This is my first post on this forum. I have found other posts and reples very helpful and encouraging.
I was diagnosed with AF in August. I was stung on the tip of my tongue, had a reaction so I admitted myself to A & E. The sting was sorted by a steriod injection, but they were concerned with my high (120) heart rate. So they kept me in overnight and in the morning after several ECG's they advised me that I had early onset AF. Since then, I have been on Rivaroxaban 97.5 mg) and Bisoprolol (20mg). I had an Echo Cardiogram at the end of August where they advised everything was normal apart from a dilated left ventrical. They dont know whether the dilated LV caused the AF or vice versa. The Cardiologist said that the Left Ventricle appeared to be functioning quite well though and that there were no signs of faulty valves.
I have been very active over the last 20 years, (cycling 5.000 + miles per year, rides of 100 plus miles etc). I am 56 years of age. I don't smoke, have a pretty good diet. I hardly drink at all now since my diagnosis.
I had a cardioversion last saturday which was successful at the first attempt. I was discharged from hospital with a HR of 52 so they reduced my Bisoprolol to 5mg. Through Sunday and Moday I had a HR in the 40's and so I became concerned about this, so I sought advice from GP who advised to reduce to 2.5 mg. I also received advice to take the Bisoprolol in the mornings so I did this as I have been taking them in the evenings with evening meal (when I take my Rivaroxaban), up until then. On Monday I developed a bug (sickness and diareha) and felt pretty rough. On Wednesday morning I woke up with HR of 114 and have now gone back into AF. Before my Cardioversion, I was in persistent or permanent AF so I am assuming this will be the same again.
Am pretty upset with this outcome as I left Hospital feeling pretty elated that the CV had worked. So I was wondering if anyone has any views or experiences to share which maybe silmilar to mine and whether the bug may have caused the AF to return after 4 days. Also what should my next step be?
Thanks in anticipation of taking the time to read this post.
Written by
Gunnersawus
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Hello and welcome and yes the bug may well have triggered the AF event but you should understand that you have AF and this may happen. Cardioversion is never a cure for AF but it can signpost further treatment options such as ablation.
You talk about your past sporting activity and of course you may also know that this may well be a cause of your AF . Endurance athletes have a high incidence of AF compared to couch potatoes similar to that for fighter pilots where fighting high g puts a high loading on the heart.
As far as future treatment is concerned I would look to see a specialist rather than your GP. An electrophysiologist is a cardiologist who went on to further study arrhythmias and their treatment. Bisoprolol is the fall back drug on first diagnosis but there are plenty of other ways to treat this mongrel condition if you see the right people.
Thanks Bob that's very helpful. I do feel that my exercise has caused the AF. I'm continuing to ride my bike, but I don't strain or over do it going up hill anymore. I'm seeing my GP next week. The Cardiologist has previously said he wants to do an MRI next to see if there is any underlying cause of the dilated Left Ventrical. I have read about Catheter Ablations, their success rate and recovery periods. I must say I wouldn't look forward to having one but will if its recommend. I wonder if you think it's worth having another bash at a CV?
Personally I'd say a CV is a waste of time in many cases. They were going to do one on me some time ago and my heart reverted to NSR the day before, probably due to it not wanting to be electrocuted
I'm afraid it does sound like you're a likely candidate for an ablation, but I will also say they have a very high success rate. Some people do need second or third ones but that's usually just to finish things off and their QoL was improved after the first ablation.
I guess I'll find out at some stage whether or not the Cardiologist advises on a Catheter Ablation. Have you had one and if so how did you feel in the following months?
Yes I had mine in 2013 as the result of a heart bypass op in 2010, but it fixed me up well and I feel a new person. It did take 6 months to recover but that was nothing compared to the 2 years the bypass took. I've had two re-occurances of AF, once for 3 weeks and once for 4 days, both due to viruses. Rest of the time get the odd ectopic but nothing bad.
After my Echocardiogram the consultant said that I had a dilated left ventricle which seemed to be functioning quite well but it was difficult to measure the ejection fraction from the results. Maybe an MRI next and another CV
I was you a few years ago. Still in great shape and had 1 extended AF event needing Cardioversion about every 12-18 months. Was on meds. IT ONLY GETS WORSE WITH TIME, NOT BETTER. (Managed risk) I was tired of drugs. I had my Catherter Ablation (Which caused a massive PE) and I was over it all in 90 days. Glad I did it. Only had one AF episode in 9 months. (Stress) .. Hoping it works long term as I stay healthy active and don't smoke either, but do have a taste for a scotch or bourbon toddy with the news nightly (Unless King trump is speaking, then I have 4) .
