AF and cardioversion

[Pastafarian]

My Doctor isn't keen on progressing a cardioversion for me to fix my AF. Her reasoning is that I am prone to AF and that the most dangerous time is when you flip from normal heartbeat to AF. I had a cardioversion 5/6 years ago which did fix my AF. Started getting paroxysmal AF about a year ago and persistent now for 5/6 weeks. Currently on rivaroxaban and bisoprolol for the AF, but pulse still 80-90 bpm and irregular. Any views?

[Paulbounce]

Let's be honest - a CV won't 'fix' your afib. When you say your doctor do you mean your GP or a cardio / EP ?

Best,

Paul

[Pastafarian in reply to Paulbounce]

GP - not seen a cardiologist lately.

[BobD Volunteer]

I'd change my GP if I were you. No DCCV doesn't cure anything but it can direct different treatments such as ablation if a) it works and b) you feel better in NSR. What does your cardiologist say about it?

[Pastafarian in reply to BobD]

Not seen a cardiologist lately. My AF doesn't make me feel particularly unwell. Just get tired more quickly.

[Desanthony in reply to Pastafarian]

Ask for a referral to an Elecrophysiologist (EP) or at least a cardiologist as it is they who would be doing the CV and are the correct people to advise you on this. If you feel better in Normal Sinus Rhythm (NSR) then go for a CV, if the CV works - even for a short while then it would suggest that an ablation would work and keep you in NSR for longer. An ablation is better done sooner rather than later as if in permanent AFib for too long the heart remodels itself and neither a CV nor an ablation would work. If you can afford to get a private referral to an EP then that may be a good way forward in these times. A consultation would cost from £150 to £300 but if you choose a specialist who is in your local health board you can then be put on their NHS list for future consultation and/or treatments.

[Paulbounce]

Ask for a referral to a cardio - you have every right to do this.

Thats my take and good luck.

Paul

[Hidden]

Please seek care of specialist.

Cardioversions are not always successful or if they are, don't always last long. (1 month, 1 year) etc. But you can get more than 1 shock...I know some people that have had 1 per year for 4 years, for example.

If in afib long, your heart gets use to that new electrical path. Many specialists say afib is ok to be monitored as long as heart rate isn't over 100 at rest. Meds can help control that.

However, if you want another cardioversion, you should get one. If it lasts another 5 years, great, if it doesn't last long, then you can decide if you don't want to do it again. But I would seek a specialist for now.

My husband has had 4, myself 1 & we both need 1 again. (He is 63, I am 51). If this next 1 doesn't last long, neither of us will get another.

Good luck!! Be well!

[KMRobbo]

Get a different doctor, preferably an EP to get some proper advice on stopping your Afib if possible. You dont want to be in Afib if it can be avoided. Not medically trained but not currently not suffering Afib after ablation 4 years ago

[Jajarunner]

Surely if the first one lasted five years it's worth trying again! You need to see a specialist, I would think x

[kkatz]

I would politely insist on a referral.It took me a long time to get mine.Basically it was quality of life for me.I was then told by 1st Arrythmia nurse specialist that they would be limited in what they could do due to Tia history.They arranged 24 hr monitor.I then spoke to the senior nurse & he said as in AF 95% of The time a CV was the way to go.I got the impression being in Persistent AF not good for the heart.

[Perrylees]

Anti coagulants and bisoprolol won’t stop your AF. A heartbeat of 80-90 is normal on bisoprolol ( depending on the dose of course). If you feel well then I’d say try not to worry?I have permanent persistent AF with a similar heart rate to you and I am well. I did have an operation to fix it which worked for 2 years ( I don’t like taking drugs everyday…) but then my heart decided it wanted to go back to its old ways. That was 4 years ago. Now I don’t worry about it. Had a long talk with my cardiologist and decided to live with it . I don’t regret my decision but I don’t have many symptoms - if you do and it is making your life a misery then you should see a cardiologist and make an informed decision after that. No offence to my GP but I found they don’t really know very much about AF you need to speak to a expert if you are worried.

[mjames1]

You want to see an ep. In general, GP's really don't know a lot about afib.

Everything being equal, if you're on a thinner, ECV should not be dangerous. The question is whether or not it's the right choice.

If you're only going into afib every few years, it makes sense. If it's every six months, then a marginal decision.

Alternatively, you could ask for an anti-arrythmic drug like Flecanide, either as a pill in the pocket to convert, or for a daily dose. The former if you only have occasional episodes, the latter if you're going into afib frequently. But again, this is something to discuss with an ep, or a very well versed cardiologist, not a GP.

Bottom line is that you've been in afib 5-6 weeks, and while a long way from permanent, you really should take some sort of action soon, or it can develop into permament afib, which will significantly affect your treatment options.

Jim

[suenygaard]

This is exactly what happened to me yesterday. I have been in persistent a-fib for about 5 weeks, and had a cardio version yesterday. It lasted precisely 9 hours and then I flipped back into AF. I have never felt so discouraged. Next step-more aggressive medication.

[Dixidude39]

Why not a pacemaker (and perhaps a defibrillator)?

[Afibflipper]

I’ve had paroxysmal AF years, 2 ablations and recently been really brought down with new attack of itLast night cardiologist said I need 3 weeks plus on Apixaban together with increase bisoprolol then cardoversion and try to introduce Flecainide. Said the AF will undoubtedly come back as I’ve had it so long but hope I won’t feel this bad.

As I’ve had 2 ablations it is an option and may be covering old ground trying to redo or just leave me I am trying different drugs.

I had a horrendous few days following bad reaction to Amiodarone so I’ve gone for the cardioversion attempt next month or month after

[Pastafarian in reply to Afibflipper]

Thanks for your reply and info. Good luck with the CV.