I am 52 live in the UK and have had permanent/persistant AF for I don't know how long as I only found out about it 25+ years ago by accident in the gym. I think they call it Lone AFib as historically I have rarely had any troublesome symptoms apart from more recently starting to get a lot more fatigued and breathless than I use to and occasional bedtime palpitations that don't bother me either. I was released by my last cardiologist 7 years ago with no medication needed but decided about 18 months ago to get myself checked out with a new cardiologist as I was taking up running again. Fast forward 18 months and several scans later, I am now on a rate control program of 10mg Bisoprolol daily which has not managed to control my heart rate, it still beats too fast ( I am still running though, albeit a lot slower than I would like) with the very real prospect of the last chance saloon ... an AV Node ablation as the last option. My cardiologist has said my heart needs to slow down to avoid additional damage and heart fatigue.
My question is, am I too young for such a, last chance, 'final' procedure as AV Node ablation and is there any other options out there before I have to consider having this done as i have been told once this is completed no other future procedures will be open to me?
I had 2 unsuccessful cardio versions about 20 years ago but apart from that and trying rhythm control meds that didn't work either that's it, I have never had an ablation or felt the need for one as my life has been perfectly fine until more recently when my current cardiologist showed this concern for my racing heartbeat and lack of control.
I'm too far gone I think for a normal ablation (or so I have been told) as it most likely wont work but have read about a Hybrid Ablation for persisitant Afib, anybody know about this?
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Mimak569
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This and your second post flag lots of reds for me. I'm sure that you will have been told already that it is most likely your activities which have brought this on in the first place so to ignore all that and push on regardless does seem ill conceived. Even if you do go the pace and ablate route and become reliant on your PM that alone may limit your activities (depending on how advanced the technology may be) . It will not stop the AF as I'm sure has been explained and this will continue to affect the left atrium even if your ventricular (heart) rate is governed by the pacemaker.
Many of us have found that a diagnosis of AF has made us look long and hard at our lifetyles and in most cases change a little. It is true to say that for lots of people a diagnosis of AF can actually be life enhancing as we make adjustments to life style issues.
Yes 52 is young as on average you will need maybe three new units in your expected life span.
Thanks for the reply Bob much appreciated. To be honest I have already made lifestyle changes. Covid plus this Afib and a touch of asthma have seen to that so I know and accept I won’t be able to do what I once did, I’m just worried where I will end up if I really need to have this AV Ablation, I like a challenge, a goal and I’m worried about whether this will mean the end of all that. im currently back to doing a couch to 5k my fitness has regressed that far due to lack of exercise and it’s tough going! I just want to be able to walk the hills, run a bit and try and keep fit n healthy, I hate feeling overweight and tired. I just want to find out if anybody else has had a positive reaction health and exercise wise to av node ablation or any alternative procedures that can keep you from slowing to an almost stop. Surely 52 is too young to give up on an active life!
You do not need to run or hillwalk to keep fit and healthy. Brisk walking on the flat will do the trick . A 30 min bike ride . Challenges and goals do not have to be physical either. Forgive my bluntness but it seems to me that your real problem is changing your views about what fit actually means. Your post hints at a past life filled with far more rigourous exercise than is sensible . It is not a coincidence that afib is common among those who over exercise.
I have to disagree with you Auriculate, my past life wasn’t filled with far more exercise than is sensible at all, compared to most I know I really am not that driven. Since when was hill walking bad for you? I didn’t even start exercising until I was in my mid thirties and only found out I had Afib in my mid twenties when I was walking on flat surfaces and cycling 30 mins max so that’s not true.
Afib is caused by a myriad of different things, exercise may play a part especially in endurance athletes but my Cardiologist says exercise is far better than not exercising (not that I need telling this) if it was athletes, footballers, rugby players would all have it, dancing all evening would be bad for you, how about going up n down a ladder all day as a window cleaner, maybe being a postman in a very hilly village. Afib is common amongst a very wide range of people and social interactions not just exercise and not just people who walk up hills and cycle for over 30 minutes.
I did not say it was. What I said was that it is possible to keep fit without hill walking or running. It is movement that is important . Our bodies evolved to move but moving fast was usually for running away from predators or hunting . If you cannot do the things you used to do physically then you need to come to terms with that mentally. I understand this is not easy - I have had to do this myself. For 24 years I was Bharatanatyam dancer. This is a very vigourous form of dance . I have no idea if it played any part in my developing afib but it did play havoc with my joints and I was very apprehensive about retiring from performing and teaching as being a dancer was part of who I was and was an outlet for my creativity. Now I pour my creative impulses into my garden which also provides me with movement - but not the endorphin highs that dancing gave . Are you sure that your high dose of Bisoprolol is not responsible for you feeling sluggish? It would probably hamper you in running.
