I've been in AF since mid November 2022 having previously had only the odd episode of no more than 6 hours. All started after the C virus vaccine and then after the boosters. I consulted a private EP and he has prescribed Amiodarone followed by cardioversion. Presumably that will lead on to ablation if the exprience of others is anything to go by. My heart is otherwise healthy. I keep putting it off mainly due to the bad side effects of amiodarone. Meanwhile my blood pressure is not adequately controlled by my current medicines but the GP won't change anything. I've read quite a lot about AF and also other people's experiences. I'm fed up with feeling like this and it has certainly impacted on my quality of life. When I read your stories about ablation it seems a pointless exercise because each time healthy heart tissue is burnt away and this doesn't always facilitate a cure. Looking forward to hearing from anybody who has the cardioversion that has successfully cured AF; where they went for treatment and any other tips. Many thanks.
Uncertain about Amiodarone and cardio... - Atrial Fibrillati...
Uncertain about Amiodarone and cardioversion
A DCCV (cardioversion) will not cure AF. It may hopefully return you to normal sinus rhythm (NSR) and if so may indicate that an ablation may help. There are no guarantees and it is very important to understand that any and all treatmnet for AF is only ever for quality of life i e symptom control. There is no difference in final outcome whether a patient is treated with rhythm control drugs such as amiodarone , flecainide etc. rate control such as beta blockers or ablation. provided of course that that person is suitably anticoagulated where appropriate since stroke is really the major risk with AF. .
Is ablation worth it. It was for me since three years after my final ablation in 2008 I was diagnosed with prostate cancer. I had quite a fight with doctors to have major surgery during the course of which it was discovered that the cancer had already escaped the prostate meaning that I went on to have both radio and hormone therapy. Had I not had the ablation and still had AF they would not have operated , gone straight to radiotherapy which would have missed the cancer and it is highly likely you would not be reading this. As my old uncle would say, "you don't know what's hanging till it drops".
Cardioversions would always work for me, but you must take it easy afterwards. I once walked up a hill the day after having one and my heart immediately went back into AF. When you have yours let your heart gain strength beating in its correct rhythm, before you do anything that requires effort. Don't wear tight clothing around your waist or ribs. Other cardioversions I had lasted for months to years.
After three ablations I'm now in constant AF, have been that way for the last few years.
They decided I'd had enough cardioversions and I must admit my heart rate is now a quite respectable 60-80/90 when resting. One thing that I do wonder is that it was discovered that my thyroid was underactive. I appear to have been a lot better with my heart rhythm since taking tablets to rectify that. If you haven't had yours checked it may be an idea to do so. I was blaming my extreme tiredness on AF.
Artificial additives to food and drink, especially artificial sweeteners were a sure trigger for my AF during the years when I used to get it periodically every 4-6 weeks. How I wish I'd known that before I had any ablations.
Jean
Hello Rosie, I just wanted to add a couple of things to the replies you have already received. The treatment plan you have been prescribed by your EP is quite commonly offered to any one with persistent AF. From what you have told us, the only thing which may be different from normal, assuming it’s your first cardioversion, is actually using Amiodarone but if it’s not your first, then taking Amiodarone either side of the CV is fairly common. Amiodarone is probably the most effective rhythm drug available. I’m not medically trained, but from what I have heard from medics is that the side effects are reasonably well tolerated for limited use but of course this will vary from person to person. If you have not had a CV before, I suggest you ask your EP why he/she has recommended it so early in your treatment.
I can understand why anyone might be concerned about the potential risks associated with having an ablation but it’s probably not a good idea to base your judgement on what you read on the forum. The reason why I say that is that there are around 10,000 ablations performed in the UK every year. Apart from issues raised during the so called blanking period, it’s actually quite rare to hear from anyone who regrets having their ablation. Over the years, the procedure has evolved and the equipment used is actually far more advanced and the very natural concerns you express are rare. As I understand it, this is due to sensitivity of the catheters used to scar the tissue.
As is pointed out many times, forums tend to attract folks with problem and honestly, there really are not that many but all the ones who sail through the recovery period just get on with the rest of their lives and who can blame them. Here in the UK, EP’s generally only offer an ablation on the NHS if they are reasonably confident that they will get a good result. By the way, I have had one CV and two ablations and have been free from AF since 2016. Finally, as has been said, CV’s are not a cure, especially if Amiodarone is required. Other treatments to consider are Hybrid Mini Maze ablation but these are hard to come by on the NHS and are by no means risk free…….
May pay to get a second opinion Dr hand out amiodarone and do not keep a check on side effects. Amiodarone has a high iodine content which may effect your thyroid, both hypo and hyperthyroidism, and is the most common cause of thyroid storm. You should have your thyroid function checked before treatment and every 3 months. As you stated you are having bad side effects please get a second opinion. Wishing you well.
Hi Rosie - you ask an interesting question but first I would like to put context to my reply. There is no ‘cure’ for AF as you may have picked up from the previous replies. AF will always be a series of treatments with the aim of improving your quality of life, not always NSR.
Any and all treatment is to help manage what is called the ‘AF burden’ however some people do manage to stay AF free for a number of years and a few, it doesn’t return.
