My first cardioversion was successful!! On first try!
So, from the doom and gloom implied by the one visit cardiologist, I was successfully converted today by a top electrophysiologist Dr. M. Bennett. The staff and nurses, the equipment, the doctors were all positive, professional experiences. My faith in the western Canada AF clinic has been greatly restored.
Now it is a matter of how long I can remain in NSR. Any advice other than standard?
Hope this is your one and only and can be controlled with meds. Stats are different for everyone. My PAF reguired a few CV's and then I decided on Ablation. See if you can find what may have induced your AF. Alcohol, caffeine? stress? etc and adjust accordingly. Good luck!
I was actually in day 91 of persistent AF on the date of the cardioversion. I have had a BMI of greater than 30 although I have 8 pounds to get under that number. I have been battling high blood pressure for eleven years although I am on meds for that. My late brother had AF, as well as at least one cousin. Extreme stress and dehydration were the triggers that began both atrial flutter and atrial fibrillation. When in paroxysmal AF, alcohol was a trigger, so I now limit it to only 4 ounces of wine for special occasions. 90% dark chocolate resulted in an hour and an half episode, so I avoid chocolates of that concentration. Sweets is also a trigger so I have those only on special occasions.
In my location, a cardioversion is a prerequisite for an ablation. So, now I am waiting for the next step.
I am being kept in nsr by being put on beta blockers after cv. Prior to that I reverted to af when not on blockers. By the way the af society booklet says that remaining on beta blockers is one way of staying in nsr. Also my discharge notes after my cv specifically said that if I didn't remain on beta blockers I would likely return to af.
When first diagnosed with atrial flutter on Feb. 2, 2016, I was put on 25mg of metoprolol, a beta blocker, which did not agree with me at all and which I discontinued after two months. By September 2016 I had progressed to atrial fibrillation, so this time my GP put me on 120mg of Verapamil, a rate control, which I am still on today.
For my cardioversion yesterday, the AF nurse told me to not take the verapamil for the cardioversion. I ended up not taking it yesterday and was back in AF when I woke up this morning and took my Verapamil. By about 6 this evening I was back in sinus. I hope the Verapamil will keep me in sinus and I am so happy to be again in sinus. What a roller coaster!
I really don't want to rain on your parade but cardioversion (CV) is not a cure nor, strictly speaking, even a treatment for AF. It is simply a quick way of upsetting the erratic heartbeat and returning it to normal. The outcome is exactly the same as someone in paroxysmal AF who spontaneously goes back into normal sinus rhythm. Unfortunately, because you still have AF it's a waiting game until the next one. It could be next year or it could be tomorrow. I apologise if I'm telling you something you fully comprehend but there are many folk on this site who don't understand the limitations of a CV.
Now, an ablation on the other hand.........
You are basically right, RobertELee and a CV simply puts you back into NSR. It also tells the consultants something about your AF - chiefly that it can be controlled.
Ablations, on the other hand, concern me a little. I read so much on here about problems with them, after effects and repeats, that it is evident there is a way to go yet before it is a perfect cure. It's all we have though. I'm sure it is still being researched and perfected.
Unfortunately, the waiting game was just the next day, as I was back in AF this morning but later about six o'clock I was back in sinus and still am as I write this five hours later. So my body is not acting persistent but paroxysmal which does make me elated. Where I live my cardiologist said that I must have a CV first or the AF clinic will ask why I wasn't converted first before requesting to move on to an ablation.
Please don't apologise as I have read your past posts and really appreciated them.
Sorry to hear it's returned so quickly but yes, the upside is that you now know that nsr is achievable and, as Dadog says, that tells the consultants that an ablation would have a real chance of success. Certainly cause for elation. You know that your condition won't get any better (no matter how much magnesium you consume!!) and AF episodes are likely to become more frequent and longer lasting without an ablation. Sure, it may not work first time but the chances of the procedure making things worse are very small indeed. And once you make up your mind to go for it...you will at long last feel you're on the road to recovery.
My mind was made up when I first flipped into persistent AF. Researching the condition and following this forum has made me confident that ablation is definitely the way to go. Navigating the system to get the ablation is the frustrating part.
Yes, I've had a few cardioversions (each one successful and lasting for years/months) and my advice to you is not to exert yourself too much for the first few days. Certainly do not just sit around, but let your heart gain strength in being in a normal rhythm again before you put any pressure on it and make it race - because it may just stay in that race mode again.
Jean
I love your advice about letting the heart gain strength and not putting any pressure on it. I was planning to go back to aquafit on Monday which would be four days later, but now maybe I should wait a week?
I learnt that the hard way by walking up a really steep hill the day after a cardioversion and flipping back into AF immediately! Yes, let your heart get strong again in it's sinus rhythm before attempting anything that puts a strain on it.
Eat healthily, and exercise - gently! A good multi-vitamin-and-mineral tablet from a health food shop taken daily with food for three months can improve your overall health and could help. Magnesium is also highly recommended - research on here (using box in top right -hand corner). People with AF are known to be generally low in magnesium, though your doctor may not recognise that (they are not trained in the use of supplements etc), but you should still check with him in case there is some reason, in your case, for not using it.
One of the side effects of the rate control Verapamil is constipation which I experienced when I was started on it for AF. Subsequently, I do take Magnesium Citrate 150mg x2 (on my own, not prescribed by my GP although I told him). Recently I added about a teaspoon of Psyllium Husk to my oatmeal in the morning. The result is that all is well in that department.
I have revamped my bad eating habits and I do try to exercise, but the multi-vitamin-and-mineral tablet I haven't tried. Good advice, thank you.
All above is good feedback for you to digest. Trouble with AF that it is SO individual and SO unpredictable it is almost impossible to give generalizations but take this:-
1. You saw the right person in the specialist EP so stick with him!
2. Great the CV worked - hopefully you will stick in NSR - but don't get too disheartened if you don't because it proves you respond well so ablation would then be a very credible option.
3. Think positive and live well - exercise, diet and drinking sensibly will all help maintain your gerneral good health and have a positive affect on keeping AF away.
Good luck.
I have been reading all your posts recently. You are a great model for all of us for you "live the walk" if I have the cliche correct. Yes, I will definitely stick with the EP if I am allowed as I requested him.
Your comment that I will respond well to ablation is sweet music to my ears and certainly makes me think so positively. Thank you.
I think my advice would be to exercise and think positive. If you stay in NSR then that's great, and if you don't you'll be recommended for an ablation.
One question is didn't they either put you on aminodarone or give you flec as a pill in the pocket ?
The short answer is neither.
Since I told my cardiologist's student resident that I responded badly to metoprolol, the cardiologist said that he would not put me on Amiodarone. Flecainide was not offered either. I had gone to the cardiologist to send me to the EP for an ablation as I was in persistent AF. According to the cardiologist, the outcome of the cardioversion would most likely determine the outcome of an ablation. His words were, "If the cardioversion fails, then so would the ablation." You can imagine the anxiety I felt leading up to the cardioversion thinking that my only option might be drugs. I can now breathe freely.
Follow up after cardioversion 
Cardioversion 
1st cardioversion 
Cardioversion + TEE
cardioversion
