Hi there , i haven't been on the website for a while as everything seems to have been going well ..too well in fact which is why I'm hoping for some advice from anyone who's shared the same or similar experience... I have been on flecanide and bisoprolol since march last year small dose of 50mg twice a day and 1.25 mg bisoprolol once a day for my afib episodes which were nearly every other day for about two to three hours long.. i was also advised by cardiologist to reduce my fitness training as he said its quite intense with a lot of hilly fast cycle rides , gym work and swimming...his take on it was if I reduced training by at least 50 % that my heart could settle down after 6 to 9 months..so I've done that with no cycling or gym work just a couple of moderate swims each week and walks a week since April last year...I have not had an episode or felt like going into an episode since i started the flec and bisoprolol so tried halfing the dose last October to 25 mg flec twice a day and 0.75mg biso once a day , and still no sign of an episode...my question is do I still push for the abalation or hold off a bit longer in case the cardiologist was right that the intense training was the cause...I don't want to come off the abalation waiting list and start wiv afib again only to find I have another 18 month wait for an abalation.. any advice would be greatly appreciated thanks andy..
Upcoming abalation concerns - Atrial Fibrillati...
Upcoming abalation concerns
Similar situation except I'm 20 years your senior, so not the same.
50mg of flecainide twice a day (bid) has stopped my episodes pretty much for close to a year. I also held well at 25mg bid for many months with only a few aflutter breakthroughs. Tried 25mg once a day but had a short episode of afib after three weeks so went back to more. I saw an ep and decided to have an ablation which probably will be in about six weeks.
That said, if I was 20 years younger, I might wait a little as long as the flecainide was doing the trick and I tolerated it well. One reason for waiting would be pulse field ablation (PFA) which is arguably a quicker and safer procedure, but not yet widely available and not available at all in the US, except in trial.
However, I decided that best to the ablation now, before I get much older, possibly developed more comorbidities and was not as good a candidate.
On the other hand, here in the US, the wait list is closer to 6 weeks as opposed to having to wait another 18 months in your case. Not an easy decision or a right answer. In any event, I do think knocking down your training a couple of notches will not only serve you well pre-ablation, but post-ablation as well, should you go ahead with it.
Jim
Thanks for the reply Jim. I am leaning towards the wait a little longer idea but maybe cause I'm a bit of a coward as well lol..I have heard of the.pulse field method and will talk with the electrophysioligist next week... all the best wishes for your abalation I hope it goes well for you thanks andy..
It is well known that such training causes AF especially in people of your age group so why not accept your doctor's advice.
We always say here that the first line of attack on AF should be life style and curbing excess excercise is as important as weight loss, stopping alcohol and all the other things shown to aggravate the irritated heart.
I am a great fan of ablation having had four but remember that all and any treatment is only for quality of life (QOL) as there is no difference in outcome whatever treatment you have.
Hi Andy. Good to hear that you've been doing well and experiencing an improvement in your afib since starting medication.
While it is possible that reducing your intense physical activity may have helped to stabilize your afib, it is also possible that the medication is playing a significant role in controlling it. To get a clearer picture of the potential benefits of each option, it would be wise to discuss it with your EP. Consider the pros and cons of proceeding or holding off a bit longer.
If you do proceed, it's likely you'll continue taking medication to help control afib symptoms in the early stages after the procedure. Personally, I'm holding tight right now. One more CV and meds then I'll pot for the mini maze or PFA. The mini-maze is first on my hit list - if I can get that I'm knocking the rest on the head and diving in on that one. I'm working behind the scenes now and will write an update very soon.
Paul
Hi Paul thanks for the reply mate...you are right of course it most likely is a mixture of both lifestyle and the meds that have helped..I shall indeed have a good talk to the ep next Sunday and only hope he can give me the correct advise...yes I have heard the mini maze can be a very good solution to these problems.. I followed mummy love on here who had the procedure last year and she seems to be doing really well after it...I hope you manage to get one mate and it sorts your problem out..take care and all the best...
I don't totally agree with that.
I think that, if I had I not had the ablation, my life would be shorter. The AF did weaken me.
Hi Physalis. You make an interesting point. However I don't think ablation will necessarily increase your life span but is aimed more at QOL. If rate control is managed effectively and you make some lifestyle changes this 'could' be just as effective.
Maybe I'm making the wrong call by waiting. Who knows - time will tell.
If you have a minute please tell me why you think ablation will prolong your life?
Enjoy your Sunday.
Paul
hi Paul, interested in you comments. What specific “lifestyle changes” - apart from exercise and diet - did you have in mind that could make the difference just as effective as medical intervention ? Lifestyle change often means different things to different people. Harry
Hi Harry. There are many things you can do. An example of which is to practise good dentail heathcare. A tooth infection can have a direct effect on the heart. Oral health is very important.
