How frequent

[DaveBr]

I was diagnosed with PAF some 5 years ago and each episode was an annoyance more than anything else. Fast forward to now and the frequency and disruption have become greater. According to my latest pacemaker check I am now in AF for 20% of the time and the effect is taking more of a toll on me both mentally and physically . I was offered an ablation several years ago but turned it down for several reasons . Is now the time to reconsider my choice

[BobD Volunteer]

I would say yes. You must have been told years ago that AF is a progressive condition. The old saying is AF begets AF so the more you have the more you will get. Ablation is always best done early to prevent this so hopefully not too late now.

[Hidden]

Good morning DaveBr, it is now being recognised that the earlier an ablation procedure occurs for AF the more successful it is long term. You may like to have a look at our Patients Resources which cover the ablation procedure, including preparing for and recovery from, they can be found here: heartrhythmalliance.org/afa... If you feel like you may want to talk things through with someone, please feel free to contact our Patient Services Team on 01789 867 502 or email [e-mail]

[secondtry]

That depends on the severity of the reasons you turned an ablation down earlier. Also the AF seems to be moving quickly so worth a private cardiology appointment to discuss what is likely to happen if an ablation isn't taken up and also, if it is, when it should be done for optimal benefit.

[Tellingfibs]

Hi, I was also diagnosed 5 years ago. At first, like you, the episodes hardly impacted my life. The cardiologist had put me on Warfarin and also 2.5 mgs Bisoprolol. Until last year, everything was fine, with intermittent asymptomatic episodes. Then during 2021 an episode occurred where I experienced a bout of tachycardia. The GP raised my dose of Bisoprolol and all was fine for 6 months. The same happened again, except the GP I saw was too nervous to increase my beta blocker so I spent 3 months last winter feeling wretched. Then my cardiologist agreed to see me earlier than my arranged appointment and raised my Bisoprolol dose again, just a little. This time it didn’t help and I contacted my GP ( a different one again ! ) who just upped my Bisoprolol a tiny bit, and within hours, I was feeling marvellous. I do get episodes, but they are like they were at first, largely asymptomatic - only just noticeable sometimes. Mostly, I wouldn’t know about them if I didn’t have a Kardia device ! I told my GP that I was worried I was on the largest dose of Bisoprolol and what was the option if my episodes turned nasty again. He told me not to worry about hypotheticals, and that anyway ‘ there are a lot of tools in the box’ to address Afib.

I hope your medical team can sort you out, but don’t just sit and worry ( a trigger for Afib ! ), be proactive and make some appointments. Good luck.

[Ossie7 in reply to Tellingfibs]

Morning , curious to know what dose of bisoprolol you were / are on ? I was on 7.5 mgs a few months ago before my 3rd cardioversion for persistent AF and just felt awful on it ( sob , lethargic etc ) . It didn’t even really help my symptoms , so I’m thinking next time I may need to try a different type of beta blocker .

[Tellingfibs in reply to Ossie7]

hi, I started on 2.5 mgs, once daily, and remained on that dose until spring 2021. I am now on 5 mgs, twice daily. I am very fortunate that this drug suits me, although I don’t have the energy I used to have - mind you, I am 71 now, and at this juncture in life, between the age of 66, when I was diagnosed, and my present age, I suppose I might expect to slow down a little ! I find I can do things, but once I stop, I just want to sit in the chair and watch the grandchildren rather than play with them. My cardiologist has mentioned cryoablation but says tgd Afib isn’t impacting my life enough to go down that route ‘at the moment’. He also said Sotalol was an option if Bisoprolol stopped working for me. That of course is another betablocker anyway. As it seems that for me, the tachycardia is what knocks me for six, the rate control the Bisoprolol affords me works very well. Of course, if I wasn’t on the drug, who knows, I might be running marathons etc ! You may be young, or in your mid life prime, but older people like me have to make allowances for general ageing, and not blame Afib for everything. As for Bisoprolol, it does help keep my heart rate in the low 60s, but some people might be set along the rhythm control route, especially if beta blockers don’t agree with them.

[Ppiman]

I have read that an ablation is for symptom control, so, in that sense, your thinking is correct - that if your symptoms are excessive, then it is an option to consider. As for the future physical health of your heart, then that is something I would discuss with your doctor. My elderly friend is 89 and has full-time AF yet remains healthy for his age.

Steve