Af and cardioversion

[321yella]

Cardioversion done in October and still in sinus rhythm what next??

[beardy_chris]

So long as you stay in sinus rhythm, job done.

However, it is possible that, at some stage in the future, AF might return. If that should happen, another cardioversion might be indicated. But there are plenty of example of people going several years between cardioversions. If you have addressed the causes (drinking, caffeine, being overweight etc.), I guess you might not go back into AF for a very long time.

In the meantime, it is probably sensible to continue to take any drugs suggested by your medical team to help ward off future problems.

[321yella in reply to beardy_chris]

Thanks beardy Chris for the reply. Is it normal to stay on 7.5 mg of bisoprolol? I know I need to take apixaban for life but don’t mind doing that!

[beardy_chris in reply to 321yella]

I'm afraid I'm not qualified to answer that - it depends on a lot of factors. I would raise the question with your medics.

[321yella in reply to beardy_chris]

Ok thanks chris

[Hidden]

The only thing I would add is that should AF return at some time in the future, a successful CV is an indicator that an ablation is also likely to be successful if that’s the route you decide to take

[321yella in reply to Hidden]

Thanks for that Flapjack just thought that maybe 7.5 mg of bisoprolol bit to much as resting heart rate is between 50 to 60 bpm but not breathless or in any pain, just get a bit cold easily especially my fingers toes head and back otherwise I’m ok ☘️

[Hidden]

As you know, we are not able to comment on dosage, but I can understand your logic. I assume you will have a review appointment booked but if not, try speaking to the Arrhythmia nurse attached to the hospital. They are likely to encourage you to stay on medication as this helps to keep the ticker in check and reduce blood pressure, which may or may not be an issue, but still review the dose .....the important thing is that you are in rhythm!

[321yella in reply to Hidden]

Thanks v much for ur reply new to this but I think as u say it could be blood pressure being a bit high that caused it 🍀

[Hidden]

Hi 321, I had my first cardioversion in 2011 when what I thought was a panic attack was dx as AF. Conversion was successful, had 3 AF-free years then it returned. Since then have been well-managed by my wonderful and very capable EP (Electrophysiologist) and am living very comfortably in permanent AF. Will be 74 next month. Enjoy your AF-free time. There are many on this forum who have remained in NSR much longer than me. Hope you do too. But if it comes back it is a condition that has a lot of research behind it with more solutions becoming available often-making it possible to live well and easily with this condition. Browse around and read posts if you're interested. Or if you prefer, don't focus on it now. Just sit back and enjoy you AF-free status.Take care. irina1975

[321yella in reply to Hidden]

Thanks for ur comments irina1975 feeling ok live in ireland 🇮🇪 and am amazed how common it is here in hospital with a 22 year old lad whose af was brought on by cycling over 60 miles every Saturday he getting an ablation next week. Looks as if age doesn’t matter I’m glad I came upon this site so many great and brave people here (you are not alone ) is probably the most reassuring phrase that springs to mind for me on this site!!☘️ Thanks

[momist]

Hi. I'm on the lowest dose of Bisoprolol, 1.25mg daily. My resting heartbeat according to my FitBit is down at 53 - 54 ish, occasionally as low as 48 during the hours I'm asleep. This also worries me, and I get very cold hands and feet, and also don't sleep as well as I used to. If you are in a 'normal' range just below 60bpm with 7.5mg, I doubt that there is a problem. But then, I'm not medically trained, and only your doctors can give you guidance on that.

[321yella]

Yip I think the uncertainty of it all is more troublesome than the actual af itself sometimes!!

[fnurd]

I had an ablation 11 weeks ago. The EP took me off bisoprolol and flecainide at the time. After a few interesting arrhythmias I have been AF free for the last 6 weeks. As far as I am concerned a major objective of the ablation was to get off the drugs which can have side effects, especially as one gets older.

"apixaban for life"

This one is extremely interesting, and the answer may not be at all obvious. As this may be a decision I will have to take in a couple of weeks I have been looking at all the evidence. I am a medical statistician so I am supposed to be good at evaluating this sort of thing. There are several retrospective clinical studies, but unfortunately there are no randomised controlled trials. The thinking goes this way: If one has a successful ablation, then this may well reduce your likelihood of having a stroke. If your other risk factors for stroke are low then any benefits of the anticoagulant may be less than the extra risk of major bleeding events.

It all seems to come down to risk factors for stroke, which the CHADS-VASc score summarises. The way I (and many cardiologists) see it now is that if you have CHADS-VASc =0 then it is probably best to come off the anticoagulants. If you have CHADS-VASc =2 or more then stay on the anticoagulants.

For patients with CHADS-VASc =1 the decision is far from clear. Unfortunately this is me, so I will have to do some more research and then discuss with my EP who is one of the leading lights.

I hope this helps.

[321yella in reply to fnurd]

Thanks fnurd very interesting maybe should let you become my ep🍀

[1Jerbear]

I would have a low keyed party rejoice and be glad . That's good news . My second one lasted 3 1/2 years . I m back in A-fib now even after an ablation but you can never tell what it will do so enjoy feeling good .