Also in Persistent Afib

[theluckyone]

I am in continous afib with a slower than normal heart rate (brachycardia). I experience no symtoms. I'm on the blood thinner Eliquis, 5 mg, 10 AM and 10PM to prevent my having a stroke.

My cardiologist (who performs many ablations per year) recommended I do an ablation. I consulted with another cardiologist for a second opinion. He said as long as I don't experience symptoms and I'm stable on my Eliquis medication, I'll be fine by continuing on my Eliquis medication without an ablation. I followed the advice of my consulting cardiologist and I'm doing well. I changed cardiologists which has worked out fine for me.

[secondtry]

No experience of your condition but wondered if continuous Afib may remodel the heart over time.

[sleeksheep in reply to secondtry]

I had my first ct angiogram a bit over a week ago. Eight years in symptomatic AF controlled by Flecainide and Diltiazem for four of those years ( I just prefer to forget how utterly useless Sotalol was ! ) , For the last seven I have been asymptomatic and only taking Diltiazem ( anticoagulant for the whole fifteen years thou ) .

My heart showed minimal enlargement same as what you expect to see in any seventy year old, arteries where practically clear - so all round a good MOT test.

The cardiologist doesnt want to see me for another three years.

[Desanthony in reply to secondtry]

continuous or persistent AF will mean the heart remodels over time - just how much time it would be hard to know. I too had low rate persistent AF and had 3 cardioversions over just about 4 years which put me back in NSR for about 3 of those years so was on the list for an ablation which should have taken place at the beginning of Covid Lockdown then the hospital cardio unit had to close down because 15 people on the unit and 5 patients went down with Covid at the next appointment so by the time my EP got back in touch it was about 2.5 years later and he said I had to have all the angiograms etc done again and found my heart had remodelled itself and they would no longer consider either another cardioversion or an ablation as it was unlikely to be of benefit. So now in permanent AF. I am coping well but was far better in NSR. Having said that I manage to do all the things I did before just probably not quite as well and not as quickly as before. Personally if offered an ablation I would always go for it and the sooner on your AF journey the better as I had to wait 5 months to even see an NHS cardio so went private for both Cardio and EP in the end - there was no EP in our area - even a private one at the start of my journey so had to really fight hard to where I got in the end and as soon as there was an EP here made a private appointment to see him. Just so disappointed not to be able to get an ablation. No one can make this decision for you you have to weigh up the pros and cons of this and see what will suit you best. If you are younger than I am - which let's face it at 79 most people are, you may be able to stop taking Eliquis after a successful ablation - it would have made little difference to me as I would, at my age be advised to take an anticoagulant anyway but maybe for some this would swing the decision - though you won't necessarily be able to stop anticoagulant use after a successful ablation anyway as presumably the risk would still give you a chadsvasc score which suggests anticoagulant usage for stroke risk as you have had AF.

Best of luck.

[sheffbk in reply to secondtry]

I could write almost exactly the same as theluckyone -- bradycardia (resting HR 35-55, always irregular, exercise HR up to 125, gets much more regular), 24/7 Afib, sometimes also flutter at night, but feel well, v active for a 75 yr old, first awareness over 20 yrs ago.

My well trained. experienced EP cardio consultant recommended ablation, but at that point I happened to meet with two highly regarded EP profs/researchers/heads of cardio, who both said that on balance I would quite likely be just fine without (have to say this was not a formal 'second opinion' with all my notes etc.) I chose not to have the ablation. My EP was sceptical, but to his credit he accepted the reasoning and choice.

That was 7 years ago, and things have been just fine. Only drug taken is a DOAC - apixiban.

I know the language might have to be technical, but would someone explain what they mean by 'heart remodelled', please?

[secondtry in reply to sheffbk]

My use of 'remodelling' is just my layman's word ( def no tech) for a change in shape.

[CDreamer in reply to sheffbk]

Dilated is another word sometimes used or enlarged atria.