Procedure for Morbidly Obese with AFIB - Atrial Fibrillati...

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Procedure for Morbidly Obese with AFIB

jackibar profile image
28 Replies

I’ve had AFIB for about 6 years now and am morbidly obese. Up until I got Covid a year ago, I was very well controlled on propafenone plus Bystolic. I can always tell when I go into or out of AFIB and have an app on my phone that confirms this.

A couple of months ago I had the worse constant attack ever and was in the hospital a few weeks for them to work out my meds. I’m on amiodarone now and still having breakthrough attacks up to twice a week.

They told me I need an ablation but can’t get one because of my weight. So I searched and found info about the mini maze and got excited thinking there was an option for me - only to find it also can’t be done on obese patients. Is there any hope for me? I’m 62 and have fought the weight battle since age 7. ​​​​​​​Thanks so much for any info or suggestions…

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jackibar
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28 Replies
Paulbounce profile image
Paulbounce

Hi Jackie.

Of course, there's hope for you. Let me be honest though - it's likely to be a long haul and won't happen overnight.

You may have more difficulty finding a treatment option due to your weight. In general, the mini-maze procedure may not be recommended for patients who are significantly overweight or obese, as the excess weight can make the procedure more challenging and increase the risk of complications.

It's obvious that losing weight, if possible, will often help improve symptoms and reduce the risk of AFIB and other health problems. Making lifestyle changes, such as eating a healthy diet and exercising regularly, may be helpful in managing your AFIB and improving your overall health. However, this is easier said than done as it seems you have been struggling with this problem since you were a young girl. I'm sure you have tried lifestyle changes anyway and this has not worked for you.

I'm not sure what to suggest to help. Have you tried a registered dietitian to help with weight loss? If not this might be worth a shot. It would give you something to aim for and might open other afib treatments up for you. Other than that I don't know what to say. I'm sure others will offer suggestions. One other thing I will add is if you smoke quit now. As an ex-smoker I know it's not easy but it's well worthwhile.

Good luck.

Paul

Hennerton profile image
Hennerton

it may seem an odd question but have you ever had your thyroid checked? Low thyroid hormones can cause weight problems and it is odd that you have struggled from childhood. Do you have any other symptoms that might reinforce this idea? Tired? Joint and muscle aches, low mood.. where a thyroid is not functioning properly, the effect on the body is huge, yet the problems can often be explained away by GPs as nothing very serious and patients are fobbed off for years, become more and more unwell. Just a thought….

Paulbounce profile image
Paulbounce in reply toHennerton

I think Hennererton makes a very good point Jackie. Worth following up if you have not already done so.

Paul

MummyLuv profile image
MummyLuv

hi Jackibar,

I am not aware of a procedure than can be done when morbidly obese, for mini maze they like you to be at a bmi of 30 or less. As well as increased risk of complications the keyhole instruments need to be able to safely reach. I had mini maze 8 months ago and lost 3 stones beforehand.

Having your thyroid checked is a great suggestion x

Singwell profile image
Singwell

This is challenging Jacki and I'm sorry you've battled weight issues since childhood. I'd recommend looking into the Zoe Project, which has a Programme that checks your blood sugar and fat absorption levels as well as your guy microbiome health. Using an App and nutritional advice it helps you customise your eating habits for YOUR body. It's paid, but you might get it on health insurance. Check it put. A few of us have done it here for health reasons. It's scientifically based and not about dieting!

Ossie7 profile image
Ossie7

Hi Jackie

I feel your pain . I too am classed as obese and the cardiologists have always stated that this is my main reason for going into AF . However at the time I had my first episode it was post clinical depression where I was unable to tolerate food and at my lowest weight ! Anyway , I heeded advice and managed to lose 40 pounds for my first ablation ( major struggle ). For my second ablation I had gone through enormous amounts of stress and had gradually piled on 3/4’s of the excess baggage I’d lost and as the EP didn’t do a face to face until the morning of the procedure he hadn’t been aware . So as I was recovering from the GA , feeling hideous , him and his registrar , both skinny Minnie’s , fat shamed me !! Although true , there are ways and means of discussing sensitive weight issues and I was distraught !

I am now trying to get down to a healthier BMI for my 3 rd ablation , but luckily I now have a lovely arrhythmia nurse who is sensitive but supportive . Basically Jackie , what I’m trying to say is you are not alone and I empathise .

It’s a huge struggle but don’t give up hope that you can reduce your BMI , maybe doing what others on here have suggested .

irene75359 profile image
irene75359 in reply toOssie7

My husband was fat-shamed by a young skinny GP who airily told him not to eat anything after 4pm - we worked full-time until at least 6pm most days... Nutrition is a tiny part of a doctor's training, most people know more than their GP about how to eat, it is carrying it out that is the problem.

