I have had a fib for 4 years and been advised it will not damage your heart. Cardiology advise that the terrible tiredness I get is due to something else. I cannot take beta-blockers because they lower my blood pressure, making me ill. Fleccanaide has no effect. Following a chest x-ray, (all clear), in pursuit of the tiredness issue, the GP advised yesterday my heart is enlarged. Panic on my behalf, what is happening? In the past cardiology have suggested trying amiodorone, but I am not keen because of my own, numorous eye problems and thyroid probs in v close family members. I contacted cardiology yesterday and I go back to hospital on Monday for more tests. I have queried having an ablation in the past but cardiology were not keen on this preferring to go down the amiodorone route. Any advice would be appreciated. Thanks.
A Fib again: I have had a fib for... - Atrial Fibrillati...
A Fib again
Generally AF will not damage the heart provided rate is well controlled but since you have not been taking anything for that, enlargement of the left atrium is likely. This can be reversed in many cases by controlling the AF.
There are other drugs to control heart rate such as calcium channel blockers and at least two rhythm control drugs (Flecainide and Propafanone) which are far less toxic than amiodarone so I would be very reluctant to accept this.
Why not ask for referal to an electrophysiologist ( a caradiologist who specialises in rhythm problems) as general cardio doctors are often reluctant to stray far from their comfort zone.
Agree with Bob on all counts here x
Hi Bob and Wil
The last time I rang the cardiology nurse I asked to see an EP. She told me that the cardiologist I am under is also an EP. The nurse does not think my A Fib is particularly significant because monitors I have worn in the past do not indicate my Afib is too bad. Yet I know, confirmed by my fitbit watch, that I am having 4-5 episodes a week of major A Fib lasting 4-6 hours, plus numerous lesser ones, or are they something else? A nurse I spoke to yesterday seemed to accept the fitbit readings, hence my appointment for tomorrow, to complete further checks - plus of course the x-ray info which is far more important. I have an appt with the cardiologist/EP at the beg of next month. I am dreading wearing a monitor again that apparently shows nothing! Feeling frustrated.
Its a long road sometimes to get a proper diagnosis! Keep plodding on and you will get there. How long did you wear the monitors before? I had a 7 day one once which did the trick. Good luck
It's not really appropriate for the nurse to make those decisions about your level of AF, especially if it's interfering with your quality of life. Dig your heels in. BobD gives solid advice here.
Sorry I have been a Fitbit fan for years but do not trust re heart rate monitoring.You could invest in a single lead portable ECG.I know a lot of people prefer Kardia but I use Emay .Make sure you get the one with the app.Look at comparisons online or YouTube.You can view ecgs on you phone & send or print.Use it when you feel you are in Afib.
Yes dig your heels in, broken record you need to see the EP. I have P-Afib and Hypothyroidism. Beta blockers messed up my treatment for hypothyroidism causing big problems and made matters worse re the Afib. I was moved onto a calcium channel blocker Verapamil. This drug takes a while to build up but it works like magic for me. The nurse is not qualified to make medical diagnosis so I would move past her tbh.
Do also check that you thyroid treatment is optimal not just the TSH nonsense is fine!!
Undertreatment of hypothyroidism is common and won't be helping if the case.
I agree as well.
Hi Bob,
I was interested to read that left atrium enlargement can be reversed. My diagnoses stated 1. persistent atrial fibrillation 2. Dilated left atrium with structurally normal heart. I'm currently taking bisoprolol 2.5 once daily & flecainide 100mg twice daily. Atrium enlargement reversal wasn't mentioned to me by anyone, but this sounds positive, and hopefully could be a step in the right direction for me.
Very common for things to return to a more normal state once rate is well controlled.
Interesting , thanks Bob
I agree with Bob D 100%.
Hi Hiliana
I am not in a position to argue with any specialist who may have good reason for not advising an ablation but I was not having as many episodes as you are but was offered an ablation, the episodes I had wiped me out but after an ablation coming on 3 years ago and at least 6 months recovery time it has given me my life back. You have questions that you deserve answers to, be persistent chasing them. Good luck and I hope all goes well for you.
I hope everything goes well when you see your cardiologist. Good luck and best wishes.
Hi
Hilianna. I, too, have an enlarged ventricle chamber so NO to ablasions.
I, too, have been fatigued and metroprolol sice stroke and AF was worse and not CONTROLLING my H/R day. 47 is my H/R night which hasn't changed through Metroprolol, and Bisoprolol.
A private special Heart Dr tried me on 180mg Diltiazem a CCB Calcium Channel Blocker and within 2 hours H/R fell 105 H/R Day.
It does not lower BP much but Bisoprolol does.