Eat well, live well and think well. A positive mindset is very important - I promise you that. Learn technics to relax. Learn proper breathing technics. Join a new social group and have a good social life - these things lift our sprits and if you feel good your heart will too.
Get rid of as much stress in your life as possible.
Really Harry the list is endless - make positive changes and your heart will be grateful. Your key word is positive. None of this will be as effective as medical intervention but the two together will be of huge benefit.
Paul
thank you Paul. Wise words indeed. I can’t disagree. It has obviously worked for you. But all this requires determination from the outset doesn’t it. I suppose for many of us it’s about tackling the “quick hits” first on your list - the bits that are easy to change. But certainly for me I find some of the other strategies you suggest very challenging and unsustainable. Being positive about becoming more positive is one of them. Thank you so much for your very helpful insight. There’s lots to take away and somethings I will think about adopting. Harry
Hi Harry.
Sure maintaining the right strategies can be difficult. Just take baby steps and one day at a time.
Good luck and have a lovely weekend.
Paul
If you are already on a waiting I would continue on the waiting list as they can be long, you can always cancel nearer the time. If not on a waiting list then take the advice of your EP.
As Bob says, often Lifestyle changes such as reducing exercise regime is sometimes enough.
Well done, I think reducing the exercise (many find this difficult) is a key factor. However I also think due to your episode history that you need to keep taking the drugs with the reduced exercise regime for another year before scaling them back and the exercise up.
I would also have a word with your cardiologist/EP and see if you can come out of the ablation queue and go back into it in 12 months time. Worth asking.
Thanks for the reply that is something bi shall discuss with the ep next Sunday...but o have no intention of starting to up the excercise again weather an abalation or not..I've felt just as good with moderate excercise and no I'm not putting my heart under any extra strain, all the best
Hey Andy,
I'm down for a radio frequency ablation on the 14th March (in Edinburgh) I'm now wondering if I should have it done. I'm terrified already so heaven help me come the day!! But not just because I'm really scared. I stopped taking 150x2 daily Flecainide though still on the 5mg Bisoprolol once a day and although I've had a few 'episodes' lasting hours, they actually seem to have stopped. Fingers crossed I'm not jinxing myself. So now I'm a bit confused whether to have this procedure done at all. I'm having a GA for it and will be kept in at least overnight. Oh it's a blooming pest all this AF malarkey is it not?? Whatever you decide good luck and stay well!
Blue 
It is indeed a headache not knowing which decision to take for the best...have you been on the flecanide for long or just put on it recently ??..can you have a talk to your cardiologist about what's happened with the episodes stopping and see what they think to do for the best...im hoping for some guidance but think they don't like to influence to much and leave it to the patient to make their minds up more nowadays in case it ends up being the wrong decision...i hope whichever you choose it works out well for you...
Hi, thanks for the reply. Today is not so good I'm sad to say and have been 'fluttering' since very early this morning. I have a chest infection and am now on antibiotics so all in all.....I tempted fate right enough saying it had all stopped! I was diagnosed with PAF in 2013 and put on Flecainide and Bisoprolol way back then. I now have the addition of Amlodipine and Edoxaban to my cocktail!! Today is reminding me just how horrible it is with that 'bag of worms' feeling up and down inside!!!! stay well
Blue 
Oh dear it is so unpredictable isn't it , it could be the chest infection that is causing it to flare up maybe...im still unsure about the abalation but I think if I was in your position I would probably give it ago ...I hope the flutter stops very soon for you and you feel better soon...all the best
When my Cardiologist told me I was I was an ideal candidate for an ablation I bought in. Then my AF was bordering on persistent with 3 episodes a week lasting at least 18 hours. After the procedure in 2018 I feel good and have a much better quality of life. You would have to weigh up your situation because if your meds are controlling your AF you may decide (with discussions with your EP ) that ablation is not the route. Post ablation I have returned to gym and attend 4 days a week. But I am approaching 70. Good luck going forward.
Thanks for the reply and glad to hear you are doing well after your abalation...all the best
Hi,
I think that's the deciding point....the medication doesn't seem to be working well for me. Yes, for a while then it's all over the place and definitely affects my quality of life so reading your comment kinda hits the nail on the head for me, especially today when it's running riot!! Stay well,
Blue
I’m not on the meds you’re on. They immediately put me on Eliquis, I guess because of my high blood pressure history. I was 70 years old when diagnosed. I did have the ablation September 2022. At first I wasn’t seeing much difference in my Afib encounters.
I have since had my last Cardiologist appointment until next year. I’m having fewer Afib episodes and I was able to return to playing tennis this week after 11 months of not playing! I keep praying for a complete healing.! The cardiologist had suggested a second ablation but I’m waiting it out. The best to you in your health also.
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