What happens next please?

[vajrahara]

Advice sought from those further on the path please. I had a successful cardio version in July after 6.5 months of high rate permanent AF not well controlled by digoxin, bisoprolol, furosemide, and apixaban. I was told to just stop the digoxin after the cardio version which left me on 10mg of bisoprolol per day in sinus rhythm you can imagine my HR and BP on this and how awful I felt. The GP was hopeless but after a huge struggle I got hold of my Consultant who dropped the bisoprolol to 5mg per day with 5mg for a PIP. I had a check ECG in early September showing sinus rhythm but no sign of a Consultant appointment. What have people had done about their AF medication after a successful cardio version for AF please?

[Jalia]

First of all it is important to remember that a cardioversion is not a cure for AF and it may well return. Consequently it could well be a bit premature to talk of eliminating your AF meds. Personally, bearing in mind that I'm not medically trained ( apart from Dr Google PhD...), i would give it 12 months before seeking opinion to cut back.

I've had very many DCCVs over the years and have never been able to eliminate my meds even though the gap between episodes varied between 3 months to several years. On the other hand if you are experiencing undesirable side effects you may want to discuss with your cardiologist.

[vajrahara in reply to Jalia]

Thank you so much Jalia I fully appreciate all the points you make but my partner thinks I just cannot be bothered with the hassle of trying to get an appointment your response has been so helpful x

[Jalia in reply to vajrahara]

Pleased to be of help. I meant to ask you what sort of rate you described as high?

[vajrahara in reply to Jalia]

When it first started on 12th Feb between 180 and 200 bpm put on 12.5mg bisoprolol + 3 other drugs; my GP reduced this to 10mg then despite the Consultant requesting an increase back to 12.5mg bisoprolol, after an echocardiogram showing I was ranging to 140bpm, the 10mg wasn’t changed as no one reads the letters at my GP’s : but I would recommend people to ring their GP’s if, like mine, yours don’t read the letters.

[FrankC]

Just reinforcing the earlier point. I remember having a “successful” cv about 15 years ago, since when I’ve had a couple more and 2 ablations. During that time I’ve been mainly fine with some spells of frustration but all good now. Stick with it but expect to be on a long & winding road.

[vajrahara in reply to FrankC]

Thank you FrankC

[CDreamer]

May I suggest that if you really cannot get an appointment with your cardiologist, and let's face it the wait is often long and none urgent reviews often get pushed back, you book a face to face appointment with your GP and ask them to write to your cardiologist for their view. I've had much better success from the GP pushing the cardiologist.

Ensure you are copied into both the outgoing and incoming letters. You may need to fill in and sign a form at your practice as this will not happen automatically. Keep and file every letter, even if letters are read then they often get lost or misfiled if your practice and your hospital are still reliant upon hard copies.

Many now use apps where letters are posted digitally and you are able to view.

[vajrahara in reply to CDreamer]

Thanks CDreamer and yes I file everything religiously. I only got a Cardiology appointment in the first place thanks to GP push because they didn’t know what to do with me however as the last two letters from Cardiology haven’t been read/actioned and the most recent from the eye Hospital was lost twice, so I had to go into the surgery twice, for the receptionist to photocopy it; I am thinking of emailing the Practice Manager about their ‘procedures’ however I do feel I am witnessing the death throes of the NHS.

[Teresa156 in reply to vajrahara]

If I get copied into a letter that’s sent to my GP, which mentions changing any medication, I’d have to ring them and make an appointment to discuss it and draw their attention to it. I might be wrong, but the impression I get is that I don’t think any GPs have time to read through any letters nowadays, unless patients chase/draw their attention to the letters. My surgery is reactive, rather than proactive. Whether that’s right or wrong, I don’t know, but I think it must be the case for most surgeries nowadays unfortunately.

[beardy_chris]

Good advice above but may I also suggest, if you have sufficient resources, you might like to contact a cardiologist privately? It is always an option though whether it makes sense or not is up to you. I'm not certainly how much they'd be prepared to do though - maybe others could comment - they might be able to put your mind at rest.

[vajrahara in reply to beardy_chris]

Thanks beardy_chris

[Nick1957]

I spoke with an arrythmia nurse who recommended a PVI ablation! Appointment within 6 months at St Barts and hey presto all good since. Post ablation after 12 months Bisoprolol reduced from 5mg to 2.5mg. Discharged from cardiologist. Doctor will consider more bisoprolol Reduction in 1 years time.

[Dovewings in reply to Nick1957]

Nick 1957:

I had almost SAME events though Cardiac Cath and Hybrid Ablation in April 2022. I am on NO Medication since then, except a Probiotic and Woman’s Multivitamin! Occasionally an 81mg Asprin after new left hip in July 2022.

Free and enjoying life!

[pusillanimous]

Like so many people, my AF was discovered by chance as it was symptomless ( inevitable as it is familial, my 4 sisters and my father all victims). It so happened on my second visit( six months after diagnosis) I was at my Cardio's for a check up and he declared me to be in AF and offered me the option to have a cardioversion that afternoon. I said fine since I'm here, I might as well and off I went to the ward!!!! That was 5 years ago. I now just take 1,25mg Biso (when I feel I need it, which is usually when my HR is in the 90s) and Xarelto anti coagulant for the AF and medication and a very low dose of statin for mild hypertension!

[Dovewings]

oh myyy

Ok hopefully you’re close to dosing off all the toxic chemicals in your body! We can discover on our own that multiple medications offer ill side effect’s, just the opposite expectancy, and irreversible damage.

Actually after extensive research and numerous runs in BetaBlockers, Xeralto, Pradaxa, and endless other experiments,

I’m down to daily 81 mg Asprin, a Women’s multivitamin, and a Probiotic. Blessings and wisdom on the journey

[BlueINR]

It would seem to me a cardiac ablation would be in order. I've had at least a dozen cardioversions, all successful until another episode of afib came along. EP suggest an ablation, which I had, almost two years ago, still had afib episodes, most recent was last week and current cardiologist had me see EP in his office. Second ablation scheduled for Oct 25.

[LadyLawson]

if you can afford the £200 to see a private cardiologist/electrophysiologist it will be the best money you have ever spent. Do ask your GP to forward your notes so that the consultant knows your case. The consultant will be able to advise you on the way ahead.

[qp3usavk]

I had my cardioversion in Sept 2020 after going into afib in July. In hospital for a week and put on Xarelto, 15 mgs Bisoprolol and 20mgs of Digoxin!!! Felt awful, but after my cardioversion, was reduced to just 10mgs of Biso and nothing else. 2 years on, I am now on 3.75 mgs of Bisoprolol and feeling a lot better, though am feeling side effects as my body adjusts to the change. I did it slowly, over the last 5 months, and with the support of a brilliant GP, who liaised with Cardiology to do it. I hope to reduce further after Xmas but, for now have a much more normal HR of 55/60bpm at rest, as opposed to 43 before reduction!!! Good luck with it all but you must see your GP, and he should liaise with, if not refer you, to Cardiology too.

[vajrahara in reply to qp3usavk]

Thank you qp3usavk very helpful as have been all the replies xx 😀