Cardioversion

[rcburton]

My consultant is recommending cardioversion as the next step in my AF treatment, primarily in order that I can stop taking bisoprolol as this appears to be impacting on my asthma. Has anyone experience of this procedure, success rates, issues with it etc?

[BobD Volunteer]

It is important to understand that cardioversion (DCCV) is a cure for nothing. Many of us have had several over the years and it is a non event in most respects. A couple of minutes sedation and hopefully you go back into NSR.

The BUT is that it doesn't solve the prblem of why you have AF which can return at any time.

What it can do is show if you are able to be put into NSR which then signposts other treatment such as ablation which may be more long lasting.

[DawnTX in reply to BobD]

I have had two different ablations plus the vein of Marshall and more the end of April. I had one really good month and then into tachycardia that has not eased up. Even back on Multaq for a few weeks. At my follow up my EKG was perfect I’ve had an echocardiogram and other things including full panel of bloodwork four pages worth. You are right this is just an attempt to make me NSR again. Even when I was that at my follow up I could barely breathe or walk. I had pericarditis. The big concern is that having Covid in March may have done more than first thought.

There is no cure for a fib I know that. I tried to explain it to people that just like a pipe, you can spring a leak and tape it up then get another leak elsewhere in the same pipe and that seems to be a fib in our hearts electrical system. You never know if or when another one will pop out.

I just want my quality of life I took for granted back again. To stand and wash dishes without getting breathless etc I am so glad we have this group here because you all remind me I am not alone.

[jeanjeannie50]

I've had quite a few cardioversions and they have never failed to put me back into normal sinus rhythm. They've lasted from years to just one day (I walked up a steep hill and immediately slipped back into AF). It's important to not do anything too energetic for a few weeks after and let your heart regain strength beating correctly. I learnt that the hard way!

As Bob has said it's a minor procedure and takes little time to perform. I know it's strange but I actually like having them. You go in feeling dreadful with AF and then wake up cured. It's like the most wonderful gift ever.

Jean

[DawnTX in reply to jeanjeannie50]

You just put a smile on my face. I’ve been terrified and you are the first one to make me feel better about it as I am having one Friday. ❤️🙏🏻

[jeanjeannie50 in reply to DawnTX]

There's really nothing to it Dawn. It's either done while you're on a trolley or a bed. Before I had my first one I thought I would be going to some special operating theatre, but that's not needed. They wheel the machine to where you are, stick pads on your chest, then give you a short dose of GA through a cannula in the back of your hand. When you're fast asleep they zap the heart. Mines always gone back to normal rhythm after one try, but I believe you can be given up to three.

Absolutely nothing to worry about.

Jean

[DawnTX in reply to jeanjeannie50]

Thank you Jean. As long as I’m asleep I’ll be OK lol I didn’t react like this to the thought of my three procedures so go figure now I am being a big baby but I am also so tired of feeling lousy and from what I have read hear from all of you I am hoping for positivity on Friday I will let you all know

[Hidden]

You need to think of it as hitting a reset button or re-booting a computer. It doesn’t change your heart in anyway or repair any defects but if it returns you to NSR, even for a short period, as BobD says, it does mean you are likely to respond well to other forms of intrusive treatment

That said, young patients who have only just been diagnosed can do very well, in my case I was about 69 and my CV lasted around a year and after a couple of ablations, I have been largely free from AF for the last 3 years.

Click on the link below for more information.

bhf.org.uk/informationsuppo...

[DawnTX in reply to Hidden]

It has been almost 2 years for me with two ablations and a vein of Marshall plus in April. I had Covid in March and I did end up having pericarditis again third time. I was doing well and when I finally ended my medication for the Pericarditis whim in tachycardia. Most days I can barely walk and breathing makes me nauseous unless I am just sitting. My doctor even seems a bit baffled but he is amazing and I know he intends to fix me as he said lol he is the pioneer of vain of Marshall and I trust him Thank you for what you write though it gives light at the end of the tunnel as I realized I am a newbie compared to many of you

[MrJD]

Hi,

Had a cardioversion on Tuesday this week.

New onset AF 6 weeks previously.

Mid forties. Normally well.

Normal Bp, glucose, cholesterol etc.

No valve concerns. No atrial changes on echo, albeit reduced ejection fraction.

Had a cardiac MRI due to congenital issue. Ejection fraction had improved.

Don’t know what truly initiated the AF. Think because my blood inflammatory markers were raised it may have been external to a cardiac cause as such but that was enough to tip me into AF and not come out after a cold swim. I may have had a tendency for arrhythmias as I get ectopics.

