but trust my excellent cardiologists to monitor things and advise as to the best options.

Best wishes to both of you in your AF journey.

[Zezee in reply to Finvola]

Hi Finvola ...Think along the same way you do ...hopefully we can benefit q.o.l as we are doing on medication alone ..all the best .Celia x

[maxred1]

I was given a less than 30% chance of ablation success. I had a failed cardioversion. I had to weigh up my options. I have decided NO ablation. I was extremely symptomatic. I gave up alcohol, it is now zero intake, walk three times a day, sold my business, and reduced my stress. Gradually I am felling better, not fantastic, but a great deal better. I also changed the sequence of my meds. I take 10mg, Bisoprolol, 325mcg Digoxin, per day, but changed the timings of when I take them. I came off Pradaxa. It appears to have made a difference. My HR has increased, as I dropped the Biso, used to take 15mg, from 75 to 90, and this used to bother me. I don't let it worry me any longer. It has taken two years, and a long road, but I am hopeful i have turned a corner. The QOL will determine any future decisions, but at the moment, I do what I can. By the way, the NHS cardio told me I was cured, when they managed, with large amounts of medication, to control my rate.......I was feeling very lousy. Fills you full of confidence with the cardios?? I wish you well on your journey....

[cuore in reply to maxred1]

I am interested why you were given less than a 30% chance of success?

[sleeksheep in reply to cuore]

I also was told that the first ablation is usually 30% - 40% , most need a follow up.

I am in sinus rhythm after a ( my fourth ) cardioversion . My previous condition was persistent AF so it never got worse or better untill the cardioversions. This time I had a change of drugs ( no more sotalol ) just on Diltiazem CD 240mg and Flecainide 50mg daily.

I still drink wines of my choice , ciders and beers and no trouble with tea ( never a coffee drinker anyway ) cut out all sugar including those poisonous diet type drinks [ gotta be with alcohol for me to drink em ]

Also I know what "could" trigger palpitations so I stay away from those ingredients. Everyone is different with their triggers IMO.

Since coming off sotalol I feel much better and dont have any side effects from my current medication ( although it took three weeks for my system to acclimatize to flecainide )

I would say with the right drugs and a healthy lifestyle its possible.

[maxred1 in reply to cuore]

I am permanent AF, with flutter and a specific set of abnormal arrhythmia. My EP within the NHS, discussed the reasons for me NOT to do it. I then went to London Bridge to get a second opinion. Due to the length of time I have been in permanent AF, the chances of success have decreased markedly. It is well documented that the longer one is in Permanent AF, the more difficult it will be for an ablation success. Looking at all of my options, and the advice of eminent EP's, I choose not to do it. The rider being that if my QOL deteriorated further, this would be reviewed. Please remember though, this is a very individual specific condition, and what is recomended for me, may not be suitable for others. One other thought.......a good friend, an OH Consultant, once told me. Ablation physically changes you, an invasive process. CV/MEDS/ do not change your physicality. Think carefully before you have an ablation. Just my 2c.......Be well

[cuore in reply to maxred1]

Good luck to you. Hopefully A-Fib research is accelerating for those of us in persistent or permanent afib. Dr. Steve Ryan has summarised the annual AF Symposiums in the US for years. This year's 2017 January 12-14 AF Symposium summary is now online. You might be interested in reading the latest advances.

[maxred1 in reply to cuore]

Thank you. Yes, I feel that not enough is known at the moment and all of the medical sector is still in a learning curve. Once advances have been made, and more is known, then we can take decisions with more confidence.

[123Abc123]

After identifying AFib 75% of the time, my consultant didn't give me the option of ablation. I'm on warfarin and digoxin 250mg but my heart is still beating fast so am expecting that to be increased after a blood test. I have stopped drinking coffee and try to eat smaller meals but otherwise more or less carry on as before. I have had AFib for about three years.

[jacob35]

hello Arveno,

I was diagnosed 18 months ago. I was offered Ablation which I decided wasn't for me , and opted for meds instead. I am taking Apixiban and Adizem which, together with regular exercise works for me. I am not saying I will never have ablation, but while my AF is manageable I choose the meds. route. I do have episodes of severe AF which I manage, and quieter times which are reassuring. It wont be right for everyone I know but in answer to your question, yes an acceptable life is possible without ablation, for me any way. Hope this helps.

[brucecg]

I am 80 years old and have been in permanent afib for over 5 years. I take Pradaxa and Ramipril and I have a pacemaker, About a year ago I stopped feeling sorry for myself and increased my activities including walking and treadmill exercise. Also some resistance and weights. I feel my exercise regime has increased my stamina and enhanced my feeling of well being. Mind over matter? I'm not sure but it seems to be working for me.

[Robroy16]

I have been diagnosed with silent AFib, but I have several monthly episodes of intense anxiety, dizziness and a strong urge to urinate every 20 minutes that last about 20 minutes. The doctor says I have persistent AFib. The only med I take for it is Pradaxa, a blood thinner. It has been one year now since diagnosis and I am managing it ok. There is no talk of ablation. How are you doing?

[Arveno]

Many thanks to all of you. We all are on the way to adapt at best possibe way at given moment. My husband is feeling rather well except of beeng tired. He newer complain and my impression is that he is slowly improving and less depressed. I like Brucecgs meaning: "I stopped feeling sorry for myself and increased my activities including walking and treadmill exercise." That is indeed something to try. It is so encouradging to speak with you. Good luck to all of you!!!!

[WhitstableWanderer]

I've been in persistent but assymptomatic AF since June last year, brought on, it seems by a heart attack. Which may have actually been myocarditis. After a few months treatment to get my ejection fraction back up (from 9%) and get rid of a clot in the LAA, I had a cardioversion. It worked for 4 days though I didn't feel any different, but my heart rate dropped below usual levels. Went back into AF and been there ever since. EF gradually improved, now rated at 35 to 40%, and feeling fine. Playing badminton and golf, but have cut out all alcohol and caffeine. Won't see cardiologist now until September and probably will simply continue on anticoagulant (Rivaroxiban), and rythym and rate control meds. No need for ablation at moment, hopefully. So, yes, it is possible to maintain QOL even with AF. Good luck

[hygena1]

I’m managing with meds and watching sodium in foods. Sometimes carbonated beverages are a trigger and definitely have to limit caffeine and no alcohol.