Recently diagnosed with Persistent AF

[54345]

I'm male, 57 years old and have had persistent AF for about 6 months, only diagnosed about 2 1/2 months ago. I had a DC Cardioversion and kept in Sinus for 5 days before returning to AF. there is a 9 to 12 month wait here for an ablation. Is this OK, what sort of damage will it cause to my heart to wait that long..? Is it worth selling my first born and wife and paying for it..? Thanks...

[cicek]

I sympathise with you the waiting time is about a year where I live. I had a telephone conversation with the Cardio/EP about whether it would cause any harm being in persistent AF and he assured me there was no evidence to that effect. I have actually got a real appointment on 6th August so will ask the question again. All I've been given at the moment is extra Bisoprolol 10mg and Flecainide but it's making be feel dreadful. HR is still going high when I move about but at least it is going down too. I feel like a yoyo! The members on here are very good and will help you come to terms with it all. Good luck x

[rosyG]

Hi

Sorry to hear this. We heard a cardiologist at patients’ day several years ago say that AF is not a worry as long as one is anticoagulated and heart rate was not high for too long. So as long as you go to A and E if heart rate stays very high you should be ok. Obviously also go if you feel ill or have chest pain. Heart muscle returns to smaller size when Af is stopped

[BobD Volunteer]

So long as you are anticoagulated for stroke prevention (AF makes you five times more at risk) and your rate is well controlled (under 100) there is no long term morbidity from AF. All and any treatement is fundamentally for quality of life .

[54345]

Thank you all so much for replying, I'm on 60mg Edoxaban 5mg Bisoprolol and 240mg Sotalol, My resting heartrate is somewhere in the 90's rising to 125 if I do anything, like walk upstairs... I have no energy and feel very lethargic... My Blood Pressure is about normal... Am I quite "normal"? Thanks

[Yachtsman]

Hi

My experience is very similar. I had two DCV's which failed after a few days, then waited 11 months for an ablation which has been 100% successful.

Overall from initial PAF diagnosis to ablation 21 months.

No evidence of any permanent damage to my heart.

My advice would be to hang in there and wait. Problem with going private might be the cost of aftercare should you need it.

All the best

Colin

[Singwell]

I waited a year - it's normal on the NHS. And to even be offered the procedure I had to make it clear AF was interfering with my work-life. You could put pressure on that way - people to support, physically incapacitated etc. It might help. Otherwise I agree with what others have said here- there's not necessarily any danger as the heart adapts to being in persistent AF. My brother's been there for 7 years and doesn't notice it much. You may still be adapting, you may need to have different meds. Bisoprolol I found was a bugger on stairs and hills!! Focus on your lifestyle while you're waiting to give your body its best chance when the time comes.

Drink plenty of water and adjust your diet so you have plenty of plant foods and roughage. Go for slow walks on the flat if you can.

And should you decide to go privately, do your research. Make sure the EP does a minimum of 50 procedures a year, check out their success rate and generally grill them. Not all hospitals are the same alas...

[Jetcat in reply to Singwell]

Yes I waited nearly a year for my first 2 ablations then 8 months for my third and that was because I accepted a cancellation and was already taking anticoagulants. So I think a year on the NHS waiting list is probably about rite. ?

[McIvor]

There is a study of 32 studies on persistent long standing AF ablations success rates and different technique / ablation approaches you can read. Its getting more complicated when over 2 years in AF. Generally earlier is better. The grade of fibrosis and structural changes in the atria will determine the ablation outcome too.

heartrhythmjournal.com/arti...

stopafib.org/newsitem.cfm/N...

It could well be that you feel so wasted because of the beta blocker. I tried 40mg Sotalol

years ago and I felt bad. 240mg Sotalol plus Bisoprorol would get me to the hospital.

Sotalol has rate control and rhythm properties. As I remember 160mg (could be a bit more or less) are necessary as a minimum to activate the rhythm properties. Is that the reason you take it? Looks like without success.

Why not taking Flecainide? Of course only if no impaired left ventricular function.

[54345]

Thanks again everyone for taking the time to reply, I feel much better about my situation now. For the few days I was back in Sinus Rhythm I felt 1000% better, which lasted until about 2 days after dropping back into AF. I was still taking the same meds so I don't think they are effecting me much. I have an appointment this evening with the heart specialist so I will ask about them then.

[Mabal]

HiI’ve also been in persistent AF since May

I’ve been for echocardiogram, seeing cardiologist in Sept.

I am on 10mg Bisoprolol and Apixaban

Had to have low dose Digoxin also to help me as I was finding it difficult, my HR fluctuates. The Digoxin seems to have helped as I don’t seem to get so breathless when walking now. I’m hoping to try longer walks, I’m lucky at the min I can work from home. Good luck.

I hate it though, just want to get back to how I was before.

[Dr-Gohan]

I was 19 months waiting and trying medicine but when I had the ablation three months ago, My sinus rhythm came back. Over the last few months, my body has been adjusting to the return of the regular heart beat.I'm so much better now, but I'm really watching diet. No alcohol or salt.

Lost 15 pounds on new diet of fruit and veggies. Magnesium supplement stopped night time leg cramps. Sleep and napping a lot. Just this. week I really feel like myself

Good luck.