Just a brief introduction , I have been suffering from AF for about 5 years and after 3 ablations ,1 was for flutter, I was getting episodes every 2 to 3 weeks usually lasting 4 to 6 hours. These episodes are usually terminated by PIP flecainide and metoprolol . I’m used to them now and basically ride it out till I convert to NSR. I have been in AF for over 28 hours now and even my maximum dose of flecainide has not worked. The rate is not excessive bumping around 100 to 120 but for someone whose resting heart rate is 40 it feels uncomfortable to me. Any advice greatly appreciated , do I stick it out and keep taking flecainide ? even though was only prescribed as PIP or should I maybe call 111 for a bit of advice ? I hate to burden them when others are in so much more need than me. Is this it and am I now in permanent AF? My next EP appointment is in June and again will be by telephone , I haven’t actually seen them face to face since 2019. I’m not expecting any immediate response as it’s the middle of the night and most sensible people are enjoying a good nights sleep 😂
Many thanks x
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Kjsp
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You were not wrong about the response but I have just woken up 😉. What I think I would do if I were your position is send your EP or his secretary, a brief email, containing much of which is in this post, but perhaps asking if would think if it would be beneficial for you to have a cardioversion asap. Your heart rate is only just outside the normal range but if you are feeling uncomfortable it’s worth a try……..good luck
I don't think that you should expect to be in a permanent rate over 100 bpm. You could try 111 for advice or maybe your EPs secretary, arrhythmia nurse, if you have one,( probably best idea.. ) or even your GP !
Hopefully you may have converted to NSR by now.
I once converted after 40 hours at 140+ bpm ( on a cruise ship) but unusual for me.
Wishing you well. This is all so tiresome for you when you feel the sustained rate is not high enough to seek emergency treatment but not a good idea to be permanently functioning at circa 100/120 bpm
You are unlikely to be in permanent AF now, that period of time at the rate you're in is quite short.
In the past I've been in AF for months while waiting for a cardioversion. Once I went back into sinus rhythm myself on the morning a cardioversion was due. I'd waited about 2 months for that too.Is the rate you're at now making you feel ill?
I've also had 3 ablations and AF for 17 years. For the last 2.5 I've been in constant low rate AF. My BPM when resting is now between 60 and 90. My EP has discharged me from his care.
I take 2x 100 Flecainide alongside 2x 12.5 Metoprolol.
Let us know how you get on please. The GPs at my local surgery are very knowledgeable about the heart and medication.
Grab it, you lucky thing. Nothing to them so long as they knock you out before they give it to you. I've had lots, but have now been told they wont offer anymore after I had two in one year that only lasted months. It's strange , but I love having them. I always walked out a cured woman.
Kjsp, you did the right thing. Sooner back to NSR, the better because the upper chambers are quivering at 300-600 BPM.Why is your heartrate (40'ish) so low? because of the medication for blood pressure or athletic background?
Just to clarify somethng here. Permament AF is not a state, it is an agreement. An agreemant that you and your cardiologist agree that no further attempts to return NSR are appropriate and that rate control will be the way forward.
Just like Jean I too have been in AF for long periods waiting for DCCV (cardioversion) and in most cases NSR was long term after that. In the bad old days before my third ablation for AF I often spent long periods with a rate well, over 100, usually around 140 and yes it is uncomfortable and one has to pace oneself. If you are still working it can be a real nuisance but it can be done. I've travalled a fair bit for work (motor sport) whilst in AF . The worst thing is paroxysmal AF actually as there are no violent swings and the body does eventully get used to a permanent state of AF and as I'm sure you will be aware, provided that stroke risk is addressed and rate well controlled there is sno increase risk of anything bad happening.
So pleased to hear that news. No exerting yourself now for a few weeks, or you could slip straight back into AF. Let your heart grow strong, beating in it's correct rhythm.
Being in the US, my reply to your original post wouldn't have been read as quickly as others. I was hoping you'd get a cardioversion and you did -- so glad to hear it! Like jeanjeannie50, I too rather enjoy having them. My longest a-fib episode was 2-1/2 days prompting my first CV. May you now continue on in NSR!
Not even close to permanent afib. As mentioned, permanent afib is an agreement between you and the doctor that no further attempts to retore your heart to NSR will be made. But to put it in perspective, persistent afib is often defined as afib lasting over 7 days and long standing persistent is longer than 12 months and then there's permanent. So again, you're not even close at 28 hours.
I assume at the hospital they are treating your rate while you wait cardioversion. You should know that a large per cent of people naturally convert within 3 days of an afib episode. I would discuss that with your doctor and personally, unless there was good reason, would wait out the 3 days either at home under rate control or at the hospital if they felt you needed supervision. Then CV if you don't naturally convert in say a 3-4 day period. As far as flecainide is concerned, I'd leave the decision whether and how to use it in terms of conversion up to an ep.
