I have gone from paroxysmal AF ( once a month) to permanent AF since the beginning of December. My EP has referred me for cardioversion which is on Feb 28th. My heart rate is constantly around 70 - 80 even when resting, with an irregular rhythm. I take Apixaban, Flecainade and Verapramil. I have a pacemaker. When I read other posts in this forum, most people seem to have a much faster heart rate than I do - over 100. My normal sinus rhythm is about 52 resting.
I feel breathless and fatigued but carry on with my normal activities. I am worried about having the cardioversion as my heart rate is not overly fast. Can anyone give me advice?
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DECILYN
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I've had lots of cardioversions and this may surprise you but I love them! You go in feeling odd with the abnormal beat and come out cured. I can tell you it's the most wonderful feeling and I'm full of gratitude to those that have performed the procedure.
The actual procedure takes minutes, but there's usually a longish wait for your turn, at my hospital about 10 people turn up at 8.30am for the procedure. The hospital have a small ward they've set up and when it comes to your turn you go in and are asked to change into a gown. They tell you all that's going to happen and put a heart monitor on you and a cannula in the back of your hand. Then the team arrive, pads are put on your chest, then you are given a drip through the cannula to make you sleep . Next thing you know, a nurse will be saying your name and pulling you out of a deep sleep. At my hospital they like you to eat and drink something, they provide, before going home - it's usually tea and toast where I go.
I can assure you there is absolutely nothing to be afraid of and you will not feel the shocks. They can attempt them 3 times, but my heart has always gone back into normal sinus rhythm after one shock.
Be aware afterwards not to do anything that requires effort for a few weeks and allow your heart to gain strength beating in it's correct rhythm. I once walked up a hill the day after having a cardioversion and my heart went straight back into AF. Oh and it's not a good idea to have have any alcohol for a while.
They're not usually a cure, can last from hours to years. Remember what I said about not doing anything too energetic for a few weeks afterwards and no alcohol.
hi Jean can you let me know whether they put you on drugs after your back in NSR following CV. I went back into NSR in December following CV and I’m on 12.5mg of Metoprolol twice daily. I’m not sure why I’m still on it. My normal resting HR is 65-70 and in AF about 85. I do get ectopics.
thanks Jean same for me after my first in September but then second CV in mid December for Atrial Flutter, so now just on 12.5mg of Metopropol. Just not sure how long they want me on it. My resting HR is now abt 58 and normally without drugs about 68 and when in AF about 85 without drugs
I think it's to keep your heart rate low and not let it take off fast again. To let the heart grow strong beating slower. Your heart rate is fine at 58 My GP said to me pulse only of concern if goes low 40's.
No, your heart rate is not overly fast but you're breathless and fatigued so your cardiologist must have taken this into account when arranging cardioversion.
Jean has given you a very comprehensive reply to the actual procedure so hopefully that will give you some reassurance. (I've had 23 😬 and live to tell the tale....)
is there a age limit on cardio versions I’m in permanent AF for 5 years had one when first diagnosed lasted two weeks but not been offered any more my age 78
As CD has said, more about general health and most importantly how fast your rate is.
I had my last one 2+ months ago not long after my 78th birthday. My rates are always pretty fast ( and sometimes starting out at 240+ bpm) . Various measures rarely manage to get under 130/140 at lowest so it has always been 'emergency' cardioversion.
Incidentally my husband has been in permanent AF for about 4 years , heart rate 60s/80, asymptomatic, has had echo and on anti coagulation. Has never been offered dccv. Not that he would particularly want one anyhow ! He's 75 & has Parkinsons and Prostate cancer to deal with so AF is the least of his worries.
Hope you don’t mind me asking, so you have had AF for 28 years? I am feeling a bit low at the moment, because my atrial flutter/SVT has returned after 3 free years following an ablation. I am 55 and have been fighting anxious thoughts about how my heart or quality of life can possibly carry on for another 30+ years hopefully!!
I’m the same - I’m 43 and have gone from running 5 days a week to struggling walking up the stairs. Had one cardioversion that failed after 3 days (felt amazing while it lasted) and then had 3 ablations and I’m having a 4th on the 16th. Oh and had a cardiac arrest 6 months ago. I now have an ICD and pacemaker - I’m like an old lady now 😞
thank you for replying - what a rough time you have had, I am sorry. Are you in the UK? Were your ablations close together? Was the cardiac arrest because of this and caused by an electrical or ‘plumbing’ problem if you don’t mind me asking?
yes I’m in the UK and don’t mind you asking at all 😀 I had my cardioversion in June 21, first ablation in Nov 21, followed up by another in March 22 and a third in Jun22. They gave me Flecanide which made my heart rate explode so after a week I was quickly taken off it. There’s been no known cause for my cardiac arrest but we suspect the Flecanide prolonged my QT inverval and it was a perfect storm of ectopic beats, heat and just a freak occurrence. I was on holiday with family in Crete and thank goodness my husband came back to bed that day, he usually got up and sat alone drinking coffee for half an hour. He came back in and I was so happy he got back into bed because I didn’t want to wake so early but then my heart just stopped. He heard my agnonal breathing and thought it was a seizure until he realised and did CPR which thankfully worked.
Gosh, three ablations so close together - I’m surprised your heart had time to recover in between each one! Which hospital were you with?
