Abalation worries

[Andyb7612]

Hi there...I am booked in to see an electrophysio cardiologist on March 25th about alternative treatment to my 2.5mg bisoprolol which isn't working that well for me now after a year ..they can't up my dose because of my low pulse rate ..my afib almost always starts when my pulse drops in the evening when I'm resting.. they have mentioned offering me an abaltion .. but I'm worried about the procedure , the recovery and most things about it really...I suffer with bad anxiety over the afib and my future with it and have read its not the best idea to have one for a worrier like me ....any advice would be really appreciated thanks andy...

[BobD Volunteer]

I can't see that ablation is any worse or better than any other treatment for AF as far as worry is concerned. It can , however, be the solution to the problem often for many years so surely worth considering.

Anxiety is the bigger problem I think you must agree especially if it delays treatment or exacerbates your other issues so maybe the thing to focus on right now.

For what it is worth, I've had four ablation for different things and have always been a devout coward. Easy peasy.

[Andyb7612 in reply to BobD]

Hi Bob thanks for the reply...I agree the anxiety that has followed the afib diagnosis has ruled my life . I was diagnosed with paroxysmal afib back in April 2021 am 54 years old and always kept myself fit , swimming, cycling , walking but this has changed everything for me. . Yet I read people saying you can still lead a normal and happy life.. I've started cbt therapy so hoping this helps a bit. I find myself sitting at home after tea every evening waiting for the palpatations to start then timing them and panicking all the way through them to see how long they last.. I hate evenings now as that's when they usually start.. thanks for the your input again..

[Singwell in reply to Andyb7612]

I've just had my 2nd ablation. Developing AF made me terribly anxious- for over a year my life revolved around 'the next episode'. You're relatively young, continue with learning to manage the anxiety -CBT combined with mindfulness is apparently very effective - and seriously consider the ablation if recommended to you. There's a good chance your life will improve because either you'll see the AF off or you'll improve significantly.

[Andyb7612 in reply to Singwell]

Hi there singwell thanks for the reply..I shall definatley consider the abalation as I am hereing more and more encouraging stories on this forum..I will definatley be trying to get my anxiety worries under control first though as you and others have said its basically the anxiety that makes it so much harder to live with ..its definatley taking over my life at the moment.. how are you feeling after your abalation? , I read you had it a couple of days ago ..hope you are starting to feel OK...all the best andy...

[Singwell in reply to Andyb7612]

Yesterday afternoon Andy. I'm doing OK I think. Tired but stable. This is my second and feels easier than the first. I'd advise having a general anaesthetic if you're at all anxious.

[Mitcham in reply to Andyb7612]

I wouldn't worry over the last ten years I have had four ablation everyone was fine. My experience of the is they are like magic bullet,, every time I have fully recovered within 48 hours.I am not sure if James any difference but my at has always been persistent, without any obvious triggers

Good luck

[Vince1001]

Andy,

I was in exactly the same situation as you some 6 months ago. I had a private consultation with an EP and much to my surprise, he recommended I switch to Dronedarone. Note its much more expensive than bisoprolol, which is the reason the NHS cardio rarely prescribes it! See link

healthunlocked.com/afassoci...

I'm delighted to saw its transformed my QOL. I still get some breakthrough, about once a month or so, but much better than previous and never at night which is a godsend. It might not be suitable for you, but there are other options for medications instead of ablation.

Best of luck

Vince

[Andyb7612 in reply to Vince1001]

Hi Vince thanks for the reply and encouraging answer .. do you get any bad side effects with this medication at all? ...I have been told there are lots of other meds to try as well and will know more once I've had my appointment but I was lead to believe the earlier an abaltion is done the better....but I must admit knowing there is other people who have tried bisoprolol and have been helped better with other meds is assuring thanks again and best wishes...

[stoneyrosed]

Hi mate, I was exactly like you, getting palpations in the evening and bedtime. What changed in my life was been prescribed flecanaide along with the bisoprolol, it severely curtailed the number of episodes I was getting. I was also put on the list for an ablation which I had in March last year. Unfortunately the af came back but I am on a list for ablation number 2. The thing is I now feel that I am attacking the symptoms by taking the meds and having the ablations rather than the AF attacking me if that makes sense, I feel more in charge rather than say waiting for the events to happen. Anxiety is caused by the palps, getting rid of the palps will reduce your anxiety. Good luck 👍

[Andyb7612 in reply to stoneyrosed]

Thanks for the reply

[Andyb7612 in reply to stoneyrosed]

Yes your right about the palpatations it's waiting for them to happen and wen they do how long and often are they going to be here....unfortunately I've got at least another 3 weeks of them until I see cardiac specialist at Blackpool.. that means another 3 weeks off work as well as getting no sleep hardly...

[Golfer60UK]

Hi Andy, I have had two ablations and its not a huge deal, however if you are over worried about the procedure you could always ask to have a general which will send you to sleep whilst the procedure takes place.

Best of luck

Dave

[Andyb7612 in reply to Golfer60UK]

Thanks dave

[secondtry]

Hi Andy, it is tough at the beginning. The anxiety is perfectly normal and you have already started using it to good effect by looking into your options here.

I also liked sports and always had low pulse (in the 50's) and BP (115/65). My understanding is Biso reduces your heart rate so might actually be doing you more harm than good by making you more prone to an AF episode in the evening. At 60 my cardiologist just gave me Flecainide (quite unusual) saying a BB/CB would make me feel unwell; you may be aware this drug deals with rhythm rather than rate. First 100mgs which didn't stop the AF and then 200mgs as an option to an ablation. So far after 8 years he has been right; although I suspect things will have to change when I retire and slow down a bit reaching 70 soon.

