Post cardioversion response

[ObiDyer]

After 6mth in persistent (continuous) AF I had my first cardioversion 5 days ago. Procedure went well, reverted to NSR and approx 60bpm after one shock and so far remaining steady, though still on 160mg sotalol.

However my exercise tolerance is approx zero! Was very weak prior to CV but I can barely get up the stairs now without largely abdominal discomfort, though my heart remains in NSR and bpm increases very little (65?). While other symptoms have improved and I feel generally brighter my capacity for exercise seems, if anything, worse than in AF!

Due to discuss with doctor next week but wondered if anyone else had similar experience, whether I'm now just on too much sotalol or whether my 6mths of little activity (and consequent muscle wastage) has just left me weak and the issue now isn't AF related.

Thanks

[Jalia]

It's good that you are back in sinus now. I think you should wait to see what your doctor has to say next week. Possibly he may alter your meds.

I've had very many DCCVs and have always, bar one occasion, felt great within 24 hours so I don't think it's normal to feel the way you do.

Maybe you should get some advice from 111 if you continue to feel the way you do over the weekend. Possibly the extreme heat we are experiencing doesn't help so make sure you are well hydrated.

Do let us know how you get on

Regards

J

[Dee5165]

I too had persistent Afib for 6 months. I had the Cardioversion procedure and felt well after a few days. Made the biggest mistake going back to my normal routine of walking (with breathlessness) and Afib returned after 12 days! You should be resting for months with no strenuous exercise for your heart to remodel itself. Eventually the problem of limited exercise was due to the Sotalol! My Doctor reduced my dosage to 40 Mgs. 2X (per day) and I added supplements. I have been fine now for 15 months so I confirmed it was the Sotalol.

[ObiDyer in reply to Dee5165]

Hi Dee, thanks for your reply which is very helpful. Not sure I fancy another few months doing diddly (there goes 2022!) but I'm certainly aware of the danger of slipping back into AF, so I guess it's the least of the evils! I'll certainly be pushing to reduce the sotalol, doctor is quite open to change so hopefully I can agree that tomorrow.. I'll let you know what happens...

[Jalia in reply to ObiDyer]

With respect to Dee, it really shouldn't be necessary to rest up for months !! Just avoid extreme exercise.

[Dee5165 in reply to Jalia]

It was just a determination that I returned to normal brisk walking and Afib returned. Therefore, it doesn't hurt to be cautious. The goal is to stay out of Afib.

[Jalia in reply to Dee5165]

Certainly! It is so easy though to end up frightened to do anything which 'might' bring on an episode. ( As I well know from past experience.......)

[Dee5165 in reply to Jalia]

Yes. True. From my past experience I was so frightened to go back into Afib. I took it easy for months. I grew stronger each day. Then became more confident as time passed.

[MrJD]

Hi ObiDyer,

Welcome to the cardioversion club.

I had a cardioversion on Tuesday after being in AF for 6 weeks.

Now sinus but 45 to 55 Bpm. On amiodarone 200’mg (for last month).

For the week prior to the shock I was at the gym lifting weights and some cardio. Not as much or as hard as per pre AF as my echo showed a reduced ejection fraction.

My subsequent cardiac MRI showed improvement and no muscle or valve issue nor atrial changes.

I too feel tired. Some abdominal fullness. Also worry about overthinking and over-doing it.

I suppose we are all individual but it is interesting to read you feel washed out.

I suppose my clinical mind is that the heart has been used to the irregular rhythm and now needs time to adjust to ‘normal’. The amiodarone also may account for slow sinus.

My EP cardiologist told me to get on when I spoke to her post procedure but it natural to be concerned.

But as Dee5165 notes. Each day you get more confident.

BW

J.

[ObiDyer in reply to MrJD]

Thanks JD.. Have now reduced the sotalol down to 120mg which has made a big difference and I can at least do some stuff without 'hitting the wall' which I hope will enable me to get my muscles working again and hopefully start the process to regain the significant muscle mass I have lost over the last 6mths.

Have had heart rate up to 74bpm (wow!) without problem so will continue to increase the exercise gradually.. Have had the OK to drop the sotalol further if necessary albeit with the increased risk of AF recurring... I'll see how far we get on 120mg and tread carefully for a while!

At least I can have some sort of life back, now just have to navigate through all the perils and triggers that I was unaware of before!! Aaaargh!

[MrJD]

Absolutely.

Onwards and upwards.

We are all unique but together we can support each other.