Why no procedure?: I have had AF for... - Atrial Fibrillati...

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Why no procedure?

Zabadak profile image
19 Replies

I have had AF for some years. My heart is sound, working perfectly, no structural issues. Recently my AF has worsened, getting palpitations, fast heart rate but not much over 100 so cardiologist is not concerned. But the breathlessness and fatigue is crippling. Yesterday after four month wait, I got another appointment with the cardiologist, but they only did an ECG and Sod's law I was in perfect sinus rhythm that day. Barely ten minutes consultation, though my GP had been phoning him to get medication advice- he stopped the bisoprolol that he told go to double, increased candestartan and added a new one, verapamil. Stopped digoxin because I go in and out of AF and that's dangerous in normal mode- note he ordered that and doubled dose so I am not feeling hopeful. No mention of any interventions like ablation. I will give new men's a try but wonder if I should be complaining?

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Zabadak
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19 Replies
Luludean profile image
Luludean

Why is Digoxin dangerous in this case?

I wonder who you would complain to? That situation is not easy.

Zabadak profile image
Zabadak in reply to Luludean

Because I have periods, days sometimes of normal ryrhym the digoxin would slow my heart too much. But he told my GP to put me on it in the first place.

I wonder if now that you have stopped the Bisoprolol you will not feel so fatigued.

Personally I would not rush into an ablation. Your heart rate is not particularly fast. Why then go for a procedure which is putting multiple scars in your heart, possibly burning completely healthy tissue, unless absolutely necessary .

Sandra

Zabadak profile image
Zabadak in reply to

I haven't stopped yet.Ihave to get the verapamil, stop the bisoprolol, wait 24 hrs then start the other one. What worried me was that I told GP about the fatigue, she phoned the cardiologist for advice about my daily AF and he doubled the bisoprolol dose, then when he saw me he cut it out. It feels a bit random, I was quite well controlled for about three years then suddenly it's all over the place. Blood pressure was 185 over 98, way higher than usual. I am trying to read as much as possible but so many people on here talk about procedures they have been having.

in reply to Zabadak

Well then wait to see how you are without Bisoprolol. You have had Candesartan increased for your BP so maybe the new drug regime will help. ( I'm on Candesartan as well and couldn't tolerate the extreme tiredness with Bisoprolol )

jennydog profile image
jennydog

I'm not sure about the complaining. Perhaps you need to speak to your GP.

Is your Cardiologist a heart plumber only, when you really need a heart electrician, an Electrophysiologist?

Best advice would be to try your new drugs regime and see how you go. If it doesn't help then you need to speak to your GP and ask for a referral to an EP for further assessment which may, or may not, mean an ablation.

Zabadak profile image
Zabadak in reply to jennydog

Yes, I do intend to give this change a chance, though it's about the fourth change of drugs and I am getting worse. An EP has never been mentioned. I think I am annoyed to wait four months to be seen, get ten minute, probably less, then read about this consultants private clinic at the Edinburgh hospital which started early that evening, just after I was edged ever so politely out the NHS door!

icklebud99 profile image
icklebud99 in reply to Zabadak

Do not be afraid to complain, this is your life and your heart. If you are unhappy, ask to be referred to an EP.

As jennydog said, if you haven't already, I'd make certain your cardio is an EP. I've had plenty of advice from cardios and EP's and personally I'd only listen to the latter.

Zabadak profile image
Zabadak

Thanks for the advice, everyone. I've been feeling a bit panicky with the heart doing a cross between hip hop and drum 'n bass! I just wish the heart docs had time to sit and explain things. I had a great consultation with the orthopaedic surgeon about my dodgy knee and he really took his time to go through all the options and how I could work towards getting surgery, what the risks were and what I needed to do myself. The cardio man was so different, like I was a stupid child not worth explaining things to. He was clearly on a fixed time per patient.

Dogge1956 profile image
Dogge1956 in reply to Zabadak

Something worth considering is that with each ablation you have the risk of damage to your pulmonary veins increases. I am aware of someone who had multiple ablation over a 2 year period done privately who has been left a cardiac cripple and faces multiple treatments on the NHS in order to stay alive. Sometimes you have to live with AF, a rate of 100 or less is not considered life threatening and adjustments in medication and lifestyle changes can often make life more tolerable.

Zabadak Re your penultimate sentence, this is all the more reason why we should be as informed as possible about our condition so we do not feel fobbed off. Lots of onfo and pamphlets to read up on the AFA website. My GP says I know more about AF than him!

Hertbeat321 profile image
Hertbeat321

I agree with jennydog my brov is on the lowest dose of bisoprolol a day and in nsr,, initially he was on digoxin but was brought off, due to low heart rate, he has an apt with the EP Dec 1st, my brov, he is eager for the ablation but with his leaky valves and his steady heart rhythm I’m hoping the EP will hold off.

WendyWu20 profile image
WendyWu20

My medication has been very 'trial and error', with yoyo-ing between A&E docs/ GPs/cardiologists. I'm lucky enough to now have a referral to an EP in 5 weeks time.

Over this year, I have rejected bisopropol, because it gave me exhaustion and breathlessness even when in sinus rhythym, and verapamil, because it made my vagally mediated AF much worse. I am now just on Flecainide (plus anticoagulant) and feeling much better.

Good luck, hope you get sorted out :o)

Dancingmaid profile image
Dancingmaid

I suffered with breathlessness due to AF and Bisoprolol. So bad I collapsed at the GPs and was rushed to hospital. Was under a Geriatrician of all things not a cardiologist but he sorted out my breathlessness beautifully. Upped the frusemide to x 2 a day, added Isosobide mononitrate, ramilpril and digoxin and reduced the Bisoprolol to 5mg. I'm in persistent AF but the frusemide keeps the fluid down so I dint get pulmonary oedema which causes the breathless and the digoxin keeps my pulse at 60 which also helps.

Saw the cardiologist last week and he's happy with the drug regime and as long as I stay on anticoagulants then he's not over concerned about the AF. I think it's a question of keeping as calm in your life as you can and just learning to accept the AF.

Good luck

Zabadak profile image
Zabadak in reply to Dancingmaid

Yes, I am beginning to realise that there is no instant cure.

Eliza2 profile image
Eliza2

Don’t be in a hurry for an ablation. I’m one of those people that got stenosis of my pulmonary veins after my ablations. And I STILL have afib.

dmac4646 profile image
dmac4646

Looks as if they gave decided to regulate rate not rhythm, as you appear to have no structural heart issues you could ask if you could try regulating the rythm ( a Fib) with Flecanaide either as a pill in the pocket or regularly- may be worth a try..

Globe-J profile image
Globe-J

Hi Zabadak,

As a few others here, when dealing with AF, or any other medical problem. I endeavor to learn as much as possible, then I make the decisions. It is my body, my health, and my responsibility. A good GP or a specialist is my trusted adviser, never a decision maker. Be bold (-:

Best wishes

Sydney J

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