Hi - I am a newbie and hoping to get some useful experience from the community. I had cardioversion in April 2021 which worked for only a short time (maybe 3 weeks). I was effectively signed off by the Cardiologist and GP as there are no other issues. I am not on medication and maintain a active sporting lifestyle. However, symptoms mean I am often fatigued or find keeping the sport levels where I want them difficult.
I am considering going back to the GP to ask about ablation procedure - any advise or opinion will be welcome.
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Bobsky
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Hi and welcome to the forum, it won’t be too long before you realise the significance of that comment 😉. Firstly, it’s good that the cardioversion worked, even though it was 3 weeks, it does indicate that you have a better chance of success if you decide to pursue the ablation route for treatment. The first and most important thing you should do is discuss the need to take an anticoagulant. Unfortunately, if you have been diagnosed with AF it does mean that your normal risk of stroke is likely to have increased and anticoagulants significantly reduce that risk. The risks are measured by using the CHADSVASC score which is best googled and given what you have told us so far, your risk may be fairly low but it really is important to check it out.
It also sounds as though your “burden” of AF is fairly low which is obviously good, but may impact on your chances of getting an ablation on the NHS any time soon. The best course of action is to seek a referral from your GP to see an Electrophysiologist, a cardiologist who specialises in arrhythmias. In the current climate, this could take some time to on the NHS so if it’s possible, consider seeing one privately to have your condition properly assessed. This should cost less than £300 but be cautious of tests. Even an ECG can be quite expensive and an Echocardiogram very much more so but normally it is possible to seek any on going treatment with the same EP but using the NHS. This will not speed up the treatment process but it will enable you to decide what route is best for you.
If you are currently not prescribed AF medication and your heart rate is in normal range ie 60 - 100 beats per minute and your quality of life is not hugely impaired, then you may find it more difficult to be offered an ablation. The good news is that provided your AF is controlled, ie heart rate remains within normal range and if necessary, you are anti-coagulated, AF will not shorten your life. Hope this helps for starters…….
I ought to add that extreme sporting activity is a known cause of AF and that it can also be a progressive condition. I’ve just noticed that you CV was about 18 months ago so perhaps seeing a specialist would be a good idea….
Hi - many thanks for the very prompt and detailed reply, some really good information there. By pure coincidence my local health practice just sent me a text asking me to make an appointment to follow up on my 'long term condition'. Its just a 15 minute session next week with a non-doctor but it may start the conversation.
From reading a wide variety of posts this afternoon, I am wondering if I am looking for a 'magic bullet' and my ego is getting involved.
The good news -
Other than the AF - everything else is pretty OK - blood pressure normal, cholesterol fine and resting heart rate (according to fitbit) is consistently 62 to 65. Until starting the AF investigation, I rarely went to the GP. I have work which requires me to be on the go much of the time, on non exercise days I typically clock up 10 to 12 thousand steps - which goes up to 18 plus on footie days. I was reassured during the lead up to cardioversion (and the echo cardiogram) that the heart itself was in the words of the cardiologist - a good pump.
It has made me modify lifestyle - I was a bit on the heavy side - played rugby through to my thirties - so got heavy muscled - and then non league football until late 40s. Since then 2 to 3 sessions of five a side a week and a couple of badminton games and a bit of cycling. I have lost a stone and a half since the AF diagnosis - could do with another stone to be ideal. I have virtually cut out alcohol (boo hoo) and coffee, also diet cokes. Not smoked since fags behind the bike shed at school. I am trying to improve sleep patterns - never been a good sleeper - but making myself go to bed at a sensible time and reading a book rather than watching shite on the Ipad.
The reality check - is I am going on 63 so should I expect to feel like a young buck. I suppose my biggest fear is stroke - but given neither GP or cardiologist think medication is required (I have always resisted taking anything even headache pills) maybe the risk factor is not too great, but worth revisiting.
A couple of the 5 a side games are a mixture of us old guys with 20 to 30 year olds so although fun, makes one try very hard to keep up (ego again).
The reason for starting to investigate a possible 2nd CV or ablation is that I have been feeling unusually tired in the last few weeks and occasional bouts of light-headiness during exercise.
In conclusion - it seems like many people are facing much more impact on their lives than I am and as you suggest the NHS may consider I am low priority (quite right if I am honest), but if it turns out ablation could 'fix it' that would be an ideal scenario.
I am very glad that I found this forum and will continue to visit regularly. Thanks again for the support. Kind regards
Firstly you can check your own risk factor for stroke here:- chadsvasc.org
But know it is not the only or the best algorithm, just the one most commonly used for AF. The European guidelines have recently altered their recommendations regarding anticoagulation and interestingly their recommendations for thresholds to access anticoagulants are rising so if your doctors do not advise and your CHADSVASC 1 or less, I would weigh up all the considerations because you are talking of risks and it is worth widening your vision to see if you have other risk factors not considered by CHADSVASC.
