Atrial Fibrillation.

[Hilianna]

Hi I have had atrial flutter followed by a atrial fibrillation for approx 4 years. Medication I have tried has not been helpful and I take only an anticoagulant every day. I have bouts of af, of which I am fully aware, approx 3-4 times a week, when the heart jumps between 37 and 167 for 2 to 4/5 hours. My left atrium is slightly enlarged. It is very unpleasant when af happens and slow breathing might have some effect in lowering it. But not at other times. Getting excited about cooking and playing bridge, activities which I enjoy, or hurrying can often precede the incidents, but not always. A lot of alcohol might bring it on but since I drink very little, none for the last couple of months, I cannot be certain about this. I suffer from fatigue and low energy - cause not known. The hospital has offered me a catheter ablation or a pace and ablate approach. The latter would not help the tiredness/fatigue if this is caused by the af but would help with palpitations - although the af would not be targeted, the pulse would not respond to the af by racing, because the pulse would be controlled by the pacemaker. This is all very complicated and I feel the catheter ablation might be my best choice. Any thoughts on the best approach to try? As a non-medical person it is very difficult trying to decide which is the best path.

Thanks

[BobD Volunteer]

Pace and ablate is a bit final so always best to try ablation (PVI) first in my view. Caveat. All treatment is only for quality of life.

[Jalia]

I would certainly try ablation first. I'm surprised that you have put up with these frequent episodes so long without this intervention. Certainly alcohol, even in small quantities can be a trigger for many.

[Hilianna in reply to Jalia]

It is a bit difficult to know what is considered frequent. When cardiology test me I am rarely in fibrillation. However, the last Dr accepted what I told him, backed up by my watch, which I could not have adjusted to show fibrillation if it wasn't so. Whenever I feel the fibrillation starting it shows on my watch and also on other apps. Also my blood pressure monitor.......

[Jalia in reply to Hilianna]

I would call your episodes frequent . As they appear to be paroxysmal the problem is getting them recorded but you have evidence on your watch which has been accepted.

We are a similar age and like you I can sometimes find episodes initiated by what I term 'good stress' ie prior to something exciting happening or overdoing things.

Do think about ablation . I've had 4 since 2009 with no regrets.

[Hilianna in reply to Jalia]

Hi Jalia Yes, I can identify with the expression good stress, impossible to avoid. I think that ablation is the path I am heading for. Are you free of fibrillation at present? 4 ablations seems like a lot ....

[Jalia in reply to Hilianna]

I had my last ablation in July 2021. All pretty good until last month when I went into fast AF ( had my lovely 7 year old granddaughter staying overnight....) and ended up in CCU and had dccv. I can live with this as ok in between.

[Ppiman]

There's a new-ish home ECG monitor from a company called Wellue that - uniquely, so far as I can tell for a home device, - uses AI to send you a detailed report back. It takes readings over a much longer period, too. That might help you and your doctor see what is happening.

Being given options by doctors is never satisfactory, I find, since I want them as experts to tell me what to do for best. The problem seems to be that, often, they just can't know what the future holds for an individual's heart.

Steve

[Hilianna in reply to Ppiman]

I feel happier that the last Dr seemed to take on board the frequency of my af. I am currently getting over a rather painful knee arthroscopy (still on crutches after 3 weeks) but as soon as I feel able, will chase up the af problem. The problem with old age issues is that they never go away. Thanks for your comments.

[Ppiman in reply to Hilianna]

They don’t, and if yours are like mine, they just keep adding up. Oh to be young again.

Happy New Year!

Steve

[Hilianna in reply to Ppiman]

The stack just gets higher and higher.

Happy New Year

[secondtry]

Possible good news is more lifestyle changes (a search here should bring up many suggestions) could help eg a magnesium compound and CoQ10. However, such changes are not a 'silver bullet' taking months/years and requiring persistence. I accept many are not interested in this approach and just want to be fixed by the medics but I don't have that level of confidence in drugs/ablations etc and prefer the slow in-control approach first.

[Hilianna]

Hi second tryThank you for your post. I have never tried magnesium for A Fib. I tried magnesium some years ago for something which I cannot remember, but stopped it fairly quickly because it made me incontinent. It is very difficult to know what to try when there appear to be so many possible links to A Fib. The only life-style habits I can link it to are getting excited (good stress as someone called it) and possibly drinking a lot of alcohol, which since I hardly ever drink these days does not figure in the picture. Otherwise it just comes and goes whenever it wants, often in the evenings but not linked to a meal, as far as I can tell.