Your experience on holiday sounds horrific - thank goodness for your husband. How are you coping mentally and what is the long term physical recover expected to be for you, given that you are young? x
I’m under Liverpool Heart and Chest. I never really thought about recovery time but do feel like I’ve been in a constant state of recovery since the first ablation. I’ve missed out on so many events and feel like I’ve lost 2 years with my kids and being able to do the things I’d normally do.
Mentally, I’ve struggled because of the worry that a cardiac arrest could happen again and I need to learn to trust my device. It’s only been 6 months though so still early days…..
The ICD and pacemaker should be like your guardian angels. I wish you the very best and for many happy times with your family as you grow stronger - it’s bound to take a long time to recover x
I think the points have been pretty much covered above. I am another pro (for) cardioverson.
The only downside is no one can tell you how long it will last. However, I had two years out of my last one which I was very happy with. Even if you just get two minutes it opens the door to other possible longer lasting treatments.
I haven’t had cardioversion as an option, but glad it has worked for you. True what you say about continuing medical advancements. I suppose I am viewing the future based on treatments now, but things could move on over the next 5/20 years.
Some very useful info above from the cardioversion experts. I have never in 15 years of AF been offered a cardioversion and my understanding was that it is often used as a diagnostic assessment as much as a treatment. That certainly was the case and explained very clearly to my husband who had one - NSR lasted 30 seconds after 3 shocks. My husband was then given very clear treatment options, risks and benefits of each. Without the cardioversion and knowing the outcome the options would have been very different.
Thank you for your reply. Do you mind me asking how old you were when you were first diagnosed - you say that you have had 15 years of AF? Have you had ablations during this time or do you take daily medications?
I am interested in how daily life is impacted moving forward over a period of time eg overseas travel?
to get a full reply you can browse my posts - synopsis
Diagnosed 2007 but had AF far longer than that.
I didn’t get in with the meds - Flecainide & Bisoprolol, refused all other options - 2007-20013.
Ablation 2013 Dec made things worse. 2nd Ablation 2014 after 3 days in NHS ACU. Both privately funded - London - as not offered on NHS at that time in my region - Devon.
No AF 2014-2017 but suffered TIA as I came off anticoagulants after 12 months AF free.
AF returned - can’t have any heart meds - ever now - so had Pacemaker implanted on NHS which my EP had to fight very hard to get the funding for as RAT PM. Hardly any AF since PM implanted 2018.
AF has never, ever stopped me travelling COVID & neurological condition and old age (my husband’s) has but sadly did curtail scuba diving & competitive sailing but the latter was also old age! Otherwise I’ve sailed, skied, flown in small planes, travelled long distance in big planes, trains cars and boats with and in AF.
Now in my 70’s & my husband 89 we don’t travel outside of Europe now.
Thank you very much for your lovely reply - you sound amazing with all the travels and activities!
It is so interesting to hear of your treatments - I am back on Bisoprolol, but don’t find it that it makes me feel very sluggish. I am glad that I stayed on anti coagulants, my choice , medics told me I could stop taking it. I will see what the consultants recommend and take it from there, but very heartening (no pun intended!) to hear of a long term life experience with this condition and I will try and stay strong!
You are in a super part of the country by the way - my 90 year old dad lives in Devon - I am in Hertfordshire.
I had low rate persistent AF but it made me breathless and fatigued my resting rate is under 60 - usually mid 50's and even when exercising never goes over 130 - and then only a short peak now and again. Cardioversions lasted in total about 3 years - I had 3 so the average length they kept me in NSR was a year. the first one was 11 months, second a little shorter but the 3rd one kept me in NSR for 15 months. I should have had an ablation the April of the first lockdown but of course that couldn't go ahead so in the end over all the lockdowns I lost my chance at an ablation as by the time I got to get one the tests and scans I had had were over 2 years old so EP asked for new ones to be done and they showed that my heart had remodelled itself and now a further procedure would be unlikely to have any effect. When in NSR I was so much better no brethlessness and no fatigue and coughing. I was unable to take any beta blockers or calcium channel blockers - or any rate control medication as they took my heart rate too low and made me feel far worse than the AF. Now I am in permanent low rate Af and all I take for it is is apixaban. I do wish I had been able to have my ablation and achieved NSR for longer. I cope fairly well in permanent low rate AF but I still get breathless and fatigued - only have to sit down and I fall asleep. I never had any problems with any of my cardioversions and loved being in NSR - so much more energy. Remember cardioversion is not a cure and it may last for months - in some cases years or days/weeks but even if it only lasts a short while it does mean that an ablation is likely to work so signposts the way to other treatments that may work better and for longer.
I had my first cardioversion two months ago and I am still in sinus rhythm. Best thing I have had done. I’m 48 and go to the gym about 4-5 times a week weights and cardio. I still did this when I’m Afib but I feel much better now. I still take 2.5mg bisoprolol (down from 7.5) when in afib. Rest heart rate is high 50s now. It was in the 90s in AF. I’d definitely recommend a cardioversion
Thanks for your reply Wingcommander. I hope it will be successful for me but as mentioned in other replies, it may be a way to discover other treatments,
I've had 8 that have lasted from 4 days to a couple of years. The more successful ones have been with Amiodarone prior to the procedure.I'd rather have one of these than a tooth pulled.
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