Good morning all. I've been sitting this out for 8 days in the hope I will return to NSR spontaneously but it doesn't seem likely. So this morning I will go to A&E.
Generally at St George's they are reluctant to give cardioversion particularly as I've had about 10 before. So my question is - is there any evidence cardioversions cause long term damage?
Tim.
Interestingly enough, I was listening to a cardiologist last week who has a weekly segment on a talkback radio show and someone called in about this - the caller was saying he’s been recommended to have an ablation but he’d had a few cardioversions and was on meds. He was asking if he should continue the way he’s been going and the cardiologist said that you don’t want to keep having cardioversions as every time you do it does a little more damage to the heart.
That's really interesting to hear Kaz. I wonder what sort of damage the cardioversions do?
Jean
I don’t know but it was Dr Ross Walker who said it who is a high profile, highly regarded Australian cardiologist
Thanks for that Kaz. That's the same line trotted out by most A&E doctors but I was interested to know if any one knew if there has been a study with some real evidence to back this up. There are several people on this forum who've had way more than me with no apparent long term I'll effects.
Tim.
It’s probably like a lot of things in medicine - whether you believe it can or you believe it can’t, you are probably right and will find a study to back up your argument 😂
Good morning Jean. How's that lovely garden of yours doing?
Battered by the wind and rain right now.
You could send a bit of that rain in my direction please. I am having to water patches of soil in order to dig holes for planting. The garden is too big to water so only the veg and newly planted stuff is getting watered. I long for a really good downpour!
We were the same as you and desperate for rain. I was delighted to see it. Will send your way now.
Thanks! We have very hot dry periods every summer but they are getting longer with climate change. We chose this area of France over 20 years ago because it was always green. Summers were good but heat would lead to frequent storms. Perfect weather for gardens (as long as taller perennials are well staked). Now it is getting more like the south of France but a typical English style garden with lots of perennials can start to look sad and wilted. Everything is very early this year with Michelmas daisies out already. Good job I Chelsea chopped half of them so as to feed our bees later in the season.
The last one I had stopped my heart needing CPR for some time to bring me back so rare though it is there are risks. Read the consent form!
Thanks Bob. A very sobering thought. Perhaps I'll just stick it out and take more Bisoprolol.
I would think - and am just guessing here - that each cardioversion could potentially produce a small amount of fibrosis in response to tissue injury of the heart muscle from the current run through it. I have heard some patients report that their skin is actually burned from the process and the burns takes time to heal after! Maybe too many joules were used in those cases. I have been reading recently about the process of fibrosis formation in the afib heart... and what can be done to halt and reverse that since it causes a structural change to the atria/atrium, predisposing it to further afib. I would think higher than normal current being conducted through the heart could also have a fibrosis-producing effect since it is an injury of sorts.
Thank you Kim. Perhaps you are right but it seems there is still no real evidence of any long term damage, just speculation. As to skin burn this has never happened to me but I did wake after one cardioversion with a lot of muscular pain across my chest which took a good few hours to wear off.
I’ve been in PAF for over a year now. Had 2 dc cardio versions when the diagnosis was first made. My EP said that there was no point in having anymore as they didn’t work for me so on meds for rate control and yes the pads do leave circular burns on the chest & back which take around a week to heal.
I’ve had 3 cardioversions over 5 years and my cardiologist suggested an ablation after the 2nd one but after going to the European cardiologist conference in late 2018 he changed his mind and says ablations weaken the heart more than cardioversions. I personally feel it’s less risky having a cardioversion. You’re in and out in a few hours. I’m sure it has to do some damage somewhere though.
I dread to think how many cardioversions I would have needed to keep me in NSR for 3.5 years. I usually went out of whack between 3 weeks and 3 months.
One ablation is surely better than 12+ cardioversions, and cheaper.
(not that I would have been allowed 12+ cardioversions)
I’m in South Africa. My 2 cardioversions here, cost R40K and 35K . I had one in St. Lucia and the people I was contracted to on that job paid for that one. An ablation here costs 250K...which right now, is not feasible for me. So actually an ablation is 5 times the price of a cardioversion here.
I understand that , but I think for me I would have needed 12 cardiovesions in the last 3.5 years x35k is 420k which is nearly double the price of one ablation.
So I would be better off in the long term , financially and QoL.
God save the NHS
That's very interesting about ablations weakening the heart. Might explain why my EP is so reluctant to give me another.
I would wonder what Dr Sanjay Gupta might say to this question? He's usually a wiz at researching others' research and coming up with a very balanced view. However, as I've never needed cardioversion, it's not my place to ask.
We are metered but I just put up with the dried up looking stuff. The plants recover in the autumn. I have been surprised at how resilient some plants not reputed for drought tolerance can be.
John I'm not on any regular medication. I just have 1.25mg Bisoprolol as a PIP and my Edoxaban. I can't take Flecainide and because my resting heart rate is low 50's I can't take beta blockers on a regular basis.
I take flecanaide and it always rights my heart in 3-11 hrs. A little bisopropol also helps to bring the heart rate down. Both PIP and I've had Afib for 11 years. When I do have a lot of blips in a short time it's usually down to digestive issues which take a while to resolve as that can trigger my anxiety. Always trying to get on top of it.
I defo relate my episodes to gastric avtivity., Lots of wind as I eat almost nothing whilst in af
Everyone’s hearts are different, you’ve got Rolls Royce’s,then you’ve got Lada’s & everything in between, some can take the knocks & some can’t!
I am in at 3 weeks today. Tried extra flecanaide as pip but no change. ECG booked at cardiac clinic next wednesday. Fear I've moved from proximal to permanent.
I do hope for your sake that is not the case.
My cardiologist said that being in Fast afib for long periods of time can cause heart failure ... be careful. I would opt for the cardio version vs extended periods of afib. But that’s just me. I have had one cardio version and thus far it has been very successful.
I was once left for a month waiting for a scheduled cardioversion and my EP was quite happy with that. And then there are people in permanent AF for years, some unaware and they don't seem to suffer any. It's all a bit confusing. I wish my EP would give me a letter to take to A&E with a set of clear instructions on how he would like me to be treated. I find the uncertainty of A&E frustrating. And I don't blame A&E - they are not cardiologists.
Prior to this bout of AF my HR was seldom above 45 and sometimes down to 33.
I think that it depends on how fast the heart is beating??? When my cardio said that, my heartrate was really high and it concerned him. He is the cardio who performed my first cardioversion and it seems to be highly successful?? My heart feels very solid and feels as though it is performing well. It's all very scary (to me) and mysterious. I do know people in permanent afib ... doesn't put them off in the least. I would HATE IT ... when I have it, it is very sympomatic ... thank you for your response. Jan
Most of the time my HR in AF is between 115 and 120. It did go down to 108 this afternoon. I know 118 is not particularly high but with a starting point below 50 it's a big difference.
That's very interesting John. I've often wondered if my slow heart is causing my AF by trying to speed up. I will certainly ask my EP.
Latest AF episode of 11 days
AF occur at specific times of the day?
meet up at AF patient day 
4 days of intermittent ectopics and AF 
Back in the hospital after my AF ablation 5 days ago 😫
