Cardioversion - preparation and after... - Atrial Fibrillati...

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Cardioversion - preparation and aftercare - advice please!

Rainfern profile image
36 Replies

Hi everyone, and hope a day of sunshine has raised spirits!I've been placed on a waiting list for cardioversion by my EP which I'm really happy about. I was diagnosed with AF last September or October (got a cat on my knee so can't get up to check the date!) and this rapidly progressed to persistent. I was very fit prior to Afib and now feel I've aged 10 years, breathless on hills etc.

My question: Does anybody here have advice on getting the best outcome from cardioversion, or is it really all luck of the draw? By best outcome I mean getting back to normal sinus rhythm for as long as possible. What did you do to help stay in NSR? Lifestyle changes etc.

I know cardioversion isn't considered a cure but would love any advice - like how quickly you started exercising a bit harder and if that helped or not, if meditation and relaxation helped, if you tried any complementary meds or supplements. Hope this all makes sense se! Thank you.

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Rainfern
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DawnTX profile image
DawnTX

I wish you the best. My first one was phenomenal. I woke up with a smile because somehow my whole body knew it was feeling good. Unfortunately, it only lasted 3 1/2 weeks. I loved every minute of it I think I felt better than I had ever felt in my life. I had my second less than a month later unfortunately, it did not work at all. It really is luck of the draw I’m afraid. The original plan for me. The second time was to put me on Tikosyn They keep you in the hospital to make sure there are no bad issues with it. When it goes well, it should keep you in NSR if all goes well. I have heard some wonderful stories. As you probably know already, a fib does what afib wants to do. If you have a great medical team like I did, it should be over before you know it. They step in and do everything just relax. I don’t remember falling asleep and then there I was awake. I still smile remembering how I felt when I woke up sending you thoughts and prayers on a good one. 🙏🏻❤️

Rainfern profile image
Rainfern in reply to DawnTX

Thank you Dawn, that's really reassuring. And your description of those three NSR weeks, and your joy and gratitude is just wonderful. I feel that if I can keep that kind of positive and generous attitude then whatever the outcome its all gonna be OK! I hope you're on a good path of recovery now 😊

DawnTX profile image
DawnTX in reply to Rainfern

i’m not positive, but it may have been Jeanjeannie50 who inspired me first and got me over the fear. They do it a bit different here in the states, at least where I am. I had two nurses come to me, smiling and introduce themselves and told me they would be with me throughout the day. Everyone that came in introduced themselves and told me what they do. It was actually pleasant and when I went to leave at the end of it, I was almost in tears. I had grown so attached to everyone lol. The time will flyby. I don’t remember, falling asleep, except they gave me something to bite because they did a TEE down my throat to check for blood clots. Prior to that we even had some laughs over the spray that I had to have in my throat, trying to decide what flavor it was. Procedures are what you make of them I think. I have a feeling she might be a bit like me. Have a good attitude. Remember they are there to help you. I was spoiled and felt like a princess. Please let us know when you were going in for it so we can find out how you’re doing.

DawnTX profile image
DawnTX in reply to Rainfern

I shoot from the hip I won’t lie to you. I have had my pacemaker one month. I have no regrets but I have good and not great days. That being said, I feel so much better than I did just one month ago when I could barely walk across the room, and when I did, it was in pain as well as being breathless and queasy. The pacemaker situation is completely different. The first was not that big a deal. Two weeks later they did the AV node, and like all ablations you may feel some ache etc. Considering what is being done and again, what a wonderful thing it should accomplish for anyone getting it. It is well worth whatever it feels like. I think the worst of everything was a sore throat. I am still amazed at the miracles that they can do for us, considering how awful a fib can make us feel. Please let us know when you’re getting it as far as your cardioversion so we can see how you are doing. This is the place to come to when you need support. I knew absolutely nothing about a fib in the beginning, and between the people here and my new doctors, I feel like I should get my medical license lol. The one thing I would suggest is don’t get so deep into it that it takes over your life. I keep readjusting my attitude because right after the pacemaker, I was paranoid about things and if I let myself, even know , I hear and feel my heartbeat etc. do not keep taking your numbers. I was told that by my doctors cardiac nurse because again you get too involved. If I’m not feeling right, I will take it for a baseline but that’s it. When you get your cardioversion yes be happy if you wake up, feeling good and your heart rate is suddenly stable and a good number. I swear I had the giggles. I was so happy. What is interesting to you is when your circulation gets going how quickly even your coloring will change. My cousin took a look at me and said I looked alive. Now that I have my pacemaker, I keep getting excited over pink toes lol my skin has looked a bit like the underbelly of a dead fish. Yes I’m being goofy. This is how I try to get through things that I find difficult. I worked law enforcement, and when you do that you get a quirky sense of humor it helps us to survive. Big hugs.

