Failed cardioversion what’s next

[Mollykin]

First cardioversion failed any ideas what’s next. I’m anxiously waiting on heart nurse to come and chat. Totally gutted and scared 😱

[Paulbounce]

Sorry to hear that Molly. Don't be scared - it happens.

The first thing to ask is did it not have any success at all or did you revert to normal rhythm - even for a few minutes ?

Paul

[CDreamer]

Hi Mollykin. You posted a while ago about Amiodarone and I just wondered what you decided to do since cardioversion on it’s own, often doesn’t work which is why people are asked to take Amiodarone for a few weeks/months prior to the cardioversion.

Don’t despair just yet as there are still options but which is going to be the one that helps you will be in the discussion you will have with the arrythmia nurse.

Cardioversion didn’t work for my husband but Amiodarone did. Pacemaker worked for me but I only went for that because I was so symptomatic and it was in preparation for Pace and Ablate - which won’t stop the AF but it will give you a regular pulse and help with symptoms, well did for me anyways.

And some people find that as they aren’t symptomatic so decide to stop chasing the holy grail of NSR - which someone said quite recently, sorry can’t remember who - live in permanent AF and live well and happily.

Best wishes CD

[Mollykin in reply to CDreamer]

Hi there, I was allergic to it so had to stop. I wonder if I can have an ablation with it having failed. X

[CDreamer in reply to Mollykin]

I rather doubt it as the likelihood of being offered ablation after failed cardioversion - which is why Paul asked the question - if you converted even for a few seconds there will be a chance but if not the chances of being offered an ablation is rather low but that will depend upon the opinion of your medical team.

I had 2 ablations which also failed, ablation may be a temporary fix for some people but many need more than one and the recovery can be brutal.

[BobD Volunteer in reply to Mollykin]

The whole point of cardioversion (for the doctor) is to see if you a) can be put back into NSR and b) if you feel better to be in NSR. Yes I know that is not what we hope for but that is reality.

This is a useful guide to future treatment plans but don't be downhearted as it is important to understand that any and all treatment is primarily for quality of life. Ablation is not the be all and end all of AF treatment after all. Provided rate is well controlled outcomes are similar whatever treatment is used so some form or rate control seems likely if there was no return to NSR even for seconds.

[cuore in reply to BobD]

When I read the EAST AFNET 4 trial I have difficulty to follow your constant "any and all treatment is primarily for quality of life" when Dr. Kirchhof says, "...once you are in atrial fibrillation for a few months, the atria suffers severe damage, some of which may be irreversible, so it becomes more difficult to restore and maintain sinus rhythm."

He also says, "We think that these results will inform the future use of rhythm control therapy in atrial fibrillation patients, and they suggest that early rhythm control therapy should be offered to all patients with early atrial fibrillation at risk of cardiovascular complications,"

Granted the above trial addresses patients in the early stages of AF, and patients at risk of cardiovascular complications, it would seem that a patient would endeavor not to have the atria become severely damaged.

medpagetoday.com/meetingcov...

Granted also that your answer was addressing cardioversion, a scoring card has not been developed for "quality of life." What may be a good quality of life for one patient may be a disastrous quality of life for another.

I do recall that Pottypete posted about "quality of life" previously.

Nevertheless, I do conclude that you were offering Mollykin some comfort that life still does go on regardless of what stage of AF one is in.

[Susangibbons]

I know how you feel, this happened to me, the Sinus rhythm lasted a few seconds then I went back into AF, after a tape test they were talking a pacemaker as my heart was dropping so low at night, I have dilated cardio myopathy and ablation not possible, I was very concerned.

Then my heart consultant tried Digoxin, and for me it worked!

Hang in there and hopefully they will sort it.

[Barb1 in reply to Susangibbons]

I had DCM but after meds heart went back to normal size and since then I've had 4 ablations with good QoL after, so don't lose hope.

[Barb1]

Did you revert at all?

[Mollykin in reply to Barb1]

I reverted whilst back on the ward and it was picked up in the ecg, but with lots of premature arterial beats which is an indication I’ll revert back soon. I feel very tired still but less breathless and dizzy so that’s good. I was so pleased though as only 54 and was hoping for an ablation at some stage. Was told I’ll have to lose weight before I’m considered so the diet starts now. Been trying but now I’m determined 😂

[Barb1 in reply to Mollykin]

Yes, that proves that you are a candidate for an ablation.

[Susangibbons in reply to Barb1]

She maybe a candidate, its not a definite, I wasn’t, heart conditions are so complicated.