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AF Association
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PAF second opinion - dilema

Hi to all! I short: had 2nd opinion today. Due to my hyperthyreosis cardiologist and current status) ( PAF November 2017, January 2018 self conversion to NSR, vagal?) and current therapy 2,5 bisoprolol, rivaroxaban and 1,25 ramipril for moderate BP his proposal is to stop 2,5 bisoprolol and rivaroxaban (my CHAD score 0-1 max). If AF happen gain, cooldown and consider ablation as a good candidate to succesfull ablation. Any comments?

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so that was in hurry :) Hi to all! In short: had 2nd opinion today. Due to my of history of hyperthyreosis (cleared 5 years ago), current status ( PAF November 2017, January 2018, self conversion to NSR, vagal?) and current therapy 2,5 bisoprolol, rivaroxaban and 1,25 ramipril for moderate BP his proposal is to stop 2,5 bisoprolol and rivaroxaban (my CHAD score 0-1 max). If AF happen again, try to coodown and consider ablation as a good candidate to succesfull ablation. Any comments?

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I think you have seen an electrophysiologist today. If so, have you been told the result of your echocardiogram, in particular is your left atrium of normal size? Many people find they need a second ablation, particularly if the atrium is enlarged.

You have good English. The word we use for overactive thyroid is hyperthyroidism or thyrotoxicosis. This is commonly associated with atrial fibrillation. Is it possible you might have had AF before treatment of your thyroid condition?

Where will you have your ablation?

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Basically, for more than 5y my hormones are normal value, and ecs ho showed normal left atrium, apart from LBBB,from time to time.

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Hi vaaga_v

Are you sure about your hormones being ok? Do you get regular printouts from your surgery? Do they test for B12, folate, ferritin and vitamin D? TPO (thyroid peroxadase antibodies) Tgab.All vitamins need to be top of range i.e., optimal and docs will just tell you normal ok over the phone. You are entitled to copies or you can register at surgery and see the results on line. I have read that thyroid if not normal can affect the heart. Doc may not want do all these tests especially vitamin D due to cost and people do them privately if they can afford it. I have Hashimotos thyroiditis and so does my son. I had a heck of a job to get him treated because they wont treat until your TSH is over 10, but it should be below 1 for normal. Alot of docs dont agree and are not fully up to date with thyroid matters. I had to get second opinion for my son. It may be nothing to do with your AF but it would certainly be worth getting thorough testings done and even a second opinion if necessary. Hi TPO means Hashimotos thyroiditis and if anyone has this they need treatment of levothyroxine or NDT (natural dessicated thyroid) for life if they have this condition.

JaneCx

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Hi JaneCx,

it started 15yrs back, caused by stress, Graves' disease, diffuse goiter, eleveted T3, T4, low TSH, type which tend to go into remission under medication without requiring treatment with thyroid radiation or surgery. Now, more than 5 years I am in remission for the 2nd time. Tyroide hormones are in normal range, due tu the fact that gland is secreting less hormones during aging process.

My cardiologist explained that such long medication with thiamazole and disfunction of tyroide gland tend to do a quite a mess with heart, even years later.

I am sorry about your son, has a same problem. Regarding test, our healtcare system is still "oldfashion" and majority of them are available, but somethime it lasts a bit longer to have everything done.

This week I am doing 24 hours holter and if needed, sleep test.

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We have agreed to do it if the next AF happen. He wanted me to get off medication first, check holter, sleep test. He was willing to discuss vagal AF compared to the other one.

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Hi vaga_v

Soumds like you have been through the mill. You are lucky your healthcare system is old fashioned at least you can get everything checked. I have been having some arrythmias too lately and waiting for a 24 hour holter. I had this when I had viral infection several years ago and then it went. Have had a viral infection again so think its related. My hubby had AF and had two ablations about 6 years ago. The second one worked but he is still on warfarin. Think his was to do with the vagal nerve too.

Hope you get it sorted soon.

JaneCx

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