As a personal story, I CV for my first three or four afib episodes right away which were always years apart. Then, a doctor told me to control the rate at home and wait a few days to see if I naturally converted. And from that point on I converted naturally usually within 6-48 hours at home.
Finally, this year, I technically went into persistent afib since my last natural conversion took 8 days. At that point I was scheduled for CV, although my ep would have done it earlier had I not decided to wait it out. I was also put on flecainide which converted me within hours so the CV was cancelled.
Morning, I am in long term persistent afib, in it all the times, for 4-5 years. I never knew I had it until I had a turn and was already persistent (which I think is prob what you meant by permanent ). Put all my symptoms down to tiredness and the menopause. There is an options other than meds, cardioversion and catheter ablation should you not convert back. I am having surgical ablation in a few weeks which has a higher success rate of converting and maintaining NSR. I hope your cardioversion goes well for you 😍
Hi I’ll definitely root for you and wish you all the best for your surgical ablation. Once done, I’d very much like to know how it went. All the more so as a few days ago I was also offered a surgical ablation as the success rate of a catheter ablation considering my condition would be only about 30%. In addition to long term persistent AFIB, I also have heart failure, a severely dilated left ventricle and the possible traces (scars) of the radiotherapy treatment I had 10 years ago for my breast cancer. I am now waiting for the surgeon to come back to me and confirm that I am eligible (so far only the EP has offered it) and if so, who knows how long I’ll have to wait for the procedure to be done. I am scared but I know very well that without it my chances are quite bad. And if successful, it may help with my heart failure as well. Sorry for the long comment.
I am so happy you answered to me, dear MummyLuv. I hope you are feeling well and I keep everything crossed for you.🥰 My arrhythmia centre is Royal Brompton Hospital, Chelsea. I live in Harrow. I know I’m very lucky because they are very experienced. I am just very worried that I won’t live long enough to have the procedure. Today I am feeling awful again and am very scared. I think I badly need some reassurance that all will be well. But I do hope you are OK.
Oh my dear, sending you strong vibes! Sounds like you are in good hands there as the Royal Brompton are the only U.K. hospital I have seen research on surgical ablation fromnjl-admin.nihr.ac.uk/docume...
I do hope you have a healthcare professional that you are able to share your concerns with 💕
Thanks a lot for you kind words!🙏Just hearing them makes me feel a bit better! Unfortunately, I haven’t got any healthcare professionals regarding my AFIB problem to speak to. So far I’ve spoken to them only once, when they offered me this option. It was a tel appointment and I spoke with the Professor himself. Btw what is your heart Centre?
My heart centre is Edinburgh but surgical ablation is not offered (unless open heart with another procedure). I am coming to London privately and the surgery is being done by a surgeon from Sheffield.
At least you’ll have it soon! Do hope it will be successful!🤞Just let me know how it went when you are better, please. What is the exact date for the procedure?I have to know this to be able to be with you then if not in flesh but at least in spirit and in my thoughts.
I hope you find the right answer to your AF. I must admit I was similar having attacks every three weeks or so feeling my heart banging around irregularly then going back to NSR. When I had an attack my heart rate went up to 150-160 bpm. However since last November I have been permanently in AF and my heart rate has settled down to around 70-80 bpm only going above 100 when doing gardening or fast walking. I must admit I feel better now in permanent AF than when I had attacks. The worrying thing though is that I’m jealous hearing people say contact your EP or arrhythmia nurse, I’m still dealing with a GP, had a holster monitor for three days 10 weeks ago still waiting results. However I feel perfectly well no Ill effects at all.
hi kjsp im just out of about 36hour bout .horrible time, and with low bp this is becoming average for me every 6-8 days or so ,ive been riding it out so far ,but the breaks are getting shorter with time.
hi saulger i havent had a specific vit d test but was getting regular bloods at health centre and thought this would be included, but im not sure, i have been taking vitamin d supplements for maybe 15- 20 years, at present 5000 iu every other day.
A test would confirm your current level. I read that 64ng/mL is an ideal level to stave off Afib episodes. I tested and was less that half the recommended...carrafibdietinfo.com/
Now that nsr is back, seek out an (another?) ablation I would think. I’m on my fourth and healing but it feels more likely to be a good one that should last a bit (hopefully ??).
With a heartrate of 100+ I would be calling my doctor and am pretty sure the advice would be to get to the ER. Not sure what your doc would say, but at the least it warrants a phone call to him. From my brief experience on this list it seems that the doctors in the UK are more casual about afib than doctors in the US. I've had about 10 episode and advice from docs has always been the same: get to the ER. Do call your doc to at least inform him/her of your situation.
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). Put all my symptoms down to tiredness and the menopause. There is an options other than meds, cardioversion and catheter ablation should you not convert back. I am having surgical ablation in a few weeks which has a higher success rate of converting and maintaining NSR. I hope your cardioversion goes well for you 😍
Permanent AF 
Question for those in permanent af
Permanent AF treatment with drugs
Transition to permanent AF from paroxysmal
Does AF always become permanent?
