Well you certainly look well and in good spirits. When in persistent AF, it’s fairly common to have a cardioversion and if it works, even for a relatively short period, it does indicate that you might respond well to ablation treatment but that does come with a degree of risk, albeit fairly small. There may be other things you could do to reduce the burden of AF such as improvements to lifestyle and losing weight if appropriate. When in AF it’s virtually impossible to take BP with any degree of accuracy but the average over 4 or 5 attempts does give a guide but try not to get obsessive as this will cause it to rise. As for next step, well that largely depends on you and your good lady. If you are coping well and able to do most of the things that folk of your tender years do, then it may be best to leave things as they are. The alternative is to seek an appointment to see an Electrophysiologist (EP) a Cardiologist who specialises in arrhythmias and see what he has to say. Whatever you decide, you seem to have a positive attitude and that’s often better than any medication or treatment....😉
Can I ask you this. I have Paf for about 16 months. Four or five attacks with rapid disorganised HB and chest tightness. happened early hours of the morning twice and twice after alcohol (not loads) and twice after playing gold bending and stretching. I get worse after a meal. I have taken this forums advice and no longer drink alcohol and am losing weight.
So the question ( I know that I am the one to decide) is I take 2.5mg of Bisop daily. It slows my heart right down but makes me tired and a very tight chest, presumably as my heart has to work harder. I think I have vagal PF.The question of ablation or not is on the horizon. What is your view ?
Hello Rod and thank you for the vote of confidence...😉.
Unfortunately, because we are not medically trained we are unable to give specific advice about medication. Highly trained an qualified medics with knowledge of their patients condition and treatment history are the only ones able to do that and I’m sure you understand the reasons why this has to be the case. However, Bisoprolol does have a reputation for causing the symptoms you describe and if you are nervous of having an ablation, why not ask about alternative betablockers such as Nebivolol or a Calcium Channel Blocker such as Diltiazem. I not well up on Vagal AF but many on the forum are, including RosyG who has made a response to Seventy 9 and as you can see, I have made her aware of your question. As far as ablation is concerned, it is very much a personal decision once you are in full knowledge of the facts. I have had 2 and would not hesitate to have a 3rd if ever recommended by my EP.......hope this helps....
Ps. The improvements to your lifestyle has to be applauded and hopefully you will soon begin to reap the benefits.
You need to bear in mind that we are all different and consequently our reactions to symptoms and treatments will also be different. After my first, a cryoablation, I had 2 or 3 episodes during the first 5 months and then was free from AF for a year or so. Then any episodes were far less troublesome and stopped quickly with a pill in the pocket. My second (RF) ablation was in September last year and again, there have been a couple of episodes but these may have been due to thyroid issues currently under investigation.
There are three studies which show beta blockers are not to be taken if you have vagal AF. There are alternatives as Flapjack has suggested -Calcium channel blockers or flecanide are used sometimes but flecanide can cause problems too. If you lose weight, have a mainly plant based diet, no alcohol and avoid large meals ( as stimulate the vagus nerve- which probably happened when you bent down too!- ) you will be able to minimise episodes. I have vagal AF and found I have to keep my potassium in the mid range ( 4 point...) and find walking helps to raise my low heart rate and keep BP down and I have fewer episodes.
Vagal AF tends to come at night when the parasympathetic nervous system takes over. Heart rate falls and if one has a slower heart rate too AF can kick in. The vagus nerve can be irritated when one eats a large meal or tests during the day too. I think people with a slow pulse are more susceptible and although pace makers are not a cure for af it’s interesting to see many report on the forum that their af stopped after a pacemaker. Exercise can raise heart rate so that’s important but not over exercise of course. I find I need to sleep partly sitting up and only slightly to the left! Think this is connected!!
your pulse and BP are excellent now so that is good for the operation. mention the breathlessness to the anaesthetist if it's not resolved but you may well be having an epidural rather than GA??
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