Rainfern profile image
Rainfern in reply to DawnTX

Ah Dawn, could tell you were in a people profession! I worked in mental health, and you never lose the sense of valuing people and the bonds you make.So glad to hear your pacemaker has made all the difference, and great advice not to get too entrenched in detail - the real art I guess is how we adapt. Along with quirky humour!

Thank you x

DawnTX profile image
DawnTX in reply to Rainfern

kindred spirits 😊🤗

jeanjeannie50 profile image
jeanjeannie50

I've had several and can assure you there's nothing to a cardioversion and the following is what I've experienced.

You go to the hospital, sit around waiting for about an hour for your turn. You go in, get undressed and put on one of their gowns. You lie on a bed and someone comes and puts a cannula in the back of your hand and you're wired up to a machine that's showing your heart rate. The team turn up all bright and happy (doc and some nurses). You have the GA injected into your cannula, are zapped and then wake up a few minutes later and for me I'm always back in normal sinus rhythm. The feeling of joy is like no other and gratitude to everyone involved sweeps over me - honestly I could kiss their feet!

At my hospital they want you to eat some toast and have a cup of tea before leaving, that's it! They tell you that you need to have someone with you for the next 24hrs and are told not to sign any documents during that time.

A word of warning though. Afterwards don't do anything to raise your heart rate for a week or so, no walking up hills, or lifting anything heavy. Allow your heart to gain strength beating at it's correct rate. I once made the mistake of walking up a hill the day after a cardioversion and my heart went straight back into AF. Oh, no alcohol for a while after either.

Best wishes

Jean

Rainfern profile image
Rainfern in reply to jeanjeannie50

Thank you Jean that's really helpful and reassuring - it's good to know what to expect. It's so easy to overdo things as soon as we have a bit more life and mobility so I'll try and avoid running upstairs! I've been trying out alcohol free these past few months and will probably stick to that.

DawnTX profile image
DawnTX in reply to Rainfern

I just said this to my EP recently when I had things going on that made me nervous with my new p.m. Once it was explained to me, it was no longer scary. It would be wonderful to know what to expect as far as what is normal and what to watch out for. My p.m. tech made a comment that I took to heart in the hospital with my doctor standing there. Evidently it’s slid by my doctor. I mentioned how great I felt with my one successful cardioversion how instantaneous the miracle of feeling good was, and how happy my entire head and body felt. The text stated that from what he understood that’s exactly how it is with the pacemaker. WRONG!!!! of course I expected soreness with stitches and all but I had not thought about the fact I had my AV node ablated know I did. I think about what my other ablations had felt like. They aren’t that bad as a rule but you know you had something done trauma has been done. Even your finger aches if you cut or hurt it and it takes time to heal so except for the strange feeling of something strange on the left side of my upper chest, I felt pretty good the first day or so, but then, although I felt better than I had previous to everything I was far from feeling good. I could also feel palpitations, etc., I had been told the PM does not help flutter. With all of this going on my heart rate went up above the 80 I was set for so of course that scared me. Again, I am so grateful for my EP and his assistant. She went over everything with me and explained answers to my questions and concerns. I was concerned about the continuing ache and pain in the center of my chest because after every procedure, I have ended up with pericarditis. It is easily treated when diagnosed but I wanted to make sure I got the help I needed if I needed it. Before she called me back she had already set up an echo with my cardiologist, if it would make me feel better to get one done and find out one way or the other if I had pericarditis again. Having everything explained made the fear go away, and I realized it all made sense. She said sometimes people are lucky and feel good right away, but very few people are like that. That’s when I told her what the tech had said to me. She said no no no he should never say that to anyone. I have a feeling he won’t be doing it anytime soon again lol we don’t know what we don’t know and we try to trust those we expect to have answers.

mjames1 profile image
mjames1

If you qualify, I would ask to be put on a daily anti-arrhythmic like Flecainide ASAP and continue with it after the cardioversion. If you do not medically qualify, a short course of amiodarone both before and after the ablation. Yes, amiodarone gets a lot of bad press, but the risks for a short course may be worth the rewards it brings to the table holding you in sinus rhythm. If you revert back, ablation should be considered.

Jim

Rainfern profile image
Rainfern in reply to mjames1

I don't think my EP is keen on anti-arrhythmics for me at this stage, at least when I told him I wasn't keen he didn't push it. He said it might be a route I'd want to take if the CV fails. He's very much of the mind that CV will indicate if ablation is the best way forward. Thanks Jim, always appreciate your knowledge on this forum.

