Coming off medication

[F-M-C-MM]

Hi, I had treatment for my paroxysmal a fib nearly a year ago, namely a radiofrequency ablation which I am pleased to say has to date left me free of further episodes of atrial fibrillation. It would be nice to hear from others on a similar journey who have given up anticoagulants which I did after 6 months. Last week I stopped taking Bisoprolol 1.25mg dose and have ceased taking aspirin. Admittedly my pulse rate is about 10 beats faster per minute presently, otherwise I am fine. I should add I am 65 and would rather be drug free. Are there any other members of our community who have taken the same route as i and are happy with the outcome?

[Hidden]

Are you making these changes with your Doctors knowledge or are you doing a JeanJeannie😉. In the UK aspirin is not recommended for AF so no problem there and your dose for Bisoprolol is low so that “may” not be too much of an issue but I think you should think carefully about stopping the anticoagulants. An ablation is not a cure for AF and many medics say that the tissue of the heart can even be made worse after an ablation so clots can still develop. At 65, your minimum CHADs score has to be 1 but it has to be personal decision as long as you are aware of the risks.

That said, it’s great to hear you are feeling well.......

[F-M-C-MM in reply to Hidden]

Hi Flapjack, could be doing a JeanJeannie alright 🤗. Indeed I must admit she inspired me to share my experience also! Yes, aspirin doesn't offer much protection against stroke and the Bisoprolol dose was tiny. However, I experienced headache on Apixaban which ceased when i stopped the anticoagulant. I may even have a CHADS score of 2 given that i am female. Nevertheless, I have had loads of medical investigations done, and have no further underlying health issues apart from a diagnosis of paroxysmal A fib prior to ablation. It's not known yet if anticoagulation is fully effective in preventing stroke and clinical trials are currently underway to see if it is the A fib or other forms of cardiovascular problems that is indeed the trigger.

I may try to paste the reference to the latter in a further post. I take on board what you said about the tissue of the heart being compromised post ablation, and my electrophysiologist found a small amount of fibrosis yet stated I could stop my medication. I may have to resume taking it the moment A fib returns. Well nothing ventured nothing gained!

[Hidden in reply to F-M-C-MM]

Having worked with stroke patients I am probably biased but I would do everything possible to minimise the risk. I currently score 1 and my EP very much endorsed my decision to stay on Apixaban. Very many people are unaware that they have AF and it’s not unusual for AF to be much milder and less noticeable after an ablation so episodes can occur anytime, night or day. Good luck with your decision.

[Upsky]

I had 2nd ablation 16th April, by beginning of July I simply couldn’t face another hot day so lethargic when I have such an active job so I stopped bisoprolol and flecainide but continued xeralto, not felt this good in over a year, I have my post op appointment Wednesday I’m sure I’ll get a lecture, but hey ho I can run away from them now 😜I’m happy to continue anticoagulant life long if need be, but I’d have to be back 220bpm to swallow another bisoprolol, I shall keep flecainide for pip. My 1st ablation worked for 10 years I see no reason at present this one hasn’t worked to.

[doodle68 in reply to Upsky]

Hi Upsky not wishing to downplay your successful first ablation but can I ask if you know for sure AF only returned after 10 years.

The reason I am asking is as someone who had the occasional episode of P-AF with very severe symptoms for many years and wrongly assumed that was my entire experience of AF.

It wasn't until I was asked to monitor my blood pressure regularly and the BP monitor sometimes recorded an 'irregular heartbeat' confirmed by checking my pulse that I realised in addition to symptomatic episodes of AF I was also getting less severe 'silent' ones of which I was unaware.

I note you are continuing with anticoagulation which I think is wise others may decide against it being under the impression their AF has stopped.

[Upsky in reply to doodle68]

During the 10 years I had extremely short af episodes 10secs maybe on occasion, not in the least dibilitating, I’d call it a heart fart. So yes for me it worked, I am not under the impression I’m cured, I know it’s a progressive disease, I also have a mitral regurg, enlarged atriums and back to the few second occasional episodes. For the 10 years I was totally drug free and that is why I’ve had the second done I simply cannot tolerate the drugs. I feel it has been effective this time also.

[KMRobbo]

Yes me, 2 ablation end January and end of February this year. Was only on a/c for the ablation so stopped after my 3 months check up with EP. All meds stopped by May 15. Brilliant. Surprisingly it took 4 to 6 weeks for the side effects of the drugs to wear off!.

However I never had issues with my AC dabigatran. Wanted off it mainly as i cycle motorcycle and climb/ scramble mountains so a hefty bang is never totally unlikely .

Also I am only 58. So my chads2vasc is zero .My EP told me to stop the AC although I always was going to. I assume he is following the NICE guidelines.

[F-M-C-MM]

Hi Upsky, you certainly did very well to have an ablation that lasted 10 years. Do you know why the arrhythmia returned? Have you developed some other health issue which may have triggered it? This is very interesting and I have not seen a discussion on the issue before on this site, namely the recurrence of A fib after a long time interval.

[Upsky]

I have a mitral valve regurgitation and I’m 10 years older 😜 an ablation never cures AF, not once in the 10 years did I have an episode where it wouldn’t stop almost as soon as it started and these were very few and far between. So it was deemed a succeful ablation for 10 years. I am now perhaps middle aged (according to society) at 47, last year felt 87 now feel 27 😊