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AF Association
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2nd visit to cardiologist. Meds now changed.

Hi, after following advise from you lovely people regarding getting areferal to see an EP. I did lots of research and then arranged to see my doctor whe made a referal. The EP in York argeed to see me. I next got a letter from my cardiolist with a date to see him which was today. I was diagnosed with AF in October 2016 after been admitted to A and E. I since had a further 5 attacks between then and December. At the time i was under a great deal of stress. I had my last attack in May of this year. The cardiologist today said he would not consider an ablation as i had been free of an attack for 5 months. Also did not think i needed to see the EP. But if i got worse to ask for another referal. I have been taking 7mg biaspropol and have a 200mg of flecainide as a pill in the pocket if i get an attack. He has now changed my meds to 5mg of beta blocker. As i was getting outbof breath with 7mg and now to takeb100mg flecinide daily. If i get an attack to take a further 200mg. 300mg is the maximum i can take. Health wise my heart.blood pressure are both normal. Does any one else take these tablets together and do you think i should not carry on and see the EP? The cardio said i would in the future possibly need an ablation but not at this stage.

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Hi Mandy, My advice would be to still make an appointment and get the opinion of an EP. Cardiologists "manage" AFib and EP's fix it. EP's are the specialists in the electrical system and this is an electrical problem. Cardiologists are more the plumbers of the heart. The current thinking is to ablate sooner than later, to not let it get worse, so I do think it prudent to at least get that expert opinion and then you can make that choice. Many people feel breathless and fatigued on the medications to manage AFib and that is why the thought of a life free of those meds is so appealing. Be well!

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Thank you. This is good advice. I will keep you posted as to how i get on. Take Care.

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Absolutely agree with you on getting to see an EP as soon as possible. Have you worn a 7 day holter to record your ECG yet??

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Oh, and a further thought: being 'attack free' doesn't necessarily mean you are not in A fib. I was shocked to learn I had been in persistent Afib in March this year when I hadn't had any symptoms until the end of April.

I couldn't tolerate the meds, hence my 2 ablations. And I am now feeling hopeful.

Research shows the progression from paroxysmal to permanent Afib is in about 20% of people not 100%.

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Hi

I have persistent Afib with NO symptoms . I m on metropolol 25 mg and benzazapril for high blood pressure ..... Did you do the halter ?

No one had me use the halter .

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Hi Salvator, yes I did do the 7 day holter and it was when the results finally turned up after three months that I learned I was in permanent A fib.

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I have persistent a fib

But no symptoms

Dr say go on anticoagulant one month before and after cardioversion

Any comments for me??

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The anti coagulants are to reduce the chance of stroke, so it doesn't really matter if you have symptoms or not. If you are in permanent A fib and aymptomatic, you need to be on anti coagulants. I am on Apixiban and tolerate it very well.

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Did u have cardioversion

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No. My brother, who presumably has similar Afib to me, has had 3 and he reverted back each time after a few days.

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No i have only had a 24 hour monitor. This showed up nothing.

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Hi Mandy, a 24 hour ECG can often miss Afib. I had two of them via two separate cardiologist referrals. Both were negative. My first 7 day holter, ordered by my EP, picked up 35 hours of Afib, the second picked up continuous Afib (and I hadn't a clue I was in Afib since I was asymptomatic).

And I agree with Rosyg's comment about flecinaide.

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Thank you for going through this. Its all so very confusing. I will persue with the EP appointment. I feel lucky that they have agreed to see me. I will update once i have been. Thank you once again.

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Hi,

I can see why the cardiologist thinks you are OK at precent BUT I don't see why he thinks you need flecanide daily is you are not having any AF so I would still press for the EP appointment- if you decide not to go for ablation at present, you could discuss with him/ her whether flecanide is better for you as PIP or daily I think.

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Thank you RosyG. The cardiologist said he did not think i would even be considerd an ablation at the moment because of the 5 month no attacks.

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I spoke to my EP this week and these were his comments At present there is no evidence that ablation reduces the chance or increases the time taken to go in to permanent AF (although there is a trial at present looking at this) which will happen to us all eventually, Neither is there evidence that it reduces the risk of stroke. The main purpose is to improve quality of life if you are having frequent symptomatic episodes of AF, so with your story he would not ablate at present.