Afibflipper profile image
Afibflipper

Hi Rainfern, that’s great news for you 🤞. My 1st lasted 4 days, the 2nd was 7 weeks. The 2nd I was given a couple of jolts so having sensitive skin it was a little sore on day 2 (like sunburn) and aloe vera gel was great. I also got heart burn (no pun intended) type pain central sternum that radiates over to left side so took pain killers. I was pretty tired for couple of days. Can’t recall (probably by end of week I think I started walking and built up over the 6wks from not getting upstairs at home to doing 3-4 miles x

Rainfern profile image
Rainfern in reply to Afibflipper

Thank you Flipper. I've got an aloe vera plant so can use that if there's burning. Sorry the CV didn't last long for you, that does seem to be the way of it so often. Im hoping that because my AFib is fairly recent it might work for longer, and I'm allowing myself a bit of magic thinking- like winning the lottery a ten year respite could be me! I hope you are doing well x

Afibflipper profile image
Afibflipper in reply to Rainfern

just a slight red mark (burn) just felt more than it looked. I have heard there’s more chance of CV working if it’s recent so here’s your magic wand 🪄 black cat 🐈‍⬛ & glitter✨ 😆 I’ve not been good, despite NSR something is a miss, extremely breathless, lots of fluid retention etc so stopped digoxin, Echo & bloods to see if I’m malfunctioning in another fuse box along the line. Rooting for you so let us know the date you get and how it goes. X

Norfolk_spaniel profile image
Norfolk_spaniel

I've had 4. First one lasted 10 years, next one 2 years, next 6 months and next just a month. They all worked on the first try. Nothing to it and you feel fantastic from the next day. My advice is to avoid alcohol and caffeine and keep well hydrated. I hope it goes well for you.

Nursingirl profile image
Nursingirl

my 40 year old son went into afib. We are in America. He saw and cardiologist and then got set up for cardioversion with an EP. He had to be on his Elequis consistently and after 5-6 weeks he had it done. That was April 3. He also had a nuclear stress a couple weeks later and we are thanking God is in NSR. He has more energy and exercises 5x/ week. Hope all goes well for you.

allotmentman profile image
allotmentman

Hi Rainfern,

had a Cardioversion in Feb 2021 and since then been in NSR apart from three small incidents. As far as I can tell these incidents were brought on by food and each incident lasted about 3-4 hours.

With regard to to staying in NSR, I have dramatically cut down on alcohol, no more than 1/2 glass of fruit cider or a small glass of wine 2-3 times a week. Coffee and tea is now decaffeinated and I make sure I go for a decent walk 5 times a week and I joined a gym with I attend twice a week. The walks and gym started about a week after the Cardioversion.

I also invested in a Kardia mobile device which has been very reassuring and allowed me to document my three small incidents.

Good luck with your Cardioversion and remember to take the tablets.

Tim

Rainfern profile image
Rainfern in reply to allotmentman

Thank you Tim, good to hear that your CV went well. That sounds good advice and hopeful too - can't imagine joining a gym at the moment but look forward to some longer walks! I'm low alcohol only and decaff coffee.

I assume by your forum name you have an allotment too? How's that going? I feel so bad I'm leaving all the heavy work on our allotment to my husband, but hopefully will be back in better form after the CV (and with the warmer weather!)

Please can you tell me what Kardia mobile you recommend?

allotmentman profile image
allotmentman in reply to Rainfern

Rainfern,

Hi, yes I have an allotment which keeps me busy. The weather is just turning so lots of digging over and seed sowing going on.

I use an AliveCor KardiaMobile (that's the name on the box) which I purchased via Amazon for about £90-£100. I have an Android phone and it works well with that. I only use it to check my heartbeat if I believe I have slipped out of NSR.

Good luck with your procedure.

Rainfern profile image
Rainfern in reply to allotmentman

Cheers, I've checked out the AliveCor Kardia Mobile online and it has thumbs up from NICE too. I was looking at Apple watches and turning green - would have cost a small fortune as I'd need to buy a high end Apple phone too! That's saved some!

Nick1957 profile image
Nick1957

I requested to be put on the last minute cancellation list and was seen within 3 days. As for prolonging nsr I'm sure you will get loads of advice from this forum's excellent members.

Rainfern profile image
Rainfern in reply to Nick1957

Thank you Nick. That's a great idea.

DKBX profile image
DKBX

Do all the lifestyle changes listed above (especially ditch ALL booze), go easy, breathe deeply and do yoga, eat healthy, live your life, and de-stress. Find the best EP team you can. Trust them (the true experts) completely rather than anecdotal opinions like you’ll find here with me!

Be prepared for a long journey and many return’s unfortunately. I’ve been through more different drug regimens, countless cardioversions, and five ablations over the past ten years trying to tame the beast. It’s all about enhancing your QOL and remember that it won’t kill you … just makes you feel like it will!

