Full diagnosis and plan in place : comments please

[mjm1971]

I know your not doctors but I have just had my diagnosis and plan put in place by my EP . All your opinions and comments would be appreciated not just on the plan but my condition compared to most as I feel I'm very lucky compared to others on here etc . .

Im male , aged 50 and don't have any real symptoms while in AF , sometimes slightly lightheaded .

A) Diagnosis : Paroxysmal AF in Flutter

Right Bundle Branch block

B) Echocardiogram Results : Normal structural Heart with preserved ventricular function , all valves were fine with normal size Atria

C) 48 Hour ECG Results : showed Substantial burden of Paroxysmal AF with Atrial Flutter , symptoms timed out with my arrhythmia

D) I am a prime candidate for a pulmonary vein isolation and CTI ablation for Paroxysmal AF and flutter respectively

E) CHADVS Score = 0/9 , no A/C required until Ablation process etc

F) Drugs prescribed = 100mg Flecainide and 1.25mg Bisoporol daily.

[BobD Volunteer]

I think D is the most important thing there re way forward. All other pretty good really.

[rosyG]

Agree with Bob. I don’t advocate rushing for ablation usually but you are young so heavy medication for years would be very onerous. Also you have flutter as well as AF and so can be very debilitating. Do let us know how you get on

[mjm1971 in reply to rosyG]

Hi Rosyg

why is the flutter debilitating ?

[rosyG]

The heart rate is usually much faster which can make you feel really bad! Sometimes AF is fast - when my rate is 150 I feel poorly but if 120-130 not too bad. Flutter is easier to ablate as just on right side of heart AF is trickier as have to go through septum to get to left atrium. Are they doing both together? Hope all goes well

[CDreamer]

I would echo RosyG’s comment - I always found AFl much more debilitating than AF and it’s an easier procedure and quite usual to have both sides done at the same time. I have several friends who find they have angina with AFl but often not with AF, I also had mild angina with AFl but not AF.

Once you understand just what happens to your heart with AFl you can understand just why it’s more debilitating, even though the rhythm will be regular with AFl on it’s own your heart rate can go x3 times faster so like any muscle, hardly surprising it aches after all that exercise.

Looks like you have a good plan.

[Rubymurray25]

Very similar to a stage on my AF journey , I eventually had an ablation for each separately three months apart and am really pleased I did as I know it has given me a better quality of life.

[Crystalbowl]

I can’t comment on your post other than to recommend that you get yourself a copy of the book ‘The AFIB Cure’ by John D Day, MD and T. Jared Bunch, MD. Someone on here recommended it recently so I bought a copy and wish I had read it 10 years’ ago although not possible as it was only published this year. They are American Cardiologists and it is a very different health system in the US as we know but it covers the things you have mentioned in your post plus lifestyle changes to optimise your chances of a full recovery especially as you are relatively young. Good luck!

[mjm1971 in reply to Crystalbowl]

Hi Crystal

already read it twice lol , very informative and a good read .

[KMRobbo]

I had two separate ablations first for AFib, then 9 days after that I developed A Flutter so had a second ablation for reentrant atrial flutter a month after the first. I was totally asymptomatic in AFib, but BUT VERY symptomatic in flutter even thought is was rate controlled at 140 bpm (lower rate than what I had when in AFib.) Doing both ablations at the same time sounds like a good idea to my non -medically trained brain and my EP told me when I went back to him with the flutter 2 week after my AFIb ablation, that if there had been any sign of the flutter prior to the AFib ablation he would have done both at the same time, so I doubt you are in new territory.

It is almost three and a half years since my ablations and I don't think I have had any Fib or flutter since, although I still do get ectopics fairly regularly but not all the time. I was 57 at the time with no other co morbidities.

Good luck!

[Hidden]

Staying in AF for any length of time is not recommended. Having no symptoms does not change the risk when in AF. I assume you are on flecainide now which has worked for me for 35 years. No AF at all for the last 7 years.

[mjm1971 in reply to Hidden]

I’ve just started 200mg a day of flecainade today . Not sure how long it will take to start working but hopefully it will stop the episodes

[Padayn01]

Can I ask what right bundle branch block means as this came up on my ECG?

[mjm1971 in reply to Padayn01]

Not really sure but was told it’s nothing serious and nothing to worry about . It’s fairly common apparently