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Hi Mandy, I was recently diagnosed with P-AF three weeks ago and it made a world of difference for me to see the EP. He was able to tell me the long term plan, which is currently Flecainide twice daily at 50mg each and Bisoprolol 1.25 mg once daily (which I take currently at night). I am having more episodes than you are. It appears that just one glass of wine might be my trigger. I had a 20 hour episode of AF yesterday that I was able to self convert with an additional 50 mg of Flecainide. This is all under doctors orders of course.

My EP's plan for the next 6 months is to take these two medications and let the heart calm down a bit. I have no other health problems, CHADsVASC score of 1 for female, and therefore am not on anticoagulants. I am changing my diet to more healthy choices, upping the light to moderate exercising, getting rid of processed food and the unhealthy carbs, and taking supplements like Magnesium and a few others. We're hoping that the AF will calm down and I can stop taking the Flecainide in the next 6 months as I have just turned 50 today, so still young. ;-).

I found it very reassuring to see the EP.

Best wishes,

Kelli

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Happy birthday to you. I hope you have a wonderful 50th birthday. I would be very interested to learn more about the supplements you have been perscribed please. I eat a healthy diet and hopefully once on a lower dose of the beta blocker can carry on walking again as i have been struggling with this on a high dose of the beta blocker. The cardiologist thinks once i am on the flec twice a day i will be able to reduce the beta blocker even more. I am very similar to you. Aged 48. No other health problems.

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Hi Mandy,

Thanks for the Birthday wishes! I had a rough time starting the Flecainide, which made me feel lethargic and like I lived in a bubble moving really slow. It took about 5 days for it to improve. For me the beta blocker wasn't the issue as he put me on a really low dose. So I hope you have an easier time with it.

I use AliveCor's Kardia ECG app and monitor, so I know when I'm in AF and what my pulse is like, which helps a lot, as mine was silent. I can feel it now that I now what I'm looking for.

As far as supplements, these we're prescribed. I've done non-stop research and reading (keeps me sane and unafraid) since being diagnosed a month ago. So please do your own rsearch and check with your doc on whether these supplements are right for you in combo with your medications:

WellWomanPlus multi vitamin

Nattokinase

Ubiquinol

Chelated Magnesium

Taurine

Acetyl-L-Carnitine

I will start potassium supplements after 30 days on the Magnesium. Magnesium needs time to build up in your system before starting potassium I read.

I hope that helps,

Kelli

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I have persistent Afib with NO symptoms . I m on metropolol 25 mg and benzazapril for high blood pressure

Saw EP - he did not recommend a halter. Recommended electric cardio version

Wants me to be on anticoagulant 1 month before and one month after cardio version . Please tell me your experiences

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I recommend seeing an EP for the same reasons others have stated here. But I also recommend reading other stories on this forum too. Everyone's Afib is different and you may just find that 100mg flec plus 2.5grams beta blocker ( a slight reduction of your dose) may be the best long term solution for you.

An ablation doesn't work for everyone. It may work for you. It may not. Keep that in mind. According to my EP its more likely to work if your have Paroxysmal...which could be good news for you.

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Hi Mandy, it seems the high stress period tipped you over into AF. No doubt that is now decreasing but you have to accept even with extra lifestyle/diet/supplement action ( discussed many times in this Forum) it will take several months/a year+ for the body to rebalance again. In the meantime, it is right you are stabilised with the minimum but just right level of drugs; keep questioning the medics on this area. Due to pulse of 60 and BP 120/70 I was put on only Flecainide, starting with 100mgs/day which is very low and didn't control my AF then increased to 200mgs which has kept me AF free for 3+ years.

I would be wary of EP's advice, that said, I consulted one myself just so I had the complete picture. He/she may well say consider an ablation particularly as you are so young. My EP visit was not particularly good, it was a private clinic even so he was very late and rushed and he just said ablation 70% success expected and probably another after that - no thank you even though my QOL was not good at that point but is excellent now.

I have used the threat of AF to change my lifestyle and habits with great success and I wouldn't go back to the pre-AF days. Although in no way can I say the change was easy (lots of research and consultations) I owe AF a lot!

Good luck.

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I have persistent Afib with NO symptoms . I m on metropolol 25 mg and benzazapril for high blood pressure

Saw EP - he did not recommend a halter. Recommended electric cardio version

Wants me to be on anticoagulant 1 month before and one month after cardio version . Please tell me your experiences

Reply

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