DawnTX profile image
DawnTX in reply toOssie7

I am so sorry to read this about the fat shaming. I am not a Barbie doll but I have not had one heart doctor say a word about it. It’s not a secret I am weighed every time I see them. What is wrong with these doctors don’t they realize the last thing you need right now is that pressure put on you? Do they think we carry extra weight for the fun of it because we just want to eat what we want? Right now I should be a size 2 the way I am eating. Not even by choice am I eating this way I just have no appetite. Perhaps once a day when I get up I like to have my egg beaters and toast then I can honestly go almost to the next day without eating. I’m telling you this because I have barely lost weight since eating this way. I was down 34 pounds then after the failed cardioversion I was up 5 pounds in a week without eating. They say your body traits to protect itself maybe that’s going on I don’t know but I can look in the mirror at myself. I am honest about not eating yet here I am far from a size 2. I was never a Barbie doll in my 20s I was maybe a size 10. I have walked an average of 5 miles a day throughout my adult life because I did not have a car and lived in the city for a very long time. I went to the gym and living in Florida I would swim every day. I don’t have fat sagging but I have the weight they don’t even look at you to see the difference Yes a button got pushed when I read of your abuse by the doctors. Scare tactics on people our age are not gonna work we have dealt with being large or fat whatever you wanna call it most of our lives and have been unhappy because of it. It never kept me from doing what I wanted to do or be with who I wanted to be with. My GP always checked to make sure it wasn’t anything else as you all suggest here. There is nothing for me to cut out of my diet. My A1c for diabetes stays below six usually 5.6 or so and I am still very solid even at my age. These medical people need to move past this and figure out a way to help us. Obviously it’s not going to be exercise when you have a fib and cannot breathe. Is this really 2023? Sometimes I really wonder because how far behind things can still be.

thinking of all of us that have this issue. If I stuffed my face with cake I would blame no one but myself but for those of us who have tried at all I send you big hugs. PS Weight Watchers has worked for me. It’s probably my favorite. You pay for it most likely although some insurance gives you a discount. Even if you have to pay it’s very cheap if you do the online even just tracking your foods and knowing what you’re eating. There are many free foods that you wonder how they can be free as far as calories etc. it’s not a wonder diet you have to pay attention and keep track but they make it fairly easy. I want to try Golo Because they talk about insulin resistance. I will run the ingredients by the doctor first because I want nothing to mess up any treatment he is trying on me right now. A fib has to come first if I cannot try the new one I am going back to Weight Watchers

Do not let anybody take your power from you and make you feel like crap not even a doctor I don’t think he’s a good one if that’s his idea of taking care of you and doing no harm

Ossie7 profile image
Ossie7 in reply toDawnTX

Thanks Dawn x

Barb1 profile image
Barb1

I am also very overweight and the only time my EP mentioned it was when he was explaining why he didn't want to do a mini maze. But he did do 5 ablations. He understood that I couldn't exercise being in persistent fast AF

Ossie7 profile image
Ossie7 in reply toBarb1

Exactly Barb , nutrition is just one piece in the obese jigsaw . At one stage I was on 10 mgs of bisoprolol and could barely walk up stairs let alone do my usual swim / dog walks . Even up to my recent cardioversion last October I was on 7.5 mgs bisoprolol and couldn’t increase my heart rate with exercise without getting angina / dizziness etc . I’m now on 2.5 mgs and dronedarone and walking fast /uphills my heart rate won’t get over 100 but my sub maximal goal for cardiovascular health should be 120 for my age . This must surely impact on my metabolism . I do feel that to lose one pound I have to starve myself which I know is not healthy . It gets me down at times , and I am sensitive about my weight . It is SO good to get support from this group without feeling shamed .

Barb1 profile image
Barb1 in reply toOssie7

Totally agree. When I eat out, for instance, I feel that everyone is judging me. But if I spend some time with friends they always comment on how little I eat and good nutrition choices I make.

DawnTX profile image
DawnTX in reply toOssie7

I am pretty much what they would consider starving these days and I was up 5 pounds last week. Fluid is definitely an issue as well as other things. I can barely walk across the room. The previous two months I had dropped about 34 pounds before weight popped up again. I’d like to see the medical degree of the person fat shaming anyone. Hang in there I too have dealt with this since I was a child. Growing up it was called baby fat. When I do eat right I am plant-based and all I drink is a rule is water. Some people are clueless because they never had the issue.