May I suggest that before you go for ablation you do a bit of your own sleuthing and research and get your GP on side for looking for and monitoring certain blood markers which can be indicative of possible triggers for AF. Inflammation is the big one and can be caused by both psychological and physical stressors. These are explained in a book called The AFib Cure - a very abbreviated version of the book in a blog on his website drjohnday.com/get-rid-atria...
I’ve had AFib now for 15+ years. Done the drugs, 2 ablations and now have a pacemaker and had I known questions to ask back in the day and been a LOT more diligent in insisting on a lot more investigations by doctor’s who viewed AF through a wholistic lens, I would have not had to suffer the horrible after affects of the treatments.
Even if you go for ablation - and sounds as though you are an excellent candidate for a successful outcome - do be aware that AF often returns and does so a lot more quickly if you still have underlying issues so essential you first :-
1. Control underlying conditions
2. Lifestyle Management - Stress, Sleep, Eating Plan & Exercise - in that order
Ablation is a fascinating procedure but it’s becoming much harder to obtain in the UK at an optimum time for the patient. Many of us found that taking a private consultation with an EP, specialist cardiologist, was well worth the money so as to be able to have the time to discuss options and treatment plans instead of waiting for NHS consultations. It may be you would need to transfer back to NHS for treatment but at least you would be a little further along the road.
I notice you say ‘no other issues’ so assuming you have had at least an echocardiogram? A fitbit isn’t very accurate during AF so as you have been getting problems during exercise I would try to get a 7 day holter monitor to see what is going on there, as you are exercising anyway saves them having to do a stress test 😉 You should emphasise any breathlessness and the lightheadedness to support your case. It doesn’t sound as if you are ‘over training’ and definitely not a couch potato so it seems sensible to find out the cause of your symptoms and whether they can be reduced. If no joy with the monitor you could invest in an Apple Watch, does not have to be the latest model but you would need a compatible Apple phone as well. Best wishes ❤️🩹
Hi, thanks for info. Yes an echocardiagram was done couple of weeks prior to the CV. I can't recall exactly what was said but generally suggested it was 'a good pump'. Interestingly I recently changed the fitbit to a Samsung watch and app on galaxy phone. It does give useful info and includes a EKG function, but this only says you have AF see your doctor. Asa and when I have the next conversation with specialist I will pass on all data. Thanks again.
My very cheap Chinese watch can be set to monitor my heart rate every few seconds and although it uses ‘green light technology’ which is not as accurate as a Kardia it gives an overall picture of my heart rate. I can see that when I have an episode of AF my average heart rate goes up and my time in ‘aerobic hr’ goes up even though I have been sitting on the sofa! I’m sure your superior kit could do the same.
I wish you all the best, but in my experience, you aren’t likely to get offered an ablation at the moment as your current Afib ‘burden’ is quite low. However, I do think EPs across the country vary a lot.
I’ve had paroxysmal AF for over 10 years, undiagnosed and very, very infrequent, then last Summer, every three weeks. Since being on a low dose of Bisoprolol since last Autumn ( not on any anti coag yet) , they seem to have stopped for now and I haven’t had an episode for nearly 10 months. I saw an EP privately a few months ago in the hope I could have an ablation and he wouldn’t entertain it at all and told me to come back ‘when you’re worse’.
Are you paroxysmal still? ( off and on?) or in Afib most of the time?
I think you might be caught between a rock and a hard place, as there may be a suggestion at some point of you going on medication for AF, should it get worse for you, as they always like to try that before ablation is considered.
Thanks for this. I never quite know whats happening as I dont usually get any strong symptoms etc, it manifests in brief light headiness sometimes a mild sensation in the chest. I suspect the condition has been there for a long time. About 5 or 6 years ago I slipped at 5 a side banged head and was out for the count for 2 or 3 minutes, I soon came round and was fully aware, by the time the ambulance came, I could give day of week and prime minister etc, but they did tell me I had an irregular heartbeat. Typical bloke I did nothing about it until the GP suggested AF during a routine appointment. From your input and other posts, I am picking up a great deal of good information as to what to do next, So although I usually resist taking any kind of medication from your experience may be worth considering. All the very best.
I think like others have said, you do need to ‘capture’ an episode then, when you next feel like you do, either on a Kardia ( they’re really easy to use, honest) or via a smart watch if you can, or both 😊
It sounds like you are paroxysmal, in that you don’t have the irregular, fast heart beat all the time, if that’s the case, then lifestyle changes, of which you are doing, is a good start definitely.
If you haven’t already done so, it might be good to get a full blood check, just to see if everything’s ok there as well and if it’s not, putting anything right, can also help. Ask to get your Vitamin D and magnesium levels checked. I was a deficient in vitamin D, I found, which certainly doesn’t help and I wouldn’t have known, had I not asked for the test. Many, including me, find magnesium supplements helps a lot particularly. It takes quite a bit of trial and error though and a lot of googling 😳
Once you know how many attacks you have, how frequent and for how long, you can build ‘your case’ for either going on medication or trying for an ablation, but as I say, they ( EPs) can be cautious about who is suitable….
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