New with persistant AF: After no previously... - AF Association

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New with persistant AF

After no previously known episodes i have just been diagnosed with persistant af which has been going now for a week,I went to a and e 36 hours after it started but all i have had so far is some Bisoprolol. My G.P has prescribed 5mg a day and written to get a Cardiologist appointment which apparently may take 6 weeks....im now waiting and lightheaded!

Im 44 ,dont smoke,not overweight,drink a cup of coffee and glass of wine(or used to!)

My question is should I go private and see an EP asap...this forum has opened my eyes.

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Hi

I have PAF and also 44 , this has been going on for over a year with me, took a few trips to A&E to work out what has been wrong. Thyroid was the start but this has apparently resolved itself, I have finally an appointment with an EP over 6 months since I started taking bisoprolol, I take 2.5mg and I am really lucky as I seem to tolerate it , well, apart from a little weight gain but woman doesn’t moan about their weight!!!

This forum is brilliant for support and reassurance that you are not alone , this being the biggest thing that I had to overcome. If I’m honest I don’t often give it a thought anymore, I check in here though still to get my reassurance!

I have adjusted my diet and exercise and at the moment I seem to be in control, not the dreaded Af!

Keep checking in here and you will receive excellent support and advice.

Lou😃

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I’m 63 but I had my first Afib when I was 39. I was kept in overnight in hospital and my heart went back to rhythm of its own accord- it was attributed to caffeine (which I thought then was implausible) and told that it was a “lone episode” which might not cause problems for around 20 years. This turned out to be prophetic. From the age of 39 to 62 I had few episodes and was only diagnosed with PAF a couple of months ago.

In your situation I would ensure that you have a great diet, low alcohol and not get overweight. The latter can impact on Afib and makes it more likely that heart disease will develop, something you don’t need on top of Afib.

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Hello Chris and welcome to the forum. Diagnosis is a shock, especially for someone as young as you but there are ways forward, as we’ve all found out.

I was referred to an EP by my cardiologist but the wait was over a year, so I went to see him privately and it was a very good decision. But - I had to pay only for the consultation (£200) as my echocardiogram, stress test and Holter monitor had already been done on the NHS in hospital. The EP prescribed Flecainide and transferred me back to his NHS list. It worked out well for me.

It is certainly the best option for getting to see the right person - just be aware of costs for private tests, should they be suggested. Best wishes

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Hi Chris, and welcome to the place your would rather not be! If you are able to see a cardiologist in 6 weeks then you are fairly lucky, many have to wait a lot longer. It's always preferable to see an EP because they are the experts in dealing with arrhythmias. The only problem with going private is that you will probably need some tests carried out to determine the overall condition of the heart and they can add quite a lot to the cost of a consultation. You also need to make it clear whether you want any ongoing treatment undertaken privately and we are potentially talking mega bucks here! There is nothing wrong with making it clear that you want to transfer to NHS but just do not expect to do any queue jumping. So I guess the choice is yours, it was the route I chose, but my initial appointment was covered by insurance.

The important thing is to establish a treatment plan specific to your condition and an EP is best placed to help your with that.....hope it helps and good luck.....

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In a word - if you can - yes. Cardiology should refer you anyway - then another long wait to see one.

Loopy mentioned thyroid - ensure your GP tests as this can be an underlying cause. There are other lifestyle triggers and things associated with AF such as sleep apnea but if you have done all you can regarding weight, fitness, alcohol and no smoking then usually interventions are required.

In our area you can go directly to ablation as first line treatment - especially if you are young and otherwise fit and healthy.

Bisoprolol is a first line treatment and normally the one that GPs prescribe. It can be helpful - lowering heart rate - but for many people including myself - it can be more symptomatic than the AF so if it doesn’t help you don’t hesitate to go back as there are other heart rate drugs available.

All treatment for AF is for quality of life - but AF can make you feel pretty horrible.

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Your experience sounds identical to mine. My simple answer to going private is yes. I saw a cardiologist within a week, cardioversion a month after diagnosis and have been in NSR since February with the help of flecanide and bioprosol. My understanding is the longer you wait the the more the irregular pathway forms. If I had gone nhs I would still be waiting for my cardioversion. I’m back to football three times a week and feel exactly the same as I was before with the exception that I need to remember to take my pills.

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Yes if u can. Get recommendations.

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Hi Chris, Was anti coagulation not mentioned? I was diagnosed by my gp with persistent af, ( I think I had had it for a fair while, maybe a couple of months) she mentioned stroke risk and to watch out for stroke symptoms but no mention of warfarin.

I had the six week wait and saw a cardiologist, was told I had a leaking valve as well and he told me about various treatments that could be used in the future if the meds did not control the af. he just upped the bisoprolol my gp had Prescribed.

He said I would need to be on warfarin for life, there would be around a four week wait for an appointment to be put on it. Week three of waiting I had a stroke, luckily my husband saw it and phoned an ambulance (I could not tell what was happening to me)

I was very lucky that I did make a full recovery and was given a treatment that worked and had a tree day stay in hospital (could not speak properly for about 18 hours, terrifying) I spent a year exhausted with everything feeling like wading through treacle, had a successful cardioversion halfway through the year.

Sorry to ramble on, it just worried me that you did not mention warfarin in your post after my experience.

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Are you still in AFIB? What is your heart rate?

Did no one discuss cardioversion with you?

I understand that you could not electrically cardioverted you as you only presented a&e at 36 hours so too late to be cardioverted if not on anticoagulant . However if you are still in AF I would have thought you could have been prescribed A/C so you could be ready for this in a few weeks time? Perhaps your GP could advise? I am just thinking that there is no point waiting 6 weeks for an EP who may say take A/C for another 3 or 4 weeks before we can try to cardiovert you?

I am not medically trained and have not direct experience of going directly to A/C as I started as paroxymal and got into all this (relatively) slowly.

However I would not be comfortable spending weeks and weeks in afib if I could find any way to avoid it. Particularly as it appears to be your first episode.

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Yes

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Thanks everyone for so much helpful information.

To answer some of the questions,all the blood tests came back fine...I had thought I should be on a blood thinners too but G.p did chad test which came out as 0 so thought not needed.

Blood pressure is fine but rate around 100...

like some others on this forum I`m not sure how useful these Bisoprolol tablets are,they just force you to take it easy, why not just decide to take it easy?!

So private it is !

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Flutterbird

I know you were very concerned about your persistent AF a few days ago and your chances of a succesful ablation

I do not know if you have seen today's latest posts as there is a person there who has just had an ablation after FOUR years in persistent AF and at this early stage it seem to be an improvement for him

Please see the link

healthunlocked.com/afassociation/posts/137883522/finally-got-it-done

Best wishes.

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