Now controlled on 120mg Diltiazem am and Bisoprolol lowered to 1.25 mg pm I am happy and no more pauses at night.
But be careful with this drug as 180mg was too much and he intended that I could be raised to full dose of 360mg. Hell NO.
No more swelling and therefore less fatigue.
Helpful has been a lower dose of PRADAXA an anti-co.agulant to 110mg x twice, removal of inflammation caused by Johnson & Johnson Mesh. It appears inflammation in the body can cause AF and high H/R.
I'm increasing my walking on a weekly basis.
Sometimes we have a STOP in the direction we thought we would try. Be positive and move on by accepting it. It must be a risk for us.
My thyroid cancer has been removed 4 mths after the stroke and my heart may return on its own. I'm crossing my fingers.
cheri JOY
Untreated AF led to me having an enlarged heart ie dilated cardiomyopathy with reduced heart function. Treatment for AF reversed this. I think that may need a 2nd opinion.
there seems to be so many opinions from drs on this topic it’s hard to know what to do.
Similar experience. As a result of persistent A Flutter, I had an enlarged L Atria which due to change in shape, altered the valve function and increased the leakage and so reduced EF. Once I had my 1st ablation and episodes dropped significantly and so Atria was working less hard, it returned to normal size, valves no longer misshaped and the leakage returned to normal.
That sounds promising as I'm in a similar position. On a valve repair list as enlarged atrium had pulled the annulus out of shape.
However, they've now decided to do further tests as since my last cardioversion 7 months ago, I've had no AF and have felt really well compared to before so EP has ordered scans yo see if atrium has shrunk back......... fingers crossed.
That would be great news if there was some improvement.
Can but hope 🙏
Solid advice from BobD. I don't know how much age plays a part (I'm 47) but I've had 2 ablations even though I've had AF for 18 years and it's well established. EP was still willing to try ablation route. Hasn't worked thus far but possibility of a third but possibly going down pacemaker route. This is 18 years down the road though.I took amiodarone previously and now have underactive thyroid. I'd definitely recommend discussing alternatives. In my experience this is often prescribed in short term only to aid other procedures such as cardioversion.
Ps. I also have enlarged atrium and reduced EF. It was scary to learn this but as Bob says, i believe it can get better. I'm keeping hopeful for this.
I too have ended up with an enlarged atrium so on the list for a valve repair and that's despite an ablation last year and being on Amiodarone.However, since a cardioversion 7 months ago, no AF that I'm aware of so is that not something they've offered to you as the success of that can be an indication if whether an ablation may work?
I can't tolerate beta blockers either so take Diltiazem for rate control.
Worth asking about cardioversion when you see your EP.
I got dronedarone instead of amiodarone due to thyroid issues. I had to suggest it though and it does have side effects in some.
I'm at the start of the journey; - one out of 4 beats are atrial ectopics; GP is saying probable af. I get a holter monitor in 2 weeks for 24 hours. Had 2 ECGs Friday. One showed nothing,the other showed 5 missed beats in around a 12 second recording. Was given bisopralol after heart attack and it dropped my bp so low I could hardly wake up. I've had numerous thyroid nodules in the past but was eventually discharged once they knew they weren't cancer so I'm very suspicious of my "Top end of normal" results. Thyroid problems are so badly treated and often ignored by GPs.
I have had afib for 8 years. Now it’s every 2/3 weeks for about 12 hours. They can’t give me any treatment because of my naturally slow heart rate. By EP said he thinks it’s unlikely to damage the heart and discharged me saying he thought my heart would cope and with no other underlying conditions or apparent heart problems he was very reluctant to carry out an ablation
Your GP said your heart is "enlarged". Based on what? What tests determined that? First thing I would want to know is the Ejection Rate. That # says a lot about the condition of the heart muscle. Next I would want to know the status of any developing blockages in heart arteries. Both the EV and blockages can be assessed through specific tests. Have you had an echo cardiogram, for example. It will tell you your EV and specifically examine things like wall thickness in the areas of most concern to us AFib patients. Have you had a stress test? It's another source of real info about the status of your heart muscle. Consider backing up and getting comprehensive testing done if you haven't already, and if you have, consider a second evaluation of the data those tests provided by another cardiologist. I've just had a re-eval of my heart muscle condition and a two week Zio monitor. After two years of incomplete info and a diagnosis of Tachycardia, my current cardiologist has backed off consideration of a pacemaker, halved my beta blocker dosage, and smiled enviously at my clear arteries and an EV of 73. I'm glad we backed up, again, after 4 years of transition from proximal to permanent AFib and re-evaled. I am 69. AFib for 8 years. I am more 'tired' today than when this started, but I suspect it isn't so much the AFib but a combination of factors: needing to look closely at meds, not sleeping as well as when I was younger, less physical exercise owing to retirement and muscle issues (I'm a Cipro reaction victim). 'Tiredness' is real, it's source, often difficult to determine, owing to multiple contributing factors. I wish you the best in identifying and addressing yours.