DawnTX profile image
DawnTX in reply toBarb1

So good to read this Barb. The last time I was in the hospital as I looked around I realized most of my nurses were heavier than I am. No they don’t fat shame you but why in an industry like this is nothing said? I worked law enforcement and it used to be the standing joke of donuts and cops and it was true lol we needed the coffee and then they would throw the donuts in for us most of the time. Police officers these days are some of the most fit I have ever seen. I was a captain running a community services office and when I first took over I would bake and bring in goodies to have in the office for when officers stopped by I soon stopped baking because they don’t eat it. They are doing healthy drinks etc. not the crazy stuff just healthy and they would come in to heat up their meals that they brought from home no fast food. To be honest that is the shape you need to be in to work law enforcement. I hit the gym or the pool five days a week minimum as well as once swimming. I’ve never been thin but I am still solid. I have a feeling that is what has helped me through some of my health issues with a fib. I also walked about 5 miles a day. However I would love to be able to do that walk now

Barb1 profile image
Barb1

I find this reply completely lacking in any understanding of the situation

Ossie7 profile image
Ossie7 in reply toBarb1

I’m with you Barb , totally unrealistic and patronising reply xxx

Barb1 profile image
Barb1

the answer to the world hunger may lie in your genes,....sarcasm has no place on this forum.

DawnTX profile image
DawnTX in reply toBarb1

I support you all the way Barb

Barb1 profile image
Barb1

I have no interest in helping anyone who doesn't want to help themselves. One of the things that I have done was to put myself onto a research programme investigating any link between metabolism and weight gain/loss. It was lengthy and involved, so please don't tell me that I do not want to help myself.

DawnTX profile image
DawnTX in reply toBarb1

good for you saying that❤️

Barb1 profile image
Barb1

Thank you

I am going to suggest you get ahold of Dr. Gundrys newest book, Unlocking the Keto Code. I just finished reading it and it was a whole lot different than was the old Keto was about. it might help you in your struggles. Just briefly one does not have to eat tons of meat and fat to get into Keto to help with all kinds of issues but which must start with weight loss

Autumn_Leaves profile image
Autumn_Leaves

I am no expert on obesity but I understand that there are specialists in obesity medicine in the US and new medications which are now available. I don’t understand the US healthcare system and what insurance will pay for or not, but it’s certainly worth considering seeing someone qualified to help. Obviously diet and exercise is important too, but your situation may well justify more than just lifestyle interventions. If it was the answer was simple and straightforward I’m sure you would not be in this situation. If help is available and/or you have the funds or insurance to cover it, specialist care might help you get to where you need to be for better AF outcomes.

DawnTX profile image
DawnTX in reply toAutumn_Leaves

it’s relatively easy to get surgery unfortunately that’s a problem for those with active a fib. Without cardio clearance I know I can’t get anything done including the back surgery I was supposed to have when a fib came back with a vengeance. The day I was supposed to have my consult I ended up having a cardioversion that failed. They don’t want to touch you. I mentioned earlier I like Weight Watchers however if you have something else going on like insulin resistance things just don’t work like you think they should. I’m told that my lack of appetite now is because of the problems with my a fib

Autumn_Leaves profile image
Autumn_Leaves in reply toDawnTX

I appreciate how difficult it can be for some people with more than one condition that needs surgery and/or medication. The person needs to be seen as a whole. I’m probably not qualified to talk about specifics as it’s not my area of knowledge or lived experience. However, if someone’s healthcare is being impacted by their morbid obesity and has had weight issues throughout life, I think it may be justified to seek help from a medically qualified specialist if such help is available to that individual. There are many diet books selling a quick fix, but perhaps the OP has tried many of these quick fixes only to regain, and in the medical context where there may be multiple co-morbidities as well as just the state of being overweight, the “yo yo” diet effect isn’t going to help that person’s long term health. It all depends on the severity of the problem and what else is going on. Weight loss for cosmetic reasons or attaining a “beach body” is different from morbid obesity with underlying health conditions. Weight is a very emotive issue these days, too.

DawnTX profile image
DawnTX

I don’t like your tone towards Jackie do you think she wants to carry the weight and has been happy with it all her life? You sound like her stupid Dr. Sorry for being condescending doesn’t do a thing. She could be insulin resistant and other things. No one is happy with the extra weight especially with the crap we see on TV where everyone is young and thin.

DawnTX profile image
DawnTX

WOW So what about the thin people with a fib? Oh it must suck to be you and be so perfect. Has anyone recently told you you’re not nice

DawnTX profile image
DawnTX

How many of us would like to see your medical degree? I’d say most of us. It’s ridiculous really? Why? Thin people don’t have a fib? Time to treat you the way that I would treat someone I was about to arrest. In my head I’ve already said bye-bye to you. I don’t know you maybe you’re a good guy just don’t know how to phrase things. You don’t know us. You don’t even know what we look like. I am still very muscular even at my age and when I say I’d like to lose 80 pounds my doctor tells me that’s ridiculous knowing my weight. Did you know if you sing a beautiful song you will get a beautiful Echo back. Try it

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