answers please

[Sally_Scott]

I had OH surgery 4 weeks ago. Came home and went into permanent Afib. I’ve got a PM. I’ve been on flecanide twice daily for last 2 years.

I went to local hospital last week and was told to go on Bisoprolol I must be totally allergic to it as was really sick, dizzy,faint, eye probs. So I took myself off and back onto flecanide.

lim due for a cardioversion tomorrow morning but since yesterday my HR has been in the 130/140. When I go into hospital tomorrow will they still do cardioversion or will they want to get my HR down first?

[Cat04]

As far as I understand it your heart needs to be arrythmic/fast to be able to do a CV. Otherwise there is nothing to convert.

[mjames1 in reply to Cat04]

While a reduction in heart rate should come after cardioversion, the procedure itself is not to reduce the rate, but to put the heart back into normal rhythm. You can have a slow heart rate with afib, either naturally or because of rate reduction drugs, but you can still be cardioverted.

Jim

[BobD Volunteer]

The whole point of cardioversion (DCCV) is to get your heart rate back to normal.

[mjames1]

That's a really thoughtful question. I've had 3-4 electric cardioversions (ECV's) and in each case my HR was brought down first with drugs. But I think that was more a function of making me more comfortable/safer as I had to wait overnight for an ECV, and not because it was a requirement of the procedure. I'm sure others will share their experiences. In any event, I would not worry, because if the rate does need to be brought down, they can do that very quickly.

Jim

[Ducky2003]

I've been cardioverted at similar rates. The procedure is to stop the AF, hopefully bringing down the HR at the same time. The HR may still remain high even though they get you back into rhythm so you'll need meds to deal with that........ beta blocker or calcium channel blocker.

[BlueINR]

The reason for doing a cardioversion is to get rhythm and rate back to normal.

[Nakesero]

Hi Sally,

Sorry to hear about your difficulties and hope that you do get some positive news soon. My situation is rather different to yours, I am in permanent Afib as from last year but do have some experience of Bisoprolol which I was put on along with Ramilpril, exdoxoban (anti coagulant) and dapaglifozin. The symptoms of Afib were quite mild (it was only picked up accidentally when I went for a hernia pre - op, the phone GP consultations regarding breathlessness when running were dismissed as Asthma related - a pity they couldn’t take my pulse over the phone. Until diagnosis I had never heard of Afib) Anyway, the diagnosis meant meditation was essential for obvious reasons but I ended up feeling that the solution was worse than the problem for me was Bisoprolol. I felt devoid of motivation, ‘disconnected’ almost depressed, cold hands and feet, awful bowels and running nose. Apart from that it was fine. I was taken off it and put on Amiodarone - which can be very toxic and can have very serious side effects. I have been fine on it, so much so that at pre op for Cardioversion the procedure was cancelled as Amiodarone had put me back in sinus rhythm - which was a real bonus.

One thing which has been apparent to me is that identical drugs of identical doses appear to have hugely different effects on people. All I can suggest is that before you alter or omit any medication you talk it through with your cardiac team or GP as they will be aware of any consequences of withdrawal from a medication and should suggest an alternative which will have the desired effect and work for you.

Hope all goes well for you, good luck, it seems that we are all on a long journey of discovery. Best wishes

[Sally_Scott in reply to Nakesero]

I had my cardioversion this morning and thank god all worked. They reset my pacemaker too. I told the registrar I had taken myself off bisopropil and gone back onto flecanide and he said that was fine. Now I can start to heal after my OHS.

[Giorgos1973 in reply to Nakesero]

what dose of bisoprolol were we on and for how long

[Sally_Scott in reply to Giorgos1973]

think 4.5 and for a week. That was long enuf!

[Poochmom]

I’m perplexed why, when they did open heart surgery, they didn’t do the Cox IV maze for AF. That is what it was designed for. I hope you get it figured out the best way for you. 🙏🙏

[Sally_Scott]

I had 2 new valves done plus I hadn’t been in Afib for 2 years. The op itself triggered AF after the op.