What a lovely form of dancing you did Auriculaire, it must have been quite a loss giving that up but quite a relief as well if it was taking its toll. Things like Afib and ageing give you no alternative but to reassess what is possible and what is not. Gardening sounds a very good substitute. Movement, fresh air and nature, great choice!
Everything is in continuous change, we either accept it the best we can and relax into it or get dragged along regardless with our nails scraping the ground as we go!
The Bisoprolol does make me feel sluggish and a bit breathless at times. I want to come off it or at least get the dosage reduced but I will know more when I next see my cardiologist as its not working for rate control it hasn't managed to slow my heartbeat enough anyway.
I found 5mg of Bisoprolol made me feel like a zombie. I told my GP that if I had to live feeling like this I did not want to live! The dose was reduced by half and then I reduced it off my own bat even further. But I am lucky. When in NSR my heartrate is normal 60-70 bpm at rest. It does go up to 145/150 when in afib .
Hi! Thanks for posting, since there were not so many people here with such a long permanent AF history. It presumably started at your age of 25-27... After such a along time, have any structural changes taken place on your heart?! I would expect at least a slight hypertrophy of ventricle walls...
BTW, I am 70, live with mild AF during the past 15 years, and do not even consider an ablation. A pacemaker, with AV node ablation, will not make you happy, it is a solution for elderly, with no other options. In your place, I would do as BobD has said - adjust the life style, waiting for the new treatment procedures to see the daylight in the (nearer) future.
Yes, about the "lone AF". There is no "lone AF"! The cause of AF is always the same, with or without the comorbidities. High BP, which is often considered to be the cause of many other disease, is only going hand in hand with them, not causing any of them. There are about 30 syndromes and disease, with unknown cause (officially), and the cause is always the same, for all of them - disturbance in functioning of Autonomous Nervous System (known as Dysautonomia). When automatics of our body starts having problems, than the devil is at loose...
Not medically trained or familiar with your history, but yes, I think an AV Node ablation may be a premature decision at this point. First, depending on how "persistent" you are, a standard rf or cryo might work although the odds not as good as with paroxysmal. But beyond that, there is the mini maze and hybrid procedure. You may have to look around for a center that does them, but you may end up with better results than with standard catheter ablation.
You should also check out posts by MummyLuv who just had the Minimaze. Not 100% sure, but I believe she was in persistent. You could contact here through PM.
Thanks Mjames1 that info is much appreciated. I have an appointment with my Cardiologist next month when I will see what he suggests next. If it is the AV node ablation then I am going to see if we can go down the mini maze etc route first, I’m not keen on the AV ablation yet it scares me!!
Hello and good morning from a sunny North Somerset, I have had a pace and AV node ablated 2021 and am now back to my normal lifestyle prior to AF suffering.Although you are quite young, I am 77, in my 50's I made some changes from squash, running 6 miles per day etc to finding golf at 56. I did and still am in love with golf, not only playing but also the social side too. The group I play with vary from 60 to 90 all from different backgrounds and areas which makes a very enjoyable time
Hi Dave, Yes I know I will have to make changes, to be honest the changes are already happening. I dont run far anymore, I run-walk, I enjoy a gentle gym workout and i walk a lot more. I enjoy putting my feet up by a river, fishing and watching the world go by as well so the changes are enjoyable ones.
It sounds like you have made great choices yourself when you had too and great to hear you are back your normal life after your recent AV Ablation… long may it continue for you.
In early 2019, when I had atrial flutter (persistent 155 bpm), 10mg bisoprolol failed to slow my heart enough, but digoxin did work well and allowed the dose of beta-blocker to be reduced significantly (2.5mg if I recall).
What is your usual resting heart rate? I suppose what the cardiologist is concerned about is the effect of the tachycardia on your heart's left ventricle? I was also given losartan, despite not having a raised BP, as a cardioprotective as it's been shown to prevent ventricular weakening.
My resting heart rate currently is about 80 - 100 bpm (since the 10mg beta blockers) prior to that it was over 120bpm all the time and any exertion and it was over 180!You’re right, he is concerned about the left ventricle as its weakening and early stages of not closing properly. He said he is hoping the beta blocker will allow the muscle to get stronger again as its fatigued b=due to the high bpm..
I’m not sure how much even a very experienced cardiologist can truly know about what state an individual’s heart will be in x years but I find myself wanting to trust them and to accept their advice. I think before I had a pacemaker, though, I’d want a second opinion.
