After failed cardioversion : Had 6 week check... - AF Association

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After failed cardioversion

Spinbiker
Spinbiker

Had 6 week check after failed cardioversion- was recommended either chemical cardioversion using amlidorone for a year with toxic side effects or an ablation- I await appointment to see EP to decide- any thoughts on which route to take - thanks

33 Replies
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Ameodarone has bad press for good reasons. Whilst it is very effective and used widely the wisdom is to only take it for a limited period, much less than a year.

I have had both options and would go the ablation route every time.

See your EP ask lots of questions and decide without further delay.

Pete

Thanks my feelings as well - best wishes

BobD
BobDVolunteer

Amiodarone does not have side effects. It has effects! See an EP and ask lots of questions . My main worry would be that if the DCCV really did fail (i e it did not manage to put you back into NSR) then ablation probably won't work either. If by fail you mean it only lasted a few hours then there may be more hope.

Some EPs like to try amiodarone assisted DCCV . You take the drug for three months or so and then repeat the DCCV.

CDreamer
CDreamer
in reply to BobD

I have to say though Bob - hubbie’s CV failed x 3 attempts and yet 2 months on oral Amiodarone did the trick. Just had the review and he is staying on it and to date no AF for last 6 months and no adverse affects.

BobD
BobDVolunteer
in reply to CDreamer

Like I said some EPs do that and yes it can work..

Spinbiker
Spinbiker
in reply to BobD

Thanks Bob - my cardioversion lasted just 5 seconds in sinus rhythm

My only experience of amiodarone was having it IV in A and E and it didn't return me to sinus rhythm as a one off. Next visit guy was a chest physician and refused to give it to me as "chest doctors don't like amiodarone".

CDreamer
CDreamer
in reply to Bagrat

Because of the lung damage.

Unfortunately those tend to be the only options on offer apart from live with it.

Personally I took the ablation route as for me I was sure Amiodarone would be too risky - but it worked very well for my husband. It really is about rolling the dice as no two people are the same and we don’t know how we are going to react until we do it.

Ablation gave me 3 AF free years.

100% ablation.

I had Amiodorone for 9 months and it damaged my thyroid as well as being house bound as I would get sunburn in the middle of winter even indoors if I stood too close to a window

Spinbiker
Spinbiker
in reply to Mikee69

Thanks that definitely helps towards a decision

It damaged my thyroid too. I'll now have to take pills for the rest of my life to rectify that! It didn't stop my AF either and I took it on two occasions probably for just over a year in total. I really think it needs to be taken off the market! At an AF meeting we had, out of 19 attending, 3 had their thyroids damaged by Amiodarone.

Jean

Jalia
Jalia
in reply to jeanjeannie50

Jean , there are so few treatments for AF that Amiodarone is still needed although as a last resort.

As CD says , it is suitable for some.

I've taken it on several occasions , the longest being about 18 months.

I too need to take levothyroxine, whether this is a direct result of Amiodarone is open to question as many ladies past 40 seem to need this . I only take a small dose and frankly it is the least of my worries medically speaking!

I was given that ultimatum after my second ablation. The chemical cardioversion is a toxic mess as far I'm concerned. Spend three days in a hospital being monitored for toxicity and then sent home to take these powerful drugs for how long? Nah... The research that I performed was based on how many people are diagnosed each year with AF, the number of cardiac ablations performed, the number of cardiac ablations performed by your EP, and the success rate each year. It's going UP. I decided that I had better chances with a third ablation than a chemical cardioversion and I was right. I've said this before on these pages, it's a matter of time before EP's figure out the best way to eliminate AF hot-spots in the heart. Maybe in two years... I had my third ablation last March- three days later back in Afib. For a month I was in Afib and started taking magnesium too. On April 2, reconverted and been in sinus rhythm since that time.

I would choose an Ablation, had mine in Aug this year and I've not looked back. X

My husband took Amiodarone for around 4-5 months during the summers of 2015 and 2017. In 2015 his heart went back into normal rhythm the day before he was due to have a cardio-version. In 2017 it didn't help just caused more damage to his lungs so he then had a cardio-version which lasted for 8 months. He was then offered an ablation which he had in March this year but he didnt take the Amiodarone whilst waiting for the ablation and will never take it again. His ablation only lasted for 4 months and he is now awaiting his 2nd but last week he had another cardio-version and is back in normal rhythm. Only you can make the decision but as many have said on this forum - ask lots of questions when you see your consultant. Everyone is different and you will come to the right decision for you. There are many good and wise people on this forum. Good luck and very best wishes.

