After Cardioversion

[David21]

My Afib definitely became flutter on Wednesday. After 7 hours of giddy & breathlessness I went to A&E. After echo they brought me back yesterday for a cardioversion. Initially fine but 11 hours later back in Afib / flutter. My question is: does this definitely mean that it has not worked or is there still a chance? Many thanks again to you all for your support.

[Hidden]

Sorry to hear this.

I would say that is has failed. The good news is that you sustained NSR for several hours so are more than likely to be a candidate for an ablation.

I would suggest getting in touch with your EP/Rhythm team asap to see what they advise the next step to be

[David21 in reply to Hidden]

I think you are right. Possibly another cardioversion first or do they only do one?

[Hidden in reply to David21]

I've had half a dozen before my ablation 2 years ago, mostly electric shock, but a couple by IV meds

I'm not sure how soon they would do another one for you, mine lasted for between 3 weeks and 6 months.

They may want to review your meds and try you with an anti arrhythmia drug, but now is the time for you to start pushing for an ablation (if you feel that you want one)

[David21 in reply to Hidden]

Thanks again. I have been on max. Dose of Flecanaide for years and yesterday Bisoprolol was added. Not sure what else there is. Ali on Appixaban

[Lizzo in reply to David21]

I was put on Amiodarone to control my AF after I went back into AF a few months after cardioversion. It did the job very well, but has a lot of potential side effects, so can't be used for long. Since then I have had 2 ablations, and, 5 years on, am waiting for another cardioversion. AF is persistent!!

[David21 in reply to Lizzo]

Thanks - I am assured that bisoprolol is the best. The consultant was not keen on Amiodorone !!

[Lizzo in reply to David21]

I am on bisprolol as well, David! I think they do different jobs! All the best!

[Hidden]

Conversion to sinus rhythm means that it worked. I'm not sure there is an objective measure of "success". You may revert spontaneously to SR, and if not you may be offered a further DCCV.

Are you up for an ablation, which seems worth considering?

[David21 in reply to Hidden]

Yes this had been mentioned. Probably next on the agenda

[BobD Volunteer]

Cardioversion is not a cure for anything so technically it can't fail. It is a useful tool to discover a) if you feel better in NSR and b) if you CAN be returned to NSR, even for a short time. If the answer to either is no then some treatments such as ablation may not be considered.

[David21 in reply to BobD]

Thanks BobD. In hospital at the moment

[jeanjeannie50 in reply to David21]

David, I'm sorry to hear what's been happening to you. I've had several cardioversions, most lasting for quite a while, but sometimes they haven't. With these I've found I can suddenly revert back to sinus rhythm again perhaps a day or so later.

Now I'm wondering and waiting to hear why you're back in hospital?

Wishing you well.

Jean

[David21 in reply to jeanjeannie50]

The flutter came back 12 hours after the cardioversion at a high heart rate. Just seen Cardiologist. They won't do another CV so now ablation beckons. Do you have any sorry of heart rate monitor which you can recommend? Thanks for your interest

[jeanjeannie50 in reply to David21]

Personally, I think a stethoscope is the best and most accurate aid to have at home.

I once had a high heart rate which didn't measure at my wrist, manually feeling there all appeared fine and my BP monitor said the same. However, I was struggling to keep conscious and unbearably hot, dialled the 111 NHS number and an ambulance was sent, that's when it was discovered that my heart rate was actually very high and not registering correctly in my wrist. The paramedics were quite enthralled by it, but the consultant at hospital was aware it could happen. Now I don't trust anything that measures in the arm.

Jean

[David21 in reply to jeanjeannie50]

Thanks

[Horse57 in reply to jeanjeannie50]

I find that interesting because sometimes when I lay on my side my heart rate feels like it’s 160+ but when I take it on my wrist it feels fairly normal. That’s really good to know

[jeanjeannie50 in reply to Horse57]

My GP has told me to always take my pulse via the top of my neck, which is more accurate.

[Hidden in reply to David21]

I use Kardia. This provides a single lead ECG trace and has a high sensitivity for AF. It will record every other type of rhythm abnormality, but will not identify them.

Recordings can be printed or emailed.

[David21 in reply to Hidden]

Thanks. Will look at it

[Bambi65 in reply to David21]

I've had afib for years, and the alivecor gives an extremely accurate ekg which can be emailed immediately to your doc or to yourself. I have a record of the past 2 yrs of every AF incident, hearr rate, and I document how many NBChours each lasted. (emails) All done with my cell phone and the small device for recording. Try it out: the app for cell is "Kardia".

[Ppiman]

The Apple watch 4 is apparently a very good product for measuring heart rhythm abnormalities. I have the v. 2 which doesn't measure an ECG, only pulse rate. I still really like it as a truly useful device.

Like you, I have atrial flutter (but I have my ablation tomorrow). You have my sympathies - I have truly struggled with it this last couple of months. When your heart is in flutter, your pulse rate will be lower than your atrial rate, which can only be measured by ECG. The atrium will be "beating" in the order of 300bpm, whereas your pulse will (thankfully!) only be a fraction and in a fixed ratio of this, (1:2; 1:3; 1:4, etc). This means that your pulse will go up and down in a step-wise fashion rather than smoothly and lead to a rather inefficient circulation that is unable to respond naturally and properly to oxygen demand from the body. This leads to the feelings you've experienced (in my case frequent light-headedness and, if I overdo it, shortness of breath, along with a general feeling of being very ill).

I did think of getting an Apple watch, despite the high price as I thought it would be more generally useful than a specific ECG device such as a Kardia. However, in the end, I wondered whether it was worthwhile since I already know when I have flutter as my heart rate lacks the natural variation and reacts instead in a step-wise fashion (75 > 105 > 155).

Steve

[Horse57 in reply to Ppiman]

The issue I have with the Apple Watch is that when your heart rate is over 120 it will not tell you if you were in a fib. It will not register a fib if your heart rate is high and I don’t know why. Of course heart rate is usually always high some exceptions when you’re in a fib so that is the problem I have with the I watch

[Ppiman in reply to Horse57]

It seems a decent bit of technology overall, though - and its “normal” functions are all outstanding and very useful.

[Horse57 in reply to Ppiman]

Agreed

[jondeanp]

If you are in flutter, my understanding is that Flecainide will not have an effect on it

[Lisa54]

It was the Apple Watch 4 I bought in January that alerted me on May 2nd that I was back in Afib at 4:00 AM with a Bpm of 137. I was sleeping but it gives your wrist a nice little jolt. It asked if I needed it to call 911. I got up and waited a while and Bpm kept going up so I went into Emergency where they verified I was back in Afib with high heart rate. They gave me Multaq to take for 10 days then scheduled me for an ablation the following week. I had two previous cardioversions - the second one lasting 10 months. Had the ablation at the end of May and watch alerted me again 2 weeks into recovery that I was back in Afib after drinking wine at a graduation party the day before. Had another cardioversion Tuesday and back in NSR again and feel much better. Apixaban is the only drug I take for Afib now. My cardiac nurse asked me to send the readings from my Apple Watch to their office twice a week (via apple phone - very simple). I now wouldn’t be without it. If you’re worried, you can check anytime of day or night to see if you’re in Afib. It is only the Apple Watch 4 that has this EKG technology. My cardiologist said they are very accurate. It has other heart health apps you can download also. I now consider it a lifeline and only take it off to charge it which takes about an hour.