Rainfern profile image
Rainfern in reply to DKBX

Thanks DKBX for a heartening response, especially the de-stress and live your life bit! I need reminding from time to time 😊

Ducky2003 profile image
Ducky2003

I've had them last between 4 days and a couple of years but you feel instantly better, in my experience. The longer lasting ones have been with priming from an anti arrhythmia med.I think someone above mentioned having GA but I've only ever had sedation.

I certainly wouldn't go overdoing it afterwards. I had a week off work for mine.

Hope it manages to get you back in nsr as you'll feel a whole heap better.

Rainfern profile image
Rainfern in reply to Ducky2003

Thank you Ducky. I'm planning a week of of rest and then very gentle qigong exercises - a bit like Tai Chi but less confusing! It helps to know you were back at work after a week.

Ducky2003 profile image
Ducky2003 in reply to Rainfern

Yes, go very gently for a couple of weeks. I only work part time so if your job is quite physical, you may want to give it longer.

Tantaanna profile image
Tantaanna

my first (I have many- after my second and third ablation during the blanking periods (healing) lasted six months.

Jeanie said it all. I was so nervous the first time and it went quickly and smoothly. As I do now I do deep breath’s- long on the exhale as I wait during the prep time. Felt great afterwards. NSR lasted six months for me, with some longer. All my best to you

Rainfern profile image
Rainfern in reply to Tantaanna

Thank you Tantaana. Isn't deep breathing wonderful! I do box breathing and 4-7-8 breathing quite regularly. It helps bring heart rate down and is so calming!

2learn profile image
2learn

Hi, I've had 3 cardioversions, all kept me AF free for over 12mths. I could stop bisoprolol immediately as it knocked me out if I continued it and my heart etc was working fine without it. Stayed on blood thinners as advised. Didn't change lifestyle afterwards and could exercise so not sure what caused me to go back into AF didn't really analyse just assumed it was the way of AF and cardioversions are not a cure. I've also had 3 ablations and my experience is cardioversions were more effective and much less hassle.

Rainfern profile image
Rainfern in reply to 2learn

Thank you 2learn. It's good to know cardioversions can be effective over time, even if not forever. It seems like a very straightforward process and listening to you all here has put me at ease without giving false hope.

Loafinabout profile image
Loafinabout

I too was fit before AFib and had a Cardioversion. All went well for about 3 months and while I went. walking in a group - and the pace was too fast for me - which took me back into AFib. I had another Cardioversion and all good - I learned a hard lesson and although I walk most days it’s at a moderate pace. I’m good for all household/gardening/DIY jobs so life for me is normal. Much depends on your normal lifestyle/hobbies/fitness level and the key is not to go to excess

Rainfern profile image
Rainfern

Thank you Loafin - that's so useful. I could decide that without my ramblers group life would be less, but actually I've been wondering if that's a sensible aim. Walking most days at a moderate pace sounds a more sensible plan - plus more likely to spot wildlife going a bit slow!

BlueINR profile image
BlueINR

Don't think there's anything you can do to prepare for the outcome of a cardioversion. It either works or it doesn't. I've had 18 in past 2 years, and most recently it was pace and ablate for me, a pacemaker after 3rd ablation.

Not always in NSR, but not having heartrate of 140+ either, so I don't know what to say. Don't know how long you have to wait for your cardioversion, I've never had to wait more than 12-16 hours, as I was always admitted to hospital. You can ask your doctor about an Rx med. I avoid supplements. They just make the supplement companies richer, doubt if there's anything that can truly help with afib.

Banquo profile image
Banquo

Hi Rainfern,AFib does make one feel older! Knocks the fitness and even the will to exercise, at least it did for me. I was in and out of AFib over a couple of years before I even knew what it was...eventually went into AFib for a month and went to the ER.. 4 days later they did a TEE cardioversion .. finally! They tried meds and all that first to get me to revert and it didn't work. So in I went and they checked for clots (TEE) and then rebooted me. I woke up in sinus and was happy as a clam..had forgotten how good that felt. They held me for observation overnight and then was released. I actually went for a low key short hike with my friend after leaving the hospital. I felt great and so pent up from the hospital days. I was put on flecainide and diltiazem and a blood thinner .. got to drop the blood thinner after a month..but stayed on the other two, my cardioversion lasted about a year, then AFib started breaking through again.. and I started down the ablation road. Anyway! The success rate on the cardioversion is pretty high. As my doc told me, eventually I would break through the drugs but at least I made it a year! I've read good things about coq10 and magnesium as heart supplements. I added those to a B complex for a while. Does it help? Meh...who knows with supplements. Some swear by them others don't, and they can be pricey. Personally I take a few supplements every day.

Good luck with the cardioversion! It is scary in some ways I'm sure.. but really little to worry about overall and lots of potential upside .. cheers!

Rainfern profile image
Rainfern in reply to Banquo

Thank you Banquo, just found your post. I'm off for the cardioversion next week!

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