Cardio jump starts only work until they don't. hours, days, weeks, months, etc... YMMD :^)
A PE (Pulminary embolism) makes the AF take a back seat. It is a blood clot in the lung that causes sudden death for up to 25% of those afflicted and up to 30% dying the first 30 days. It is what killed Jimmy Stewart, Tammy Wynette and Actors Dennis Farina and Garry shandling last year. Massive amount of blood thinners are needed to shed the clot. I could neither lie down and could not breath to take oxygen into my lungs. That was very scary.
I felt like the pretty girl at the dance by many doctors attention since it is not suppose to happen while on thinners, which I was for 30 days prior to the ablation! ONLY because I had no co morbitities and was in great shape did I survive!
Wow, Rideron the Storm, you can actually have 4 drinks in one night and not go into AF. Plus, you also daily have a drink. That is good news for some of us! One of the reasons that I haven't been eager to go on a Cuba all-inclusive is that I thought that I couldn't drink. I do hope I have the same success.
I drink coffee in the AM too.. I asked my Doc and it may be true for some and not others what brings on AF. S T R E S S is mine. I exercise fine and have a good resting pulse now 9 months later so I am not hinder in my exercising regiment. I joke I am age 60 going on 40. smile.
PE is a pulmonary Embolism. I think because you are young they may suggest ablation as it would be a long time to be on medication that has its own problems. However, I would look up al the complications of ablation and also look at everyone's stories about their ablations on here- then you can make an informed decision. Don't be too down about the failed CV- I think at least 50percent fail and perhaps more in the long term
I would also make life style changes first to see whether AF reduces/stops You may have to de-train from exercise- the heart muscle increases in size with exercise- like other muscles- and that can allow the electrics to act up!! Also make sure you are having enough potassium in your diet and perhaps ask your GP about a magnesium supplement ( best to take advice first) have lots of fruit and veg and absolutely cut all processed food and alcohol- all worth trying to see effect
I have definitely cut down on cycling since being first diagnosed (one 40 mile ride per week at the moment and definitely going slower!). Have also changed my diet for the better, virtually no alcohol now and already taking magnesium as I heard that was beneficial. Also on fish oil and garlic. Like you imply, lifestyle changes are beneficial whether you have AF or not!
My first DC Cardioversion kept me AF free for approx 2 years. My second treatment with Flecainide kept me AF free only for a few months.
I'm currently on a wait list for an ablation, although i'm not convinced this is the treatment that i want at this time as my quality of life is not affected drastically by the AF
I did revert without any intervention whilst being on the waiting list which kept me in NSR for 6 months, but unfortunately went back into AF during a wild weekend at the Munich Oktoberfest (self inflicted)
After being cardioverted for afib NSR only lasted 2 weeks. I was put on Dofetilide and reverted to NSR that so far has lasted 6 mos. Took care of my CHF and no side effects. So far a miracle drug.
I have a similar background and experience to you. I had cardioversion which lasted only about four days, after being in persistent AF for some months. I suggest you may need an ablation, as subsequent cardioversions last for a shorter period, I believe. I suggest see an EP specialist asap, and pay for this if you are able to, rather than waiting several months on NHS. You can get an ECG at your local GP surgery (the practice nurse can do this). It is also possible to purchase a small ECG device called Kardia, which works with a smartphone app (called Kardia), the manufacturer is Alivecor and the cost is £99.
It is worth reading "The Haywire Heart" by Chris Case and others, it was published early 2017 and focuses on AF which is caused by excess exercise, though most of the case studies are doing marathons and iron man and the like.
My situation is that I have always been pretty fit, cycling, jogging and hillwalking. I did not think I was being extreme, though I did up it to about five sessions a week after retiring at age 57 (I am now 62).
My ablation was January 2016 (aged 60.5). It took a few months to fully recover, and that included a couple of weeks of atrial flutter. At some stage before the ablation I had bisoprolol, but it knocked me out and knackered me even for 2 hour walks and bike rides, so I dropped it. I never completely ceased exercise, but I cut out the hard stuff (hills) while I had AF.
I am now more or less recovered. Cycling works well for me, jogging less so, somehow it triggers a high and erratic pulse. Also I need nearly a week recovery period after a week with four days of hillwalking, so I am not A1 at present as I took only three days off after a trip in September.
So for me, ablation has more or less worked, but it is then something which needs management, so that I don't over-do things and knacker it up again (as I did in September, though it is improving now).
I wish you well with you recovery, be prepared to manage activities more carefully going forward. 9I track all fitness activities on a Polar heart rate monitor). Good luck!
Dofetilide has kept me in NsR after an initial cardtoversion that only lasted a week. I have experienced no significant side effects. After 6 mos I am convinced it is a Miricle drug.
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