Amiodarone is a toxic drug but is given prior to cardioversion because it will give you the best chance of a successful cardioversion. In my husband’s case the Amiodarone was not given early enough before the cardioversion so it did not work so he now takes it permanently, and yes it has damaged his thyroid after 4 years, but it has also given him a quality of life he would never have had if he hadn’t taken the drug. He self-converted to NSR after 3 months on Amiodarone.
Ablation is by far the most widely used treatment - because it gets the best outcomes over time. I would point out that Cardioversion also damages heart tissue so there will be a limit to how many cardioversions you have. I have never had a cardioversion but had 2 ablations, the pacemaker.
Reducing high BP, as you already know, would need to be the priority so personally, in your shoes, I would seek a second opinion. Did the EP you saw offer advice on controlling BP? My husband takes a low dose of selection BP reducing drugs Beta Blockers, Calcium Channel Blocker and ACE blockers but GP only went along with it after EP instruction - it works far better for him than taking one high dose of one. There are natural foods which have similar affects and light to moderate exercise and reducing stress will all help.
After doing the gamut of treatments from drugs, through ablation the thing that helped me was pacemaker. I still have the odd episode, usually when I have an infection or COVID vaccination (no more for me) but otherwise I hardly think about AF these days.
Everyone’s answer to AF will differ simply because we all differ, our responses will differ, the doctors’ opinions all differ, there are no absolutes.
But you have to suck it and see to see which option works for you. May I suggest you visit the AFA, read up on everything, sign up to Patient Day, learn everything you can so you can make an informed decision on what you want to do - you do have to be the Master of you Destiny.
Good luck.
Rosie i had problems with high blood pressure at night told my GP so she checked and it was ok i explained i had no meds at night for it.
So i took my blood pressure monitor to her with my readings in the memory and she did something about it..
The other alternative is to go to the ER when its high and explain your problem..
Mine was about 190 over 120 at night but great during the day..
I have persistent AF and my cardio version lasted only 5 days but it varies from person to person..
Good health and harmony to you..
The arrhythmia nurses at Papworth tell me that amiodarone is a "great drug with side effects for some". My cardiologist tells me the side effects were mainly with Olden Dayes high doses. It's the only thing that is working for me now sadly so I have no choice.@
Many thanks. That’s very helpful. Can you tell me more about your experience of amiodarone. Ie. When you started it amd at what dose. Also why and how you are still taking it.
I was on it prior to and post first ablation prob five months. I then had two more ablations within 20 months, none worked for more than a few months. So I've had 11 urgent cardioversions too! Dronedarone only worked for 5-6 months. So been on amiodarone since Feb 2023. I'm just hoping the six month blood tests don't show any problems and I can stay on it for ages, perhaps by then ablations might be better. My EP wants me to have a fourth but since each took me six months to get over I can't face it at this time....Many people do have success ablations of course, but we don't hear much about them on this forum as they tend to go and get on with their lives!
Thats very interesting. What dose did you start on and what are you taking now. I know they want to do a high dose first. It’s called loading.
I was 100 first time round, but they also discharged me in afib on digoxin and beta blocker (local hospital, pretty clueless). Now on 200. Didn't do preloading as I was dronedarone but wish I had coz HR was all over the place. Hope it works for you xx
If you search for amiodarone low dose side effects, you will find a major study that showed it to be safe,. Your worries are not groundless and are understandable, but in the dose used these days, and especially for short term use, trust your doctor is my advice rather than risk being frightened by online comments.
As for the cause being the covid vaccine, it seems that this can in a very few people indeed precipitate sometimes severe issues, but not specifically because of the vaccine itself (but that's still under investigation...) but because of the individual's pre-existing immune status. It seems not possible to find this out beforehand, sadly and it is extremely rare, so you have been an unlucky one, it seems.
Steve
I had permanent afib and was given amiodarone before cardioversion and it was successful in that I no longer have permanent afib but Paroxysmal afib which is much better for me anyway. I was totally clear for 2 years after the CV but now get episodes that can last over a week but can also go months without afib. I have never had cardioversion as I'm not suitable. All I can say personally is that I am now a lot healthier than I was thanks to CV
Hi Rosie. I’m 65, healthy heart (or it was!) and I too am on Amiodarone as I haven’t tolerated any of the other meds. I gathered it was a last chance drug to try to control the raging AFib.
I was started on 200mg three times a day for a week, then two tablets a day for a week, then just one tablet a day ongoing.
Unfortunately it’s been reducing my sleeping HR (48-52), breaths per min (BPM) were dropping below 9, and my oxygen levels were going below 90%. It was all a little too low for my liking, so I shave about a quarter off each tablet every day and my readings have got much better. I think it was suppressing everything a little too much.
Sadly I’m still getting regular episodes once or twice a week, but at least my HR is lowered to around 100-140 and the episodes are markedly shorter. Huge relief.
Ref. side effects - I’ve got the usual constipation, I’ve noticed my eyesight is affected - night vision/bright lights isn’t going too well and I’m sleepier than usual.
I’m in