Not wishing to detract from CD’s and Eatsalottie’s interesting posts, something else I have given some thought to.
Cardioversion - a relatively simple procedure to stop and restart the heart in seconds. It involves no intervention therefore the existing circuitry of the heart remains unchanged which I guess is why AF is likely to return at some time in the future. Perhaps a bit like rebooting a PC to rectify a problem which is also likely to return.
Plus points are that it will determine if a return to sinus rhythm is possible and if it is, are there improvements to symptoms and consequently, quality of life, which could lead to the possibility of having an ablation. However, we know that not everyone wants to take that route and they are content with pursuing with a medication based alternative.
Unlike when AF first occurs, patients are more likely to be aware the moment AF returns after a CV and therefore they maybe more able to identify exactly what might have triggered their attack. I’m not exactly sure where I’m going with this theory but I would be interested to hear if anyone else thinks it has any mileage!
Ooh Flapjack I could say so much in answer to your post. Important things I think too, just have to give myself a few more days before I tell what's happened to me. The ship will hit the fan, if you get my meaning!
Well ignoring what you know about me Flapjack (and we don't talk about that) I am in favour of DCCV for the most part. Yes it can determine if ablation may be an appropriate treatment but the most important thing to find out is DO YOU FEEL BETTER IN NSR? If you do then treatment to keep you in NSR is helpful but there are people who feel no different and for those rate control is more suitable. Simples.
I'm certainly in favour of it too Bob, it got me back in rhythm for well over a year for which I am very grateful. My thinking is along the lines of if people are made aware that a CV may well flip and that they should be encouraged to be more prepared and try to establish if anything specific triggered the episode and dealing with that might help them in the future. Perhaps I'm not explaining myself too well or trying to be too convoluted. I can also see disadvantages in making patients aware it might not work for too long as they may well be on a knife edge waiting for it to flip back in to AF. Maybe I should delete the post and go back into my box!!! (after we have heard more from Jean of course)
Back to quality of life-different for us all. I am in permanent a-fib and feel much better with my pacer and ablation and no fooliing around with rate control drugs anymore. I am stable, asymptomatic, and even sometimes go for a day or more without giving my a-fib a thought. So I would not want to go back to times in my early journey when DCCV would put me back in NSR and then have anxiety wondering when the next a-fib "shoe' would drop.
I can only say that with a 25 year history and very many DCCV s I always know immediately when I slip into AF...usually have warning signals anyhow.
Vast majority went well. First one did not give me sufficient anaesthetic 😯and further along the line had to start CPR very briefly after procedure.
Reverted to NSR about 08.30, with lots of etopics throughout the afternoon. Following Sunday lots of etopics in late morning, back in persistent AF Sunday afternoon.
😂 Just had an image of calling the IT Help Desk at work and the guy on the other end of the phone saying, “Have you tried turning it off and back on again?”
I was cardioverted once. It lasted for about two weeks. I was set to be cardioverted a second time and I went back into NSR on my own. When I went back into afib a few days later, the EP asked me if I wanted another cardioversion. I said no and scheduled the ablation for about a month later. In the meantime, I self-converted again before the ablation. Since the ablation, no afib at all.
"Cardioversion - a relatively simple procedure to stop and restart the heart in seconds. It involves no intervention therefore the existing circuitry of the heart remains unchanged which I guess is why AF is likely to return at some time in the future. Perhaps a bit like rebooting a PC to rectify a problem which is also likely to return."
Having been rebooted 15 times now, I have to say I totally agree with your analogy!
I realise it is not a long term solution, but I simply cannot function at a HR of 150+ and being so irregular. When I can't do a school run without feeling faint, or even pick up and hold my near-1 year old without getting exhausted its not surprise to learn that I am much more suited to NSR.
It isn't for everyone, in fact the first couple of times I was facing Cardioversion I looked it up on the internet, the British Heart Foundation, and it looked fairly intense. Though it did explain why I felt lousy.
Sometimes its lasted a few weeks, sometimes its lasted months.... but usually an ablation has been on the horizon at the end of it.
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