As I had an onset date I contemplated early cardioversion, but with delayed cardioversion there is some research showing waiting is non inferior.

Loaded with a NOAC and given amiodarone.

Went for the cardioversion and it was more of a stress in my mind as opposed to the actual procedure. (Declaration I work in A&E so I see worse case scenario which did trouble me when it involved me). The staff were fab.

Sedation (very effective). Woke up in sinus. This was a relief because it may lead to long term relief or at least options as others have kindly added.

My Apple Watch each morning is lacking the usual AF notifications which is a relief, but the only heart symptom per se is a bradycardic pulse of 45 to 55. May be amiodarone. Im keeping an eye on it and gently increasing activity. The heart has been abnormally beating so will take time to get re-used to normal.

Now three days post the only issue is will it last and can I get back to living. That psychological barrier is surmountable.

I know that other peoples experiences vary and it may only be a ‘temporary’ cessation of AF but sometimes it may be permanent.

Apologies for long winded reply but wanted to assist you.

From both perspectives (HCP as well as patient) I can hopefully reassure you that if you have a cardioversion it will be ok.

BW

J.

[DawnTX in reply to MrJD]

Thank you for what you wrote no apologies needed. You are another person giving me hope and yes in my head I am terrified. I was down to 105 heart rate and yesterday and today its back in the 120s. I was in the 140s to begin with about six weeks ago. Nothing has been right since my last procedure the end of April except for one month. I had pericarditis I wonder if I have not really kicked it. I was on a medication and within a couple of days of being off of it because it was the end of it, there I was back in trouble and feeling horrible. Strange thing yesterday and today with the higher pulse rate I actually feel better so go figure. One upset was I just had an EKG done a week ago and it is noted that I have had an anterior myocardial infarction. This is the first time I have heard this but the trouble is as we all know, symptoms of a heart attack and a fib pretty much all feel the same. I am thankful I am here but it is scary to know of the damage now.

Thank you for being here and telling your story

[Bolander]

As others have said the cardioversion procedure nothing to be apprehensive about. Sedation makes you briefly unconscious and you wake up feeling better. No guarantees how long you stay in normal rhythm which can be from a day to several years, but as BobD always points out a successful cardioversion suggests that an ablation is more likely to be successful.

[BlueINR]

I've had at least a dozen cardioversions for afib, and the all worked well and got me back to NSR, the only problem is a cardioversion, at least it seems to me, is unable to prevent another afib episode. When medication won't get you back into NSR, then a cardioversion is what needs to be done. I agree with Bob that it "is a cure for nothing." It's great to get one and go back in NSR but it can't always keep one there.

[Snowgirl65]

My cardioversions (2) were easy-peasy. You lay down, an IV is inserted with a drug, my doctor said "sweet dreams," and I was awake again in 5 minutes in NSR. What an absolutely fantastic feeling.

[Ducky2003]

I've had about 7 or 8 now and they've lasted from 4 days to over a year. Last one was in April and still OK, touch wood, at the moment with help from Amiodarone. Have you asked your Dr to change your meds? I did not tolerate Bisoprolol at all, suffering with breathing issues, and I'm not asthmatic. I asked to be put on a calcium channel blocker, which was an awful lot better.You'll be out for a bit after sedation and then hopefully be in NSR again and eating a sandwich before you know it. 😊.

[rcburton]

Thanks for all the postings, in general they are re-assuring. My problem is that although I have been diagnosed with AF generally I am not in AF as far as I can tell in that I lead a good life with plenty of exercise and feel OK. The only issue I have is that I am breathless during exercise which I have put down to the beta-blocker, Bisoprolol, as I am an asthmatic. I don't really understand why I am being offered cardioversion when I've only had one severe bout of AF, 6 months ago, which led to the diagnosis in A+E. I have carried a 2 day ECG monitor which showed periods of AF, not continuous and I have done a "stress" test recently, walking on a treadmill whilst being monitored via continuous ECG and BP, which showed that I was in AF throughout the test. I am not convinced that cardioversion is the right path for me. I have suggested Nebivolol as an alternative beta blocker as this appears to have less adverse issues for asthmatics but no interest so far from my consultant.

[DawnTX]

I will let you know Friday because I’m having one. We are the same age. The reason I’m having one is because I went from NSR into Tachycardia. I’ve been like this for most of the time since my surgery the end of April. I had one good month. My EKG is not that bad doctors are a bit baffled button intend to get an answer. I probably won’t write to you Friday but if all goes well you’ll hear from me by the end of next weekend