My understanding is that AV node ablation can be done with persistent AF. Like Bob I see red flags - why the drive to 'fitness'? Are you really in danger of being overweight? Dietary changes (and I don't mean going on a diet) can address that along with a regular and suitable exercise routine. Why not replace the word 'fitness' with 'wellness' in your life? There are so many ways of looking after our body and mind that do not involve the driven attitudes that we're sold in the media and by the fitness industry as being markers of health.
Being vigorous here - but you've got a good 30 years ahead of you all being well. So you need to make good choices.
Well said. The current mania for "fitness " that is relentlessly pushed is a pain. My grandmother lived to 98 and never "exercised" her whole life. She walked to the shops when young , did all her own housework including washing everything by hand and using an old fashioned mangle . I was talking to a friend yesterday whose mother had just died at the age of 90 and was gardening right up to the end of her life. Never would have dreamed of going for a run or taking up HIT. But ordinary everyday activities do not fill the coffers of the fitness industry. For a start you don't need to buy special clothing or equipment to do them!
It’s in the way I worded the original post, I can see it makes me look ‘driven’… I am not. I enjoy exercise but its not flat out exercise to exhaustion its gentle running, having a conversation while running effort wise, same with walking and the gym. It’s not all out effort I’m too old for that now. I have always followed a fairly Zen Buddhist style philosophy and have meditated almost every day for the last 30 years so I do try to be kind on myself, I accept change and try to be gentle and go with the flow as much as I can.
I agree about the wellness wording as well. I don’t think in your 50’s it can be anything else and I really dislike the mainstream health industry myself it makes so many people feel inadequate if they match the status quo. Thanks for your advise.
Regarding your weight control have you tried intermittent fasting. I’ve found it very easy to do and very effective in controlling my weight since I’ve had to reduce my thyroid meds and my Exercise regime. I’ve replaced HITT with cycling (and it’s more the leisurely cycling than the Lycra vibe) also, there’s yoga and Pilates as options. I do understand how difficult it is to go from a very physical life to less intensive, it is a mindset change and you do have to make the choice. I can’t comment about the pacemaker option as my case is very different and I’m just navigating this new world slowly. I’m 62 and now in persistent AF and waiting for either my NHS consultant to help me or will spend my savings and pay privately for a mini maze or an ablation. I have changes to both my atria and some slight change to my L ventricle and have been told by private consultant to get on to it sooner than later.
Thanks Bodydoctor, I do Intermittant fasting already… well I eat two meals a day not three, i skip breakfast and have a late lunch then my normal tea.Good luck with your own journey, I hope your consultation goes well and you get the treatment you want and need. Keep looking after yourself it sounds like your doing lots of things right!
Thanks Mimak569, it’s such a tedious thing to have to deal with. I am currently feeling ok cause my BISOPROLOL 5mg has kicked in and taken my heart rate down to an acceptable level - mid 70’s - and the Consultant said 70 was the ideal. I’m trying to decide whether to just live with this, which is very doable, or go the whole hog and have the cardioversion and the Ablation. It’s so difficult to know what to do. Dr Sanjay Gupta told me about a study of a group of people 50% with rate control and 50% with rhythm control over a number of years and the outcome for both groups was more or less the same…. I’ve asked him for the reference so I can follow up on it. I can’t comment on the AV node issue as I don’t know enough about all these procedures. I just know that the thought of them frightens me! Yikes!
Hi, I'm 46 and have an 18 year relationship with AF, persistent for about half that time... and we have a very similar history with it. I've always been able to exercise and have looked after myself over the years. It has only been really problematic over last 2 years. Exercise is sooo much harder, I've gained weight and meds have not helped...one caused asthma and another underactive thyroid ( not helping the weight or sense of wellness). Its been quite a dramatic decline in my heart health and in my lifestyle...they think covid might have been a trigger for this. Echo last year shows heart enlarged and reduced Ejection Fraction. So a regime of more aggressive treatment was started including meds, cardioversions and ablation. All to no avail unfortunately.
I've just had 2nd ablation that was unsuccessful. Cardiologist reluctant to admit defeat but that's where we are at. For me, at this point, I'd try pretty much anything, cardiologist even half heartedly suggested open heart procedure as a "last resort", (I'm not there yet) but I am considering pacemaker, 3rd ablation or surgical ablation IF they agree to any of those. My main motivation is to increase heart function and avoid heart failure. I can live with the AF symptoms. Although the fatigue and breathlessness has got pretty bad now. But we are all different.
I'm not hearing that you are driven, I'm hearing that you want to stay fit, active and healthy, which is entirely reasonable at your age, but maybe I'm missing something.
Be interested to hear more of your story as ours are so similar in terms of age, duration and experience of AF.
Would you mind if I PM you? No problem if you'd prefer not to. Or PM me if you like.
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