AF again and long wait for appointment.

[Jbeans]

Hi. I have AF *formally diagnosed Oct 2020) and been in Normal sinus rhythm for 6 months since cardioversion in March. 4 weeks ago I went into full AF again and was in casualty overnight. Heart rate down but always an irregular heart rate again. My GP has referred me back to my cardiologist but appointment isn't till end of April 2022. I feel really unwell when I have arrhythmia. I am currently off work as I am SOB and very tired. Is it safe and wise to be in AF all this time and will it affect the success of another cardioversion. I currently take 6.25 bisoprolol ( cannot tolerate a higher dose) and Riveroxaban. I am in danger of losing my job if I am not well enough to return to work. Any advice would be appreciated

[Jalia]

You're obviously still being affected greatly by your AF even though you appear to be rate controlled judging by what you have said .Can i suggest that you speak to your cardiologists secretary and explain your situation and see if an earlier appt can be arranged. Failing in that a private appt with your cardiologist would get things moving much quicker. I believe this would be in the region of about £250 according to those who have had to resort to this and you might find that this is money well spent.

Regards

J

[CDreamer]

I agree with Julia - if you are that symptomatic and are in danger of losing your job, I would research the choice of EP in your area and fork out for a consultation, ECG and Echocardiogram - then at least you will have an informed prognosis and suggested treatment plan. Most EP’s will offer you the option to then switch you to their NHS list for treatment. At least you would then have some certainty.

In the meantime I would do as much research on AF and it’s treatments starting with Lifestyle Medicine as many people have found that adopting Lifestyle changes can improve your general health and it some cases that is all that is needed to stop AF.

Things to focus on

- ask your GP for a sleep assessment for sleep apnea.

- ensuring you are not overweight

- manage stress

- eating well - ie: fresh, organic if possible, mainly plant based foods

- breathing - many people mouth breath which has been shown to cause arrythmias - research Patrick McKeown

Most treatment for AF is based on improving quality of life and many people are in constant AF and are not symptomatic at all and adapt to living with AF. If you are so symptomatic that you can’t live a normal life you & your GP do need to look at any possible underlying causes and I would recommend reading The AFib Cure as it gives a detailed outline of how others have managed to stop their AF.

You don’t say what your HR when in AF is and your BP so worth while self monitoring & keeping a journal which many help your doctors consider treatments.

6.25 Bisoprolol is a high dose, especially to start. Many people find that it’s Bisoprolol that causes the SOB and the fatigue so maybe talk to your GP about this and ask if there is an alternative.

Best wishes CD.

[secondtry]

Agree with the suggestions so far. Maybe tell your employer you want to sort it out quickly and therefore are paying privately for an early cardiologist appointment (assuming you take that route!). Could keep your job.

[ruskin10]

Morning, if you can't get earlier appointment I would definitely go private for consultation, it's worth it. There's ways of helping to stay in SR and they can recommend. I too am poorly when in af found after trying different tabs nebivalol and flecainide work for me. Best wishes

[Ppiman]

I this AF itself won't harm your heart if it is in good overall shape. I was told that the danger for the heart was from uncontrolled tachycardia more than from the AF. My elderly friend is early 90 and has had permanent AF for many years and he is perfectly well (not that he's holding down a job, of course). He is lucky that his heart rate has always stayed naturally low.

When I had atrial flutter back in 2019 before my ablation I was always slightly short of breath and would have struggled to go to work - thankfully I was retired. Now I only get occasional AF and the same SOB feeling, but I put that down to the mild tachycardia I get with it (90-120bpm).

Have you had any heart scans (echo or MRI / CT)? They should have shown up the cause of your shortness of breath (for example, the ejection fraction being down)? If you haven't, is there any chance of paying £180 for a private consultation? That might help speed things along as you'll have more time to explain the pressures from work and so forth.

Steve

[ellishead]

Four years ago, 6 months after a cardio version I was in the same position. My cardiologist then put me on on Flecainide 50mg twice a day and apart from short ectopics and a few short episodes of afib all has been well. If you can possibly pay for a private consultation with the consultant who you would be seeing on the national health it is the way to go. He will then refer you back into the NHS. Good luck

[Hidden]

Please don't hesitate to contact the AF Association for support & information should you need it: [e-mail] / 01789 867 502

[Fullofheart]

Really helpful suggestions here. I'd add that using the bhf helpline is also very useful.I've had AF for 17 years, most of those years without meds or intervention (not the case now). I'm on list for ablation and had a cardioversion couple months ago despite being in af that long so it shouldn't affect treatment options too much with the timeframe of 6 months, but if you can expedite, that would be very sensible and a good investment. And you need advice re work by sounds of it. I've been lucky and only needed a few weeks off work throughout my time with AF but I certainly feel the pressure of trying to stay in work. That's been really tough the last 18 months. So I can relate. And of course it depends on your job. Best of luck to you. 🌸

[Fullofheart]

Oh, and I get SOB with AF but never as bad as when I was on bisoprolol. That's one of the few times I needed time off work. I couldn't breathe wearing a mask, which was necessary for my job. Been way better since off bisoprolol.

[Auriculaire]

When I was on 5mg of Bisoprolol I felt very short of breath and horribly tired even though I had returned to NSR. Some people just do not tolerate beta blockers very well . You could discuss with your GP about trying another medication to keep your heart rate under control.

[captainKFF]

Hi, what is your heart rate while in Afib?

[tunybgur]

I think you should become a massive irritation to your cardiologist until they give in and see you earlier....alternatively you could go private but I don't know how you are fixed that way.

Many AF specialists believe that 'AF begets AF', in other words the longer you are in AF the more intractable it becomes.

I hope this is not the case, but there's no doubt there are structural changes to the heart caused by long AF, whether it does make it more intractable I don't know....but I suspect it does.

You must become a big nuisance until you are seen, exaggerate and tell porkies if you must.

Good luck

[Spud12345]

If you r symptomatic you could go to the emergency room to get seen by a cardiologist and cardioverted

[Jajarunner]

I totally relate to your dilemma. I was discharged from hospital barely able to walk or stand due to afib and told a cardioversion would not be possible to the end of covid. This was March 2020. I felt forced to go private which I did at which point I was referred back into the NHS as an urgent case. The appointment was pricey at £250 but I still regard it as money well spent. I was also lucky enough to be able to afford it which not everyone can.Too many hospitals think that lowering your heart rate is good enough to discharge you but it is nonsense as you have sadly found. I wish you all the best.