Permanent AF and A flutter but rate control reasonable but permanent erratic rhythm AF is this something you can live ?

[shwills]

Permanent AF and A flutter- rate reasonable but rhythm not

AV node ablation was on the cards but not now as rate under control, I am little concerned as I do have moderate heart failure as well. I have a pacemaker to control bradycardia and sinus pauses which is great, but the rhythm is so erratic and permanent, my consultants were going to have a discussion with me about having AV node ablation. How long can your heart keep going with permanent AF, is the rate the main problem or the rhythm? I am confused as I really don’t know what to think, any ideas ?

Thank you

[BobD Volunteer]

There is no difference in outcome for any treatment for AF be it rate or rhythm control. All treatment is for quality of life (QOL) Provided that your rate is well managed there should be no degrading of heart function and in many cases the conditon of the heart can improve under such control.

Permanent AF is not a state it is a decision. It merely means that you and your doctors have decided not to attempt any more strategies to obtain NSR (normal sinus rhythm) and accept AF under control. Many people in permanent AF live to be very old.

[RoyM]

Hi shwills. I have been in Permenant AF for nearly 4 years I take 1.25mg Bisoporol per day for rate control and Apixiban for stroke protection. I live a very active life. I swim, walk longish distances, cycle and chase after my 6 year old Grandaughter. I was in PAF for a number of years but found that going into permanent AF much easier to live with. So, between my EP and myself it was decided not to under go an Ablation. Personally I don't regret that decision. I have now been discharged from hospital and I have stopped chasing the holy grail of NSR. I am a 72 year old male. BobD is quite right that any treatment is about improvement in your quality of life. Cheers Roy

[CDreamer]

As Bob said - it is a decision rather than a condition - really all depends upon your quality of life generally. If you are very symptomatic, cannot do moderate exercise - eg: walking, housework, gardening etc then you might think about treatments to improve your QOL which would be drugs, ablation or Ablation of the AV node.

The latter would not stop the AF & AFl so you may still feel palpitations but it may reduce symptoms such as breathlessness, fatigue etc as it would mean that although your atria, top chambers of the heart, may continue to be out of rhythm, it would not be transmitted down to the ventricles, the larger bottom part of your heart which pumps the blood around your body which means your pulse would remain steady. It will also mean you are pacemaker dependant so not something to go into lightly.

AV node ablation is the last option normally offered and normally when all other options are not thought to be viable or desirable.

If you can live a reasonably acceptable (to you) quality of life as you are then there would be little need for further interventions however if you are very symptomatic without quality of life then it is definitely worth consideration and discussion with your doctors.

Many people live active and fulfilling lives with AF and heart failure means that your heart is just not pumping as much blood around your body as it could in it’s heyday - what it does NOT mean is that your heart is going to fail to work any time soon.

[shwills]

Hi

Thank you your reply was very helpful and gave me lots of information

I am very reluctant to have AV node ablation as it is so final

I have had 4 ablations in the last 5 years to try and fix the AF of course it has not worked

If the rate control is stable and the rhythm does not damage my heart anymore then I will stick with it

I do get exhausted and tired and feel washed out on a lot of days

I work in a very stressful job which does not help, but I am 63 and must continue to work as I have no other income

Think having heart failure as well contributes to how I feel and I have got other health problems spinal stenosis as well as other things

Again thank you for great information

[Hidden]

I can live with mine quite easily, mainly because I keep my Afib episodes to a minimum and I barely notice them sometimes. Give this a try and perhaps it will work for you:

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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//cardiab.biomedcentral.com/a...