Very helpful advice thank you

Well my experience was amioderone upset thyroid gave me lady boobs painful nipples and sunburn couldn't go in sun more than 10mins.

I opted for ablation 1st worked for 6 weeks 2nd for 3 weeks 3rd didn't work he said he was chasing ghosts he would ablate one false signal then others would appear. So stopped .

We are all different so cannot advise I dont feel any worse for having these procedures.

Same ejection factor same blood pressure same heart rate 9 years on

I wish you all the luck

Spinbiker
Spinbiker
in reply to Atriljohn

Thanks for that it helps me to make decision

cuore
cuore
in reply to Atriljohn

Your case is interesting. Did you have the same EP for all three ablations? How long was your third ablation that the EP stopped? On the third ablation did he cardiovert you into sinus rhythm when he decided to stop? You appear to be saying that your third ablation was nine years ago and that you have been in AF since.

In my case, I was one of the most complicated patients at the 6 month persistent stage (defined by the first ablation). So, I was cardioverted to sinus rhythm when the EP decided to "stop." ( my right superior pulmonary vein reconnected twice, so perhaps this was the trouble area. I didn't ask the question). I have continued to be in sinus rhythm for seven months since this third ablation.

Atriljohn
Atriljohn
in reply to cuore

2012 was my first ablation pulmonary arteries a line across heart 9 hours taken ok for 6 weeks

2nd ablation went over first ablation scar tissue 6 hours lasted 3 weeks

3rd ablation spotting and ablation random signals 4 hours no cardioversion

So 2012/13/14 so 5 years since last ablate no changes to heart. Had 5 ops on bladder cancer ongoing life can be shit but hey still here

cuore
cuore
in reply to Atriljohn

So sorry Atriljohn that you have double whammy -- AF and cancer. Do hope you got rid of your cancer. In terms of AF, I see from your previous post that you are in permanent AF. Best wishes for your heart to stay steady.

What exactly is going on with your heart rhythm? Is it flutter, fib, or something else?

Spinbiker
Spinbiker
in reply to Jt222

I have no palpitations or audible beating - just had extreme fatigue- really extreme bisoprolo didn’t help so now I am on nebivolo- much better

I would go straight to ablation, as I did..

Spinbiker
Spinbiker
in reply to Dslokes

Yes my feelings as well thanks

Ablation no Amiodarone

Hi spinnaker.I went through both routes took ameordarone for 1 year and ended up in hospital from side effects.i had an ablation march this year which has been successful so far .I would choose a ablation over medication anyday

Spinbiker
Spinbiker
in reply to Longmolly

Yes I am thinking this way as well many thanks

Very common to need second ablation. What about Tikosyn? Works very well for me. Was on it for 4 years, then it quit working. Had two ablations now it works again. Afib burden only 10%. Went on amiodarone for a year after first failed ablation. Very effective. Only side effects were sensitivity to sunshine and seeing Halos when looking at lights at night. Although rare, some side effects can be dangerous. Good drug for short term. I’d be ok taking it while waiting for second ablation. Best of luck!

Try this route and see if it works:

-----------------------------------

After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer (this is why all doctors agree that afib gets worse as you get older). If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate (afternoon) exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt?? I also found that strenuous exercise does no good – perhaps you make yourself dehydrated??

I'm pretty sure that Afib is caused by a gland(s) - like the Pancreas, Thyroid (sends signals to the heart to increase speed or strength of beat), Adrenal Gland (sends signals to increase heart rate), Sympathetic Nerve (increases heart rate) or Vagus Nerve (decreases heart rate), Hypothalamus Gland or others - or an organ that, in our old age, is not working well anymore and excess sugar or dehydration is causing them to send mixed signals to the heart - for example telling the heart to beat fast and slow at the same time - which causes it to skip beats, etc. I can't prove that (and neither can my doctors), but I have a very strong suspicion that that is the root cause of our Afib problems. I am working on this with a Nutritionist and hope to get some definitive proof in a few months.

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

PS – there is a study backing up this data you can view at:

https//www.cardiab.biomedcentral.com/articles/10.1186/1475-2840-7-28

I seen my arythmia nurse 4 days ago after failed cv two weeks ago, sadly got told they won’t ablate me as I’m overweight ( trying hard to lose ) .

I chose amiodrone happily try anything they know I’m asthmatic said decision up to me so I said go for it ! So far noticed my heart rate has come down a bit.

Was told I’d be on it a year which I’m hoping not that long.

Keeping my fingers crossed it goes ok. I would have definitely went for ablation if I could have.

Spinbiker
Spinbiker
in reply to Janelr

Thanks good luck with your treatment and best wishes

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