Isn’t an enlarged heart established from the measurements done during an echocardiogram? I believe that that is how they established I had an enlarged left Atria and subsequently how they established post ablation that it had returned to normal size.
Yes, echocardiogram shows size. But that might tell very little about actual heart health, or function, in my experience. What is the Ejection Rate? That number is a good indicator of heart function, as opposed to size. An a cardiogram will give that info. We AFib folks expect some enlargement of the left atrium, but that doesn't mean an unhealthy heart. On the other hand a low ER has clearer consequences and indications.
For me, the EFactor dropped with the enlargement of the L Atria but I believe that was because the resultant misshaped heart resulted in my Mitral valve leakage going from mild to moderate. Once the LA returned to normal size and Mitral valve leakage reduced, the EFactor went back up. The EFactor therefore highlighted more of an acute than chronic situation in me? However, presumably if there is chronic damage to the heart, the EFactor is a good indicator / measure of this?
Poster said they'd had a chest x-ray. Mine showed up on an x-ray to start with as well.
I had an atrial ablation for AFib 2 months ago and it’s been successful so far. But I did develop atrial flutter 4 weeks ago and my EP put me on Amiodarone, which I was reluctant to take. After 5 days of consistent flutter he did a cardioversion which has also been successful so far. We discussed amiodarone again and he acknowledged that he didn’t like to prescribe it but felt it was the best for me. More importantly he assured me that the assorted side efffects I feared are not common for shorter term use and generally only appeared after long term use (over a year). I’ve had no side effects from it so far and my heart has been good
I am almost 81 and have dealt with a lot of docs for decades. I totally agree with bayonnejoe1 re getting tested, tested, tested. I always remind myself that the average doctor was a C student and that the doc at the bottom of the class is called "Doctor" so I don't hesitate to ask for a second or third opinion. I live in the state of Idaho (USA) which doesn't even have a teaching research hospital, consequently it is hard to find a doc who is cutting edge. As a result, I go to the University of California, San Francisco for an EP. Look for a hospital and doctors who have top reputations for their work, if you can. After all, it is a matter of quality of life and possible death if they screw up. Stick to your guns; too often people don't listen to the patient as they should. Best of luck to you.
On the fatigue issue. From my experience over a couple of decades, frequent Afib can give me serious fatigue. I was on beta blockers for about a decade and reached the point where catheterization was decided to be necessary. After that, I was much improved, but you also need to avoid stress and eat and exercise correctly. I didn't and was warned that I may have to have a second ablation. I now avoid stress (I was one of those activists who would get arrested for the environment and human rights) and aviod salt in my diet and my afib is less than 1%.
hello Hilianna,
Have them put you on Multaq . This medication mirrors amiodoron but without the harmful side effects. It is expensive for no generic for the Multaq. If your heart ejection factor less than 50 you should take care to reduce the number of episodes .
I agree with you about the Multaq I am back on that and Metropolol I suffered with amiodarone for four months following my first ablation and it was a nightmare I was so sick. Since I was put on Multaq I have had no problems. No we are all different so what works for me may not work for you but I’ve been happy with it along with a Metropolol. If you are not in sinus rhythm be aware Multaq will do nothing for you. My new Cardiologist was baffled as to why I was on it with tachycardia 158 heart rate. They started me back on it after pulling me off of it for a week it was first given to me about an hour after I woke from my cardioversion. I am now on my truck lol once each night because evidently nighttime is when AF likes to act up the most. Best of luck finding your perfect fit
Do a full body detox with zeolite, or NAC and zinc, or EDTA (heavy metal toxicity). Bet you get energy back. GL!
I have had AF for 14 years.Caused by Mitral Valve disease.Had it replaced via a Sternotomy Tissue valve failed after 12 years.Not well enough for repeat Sternotomy so replaced Valve within a valve.Still getting AF.Fairly controlled with Digoxin.
The tiredness is very much a part of a fib especially if your heart rate is high. I’m not so sure about the comment that it cannot hurt your heart. I just spent five months in tachycardia running about 158 constant heart rate and was told I was a ticking time bomb and it was like giving my heart A five month stress test. Now I don’t know about you but they had to do a chemical stress test on me and the minute it started I needed it stopped because of the pain and stress. I don’t know why they seem to think your exhaustion is unusual with a fib. Our hearts must work much harder you also do not have the circulation that you should have. Since my cardioversion I have even discovered that the needles and pins in my arms and legs are gone as well as the aching. I have no doubt it is due to circulation again doing what it should be doing.
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