At your stage: Collect all the information you can from here, EP, Cardiologist and an experienced in AF Alternative Practitioner. Keep an open mind and stay in control (don't roll-over to medical advice), you know best when it comes to your anxiety and a subjective decision. Lastly, 'flatten your life', i.e. no hectic stressful days, no pushing yourself cycling or in the pool, no large late dinners and no collapsing in front of the TV in the evening or into bed without a gentle wind down before retiring.

Best wishes, hope something above works for you.

[TopsyJones in reply to secondtry]

Hi Andy. I was given exactly the same recommendation, come off the Bisoprolol and go on to 100 mg of Flecainaide. I was 64 years old and did a lot of exercise. From having episodes nearly every day I have only had 2 episodes in the last 9 months and I feel great.

[Andyb7612 in reply to TopsyJones]

Hi there yes I have got 3 weeks to wait and it cant come soon enough .. I might just stop the bisoprolol till my appointment and see how it goes .. hopefully another med will help...did you have to undergo heart tests before they put you on flecanide ?

[TopsyJones in reply to Andyb7612]

I had already had all the tests , mainly wearing monitors to check the rate and rhythm but also an echocardiogram. Everything else about my heart was healthy which is why I could go on the Flecainide.

[Andyb7612 in reply to TopsyJones]

Hi thanks again....yes i had an echochardiagram and all tests last March 2021 and all was well .. weather they will want new tests I dont know...

[TopsyJones in reply to Andyb7612]

I doubt it. My doctor said I would have an ecg every two years , but nothing else, unless there were new symptoms. Good luck and let us know how you get on.

[Andyb7612 in reply to TopsyJones]

Thanks again will do

[Britishgas]

Hi Andy I also have low pulse and was put on 1.25 Bisoprolol a few months agowhich took my pulse down to low 40s Last week I ended up in A&E as feeling rubbish and my pulse was in 30s. HF nurse said to stop taking it. I have been off it for 2 wks and still getting symptoms starting early evening but not as bad as before but I am worried they will creep back to the heavy thudding that I had before taking Bisoprolol. Saw my cardiologist yesterday & he said stop taking your pulse it’s not the numbers it’s how you feel !! Told him I felt dreadful . He is arranging Holter monitor then talking about Ablation and or pacemaker. Keep reading these posts as I feel I learn a lot more from people in our situation than ever I do from the medics. Are you seeing EP through NHS or private as I’ve paid out a lot to see cardiologist but don’t know of any EPs. Best of luck.

[Andyb7612 in reply to Britishgas]

Thanks for the reply

[needlestone]

Hi Andy, you mentioned it starting every night after tea. Look at what you are eating and drinking each evening. You may find a trigger causing it. Does your tea include artificial sweetener or caffeine? These are triggers. Are you eating different foods at that time?I did have an ablation years ago and surgery and recovery were not bad. I continued to have trouble though for months after until I figured out triggers. Mine were artificial sweeteners, gluten/wheat and caffeine. Years later, I can on occasion have caffeine without problems, but can’t even chew gum with aspartame in it bc it sets my heart off. As long as I avoid triggers I don’t even have to take meds. I am 53 and suffered 3 years with the stress and anxiety from this condition when I was in my mid forties. I now live a normal life minus gluten and artificial sweeteners. If you haven’t tried yet, look for your triggers.

[Andyb7612 in reply to needlestone]

Hi there ..yes I am always looking for triggers , I think ive found them then it happens again...I am in a bad situation as well as I now get the episodes every two or three nights lasting about 3 hours each time...I don't get much sleep and the bisoprolol doesn't work at all .. I've contacted my gp for help but he says I have to wait for the 25th march appointment at Blackpool cardio Centre for them to deal with it...so I am now really worried that by the time that comes around in 3 weeks I might have gone into persistant or permanent which will be even harder for them to deal with ....

[wilsond in reply to Andyb7612]

Persistent and permanent AF takes considerable time to develop. Hang on in there . Xx

[Andyb7612 in reply to wilsond]

Hi there I hope your right thanks again

[needlestone in reply to Andyb7612]

Andy, I am so sorry you are going through this. I have been where you are. I waited 3 years before I had my ablation. Wish I would have done it sooner. Mine was so bad that I had to leave a job I loved bc I traveled heavily and began to panic alone in hotel rooms, on planes and on the road. I did yoga and meditation that helped somewhat but ablation and finding triggers eliminated it for me. I know the place you are in now, you feel helpless. It will all get figured out and you will get better.

[Andyb7612 in reply to needlestone]

Thanks for that..I really hope your right as it just seems to be getting a lot worse with time ...

[Sandych55]

Bisoprolol didn't suit me and I swapped to sotalol but I am considering coming off betablockers altogether. When I was on Bisoprolol I dreaded going to bed as I was getting a racing heart, missed beats etc as soon as I lay down. I read on here that taking it in the evening is better so over the course of a few days I altered the time I took it and it did make a big difference. I changed because I just didn't feel well on it but it might help you over the next three weeks if you change the time you take it.

[Andyb7612 in reply to Sandych55]

Hi there thanks for that I will give that a try ...

[Cos56]

I agree with Vince. My EP prescribed Flecainide 50 mg twice a day. I also take Eliquis and metoprolol 25 in am and 12.5 in the evening.

It changed my life. My episodes would occur at night when I was relaxed.

It’s an old medication and very inexpensive.

Maybe mention it to your doc. I don’t know your entire situation but it’s worth having a discussion. It prevents AFib for me. Mine is Paroxysmal. My echocardiogram and nuclear stress tests show no structural issues. I don’t know the future, but right now it’s working for me.

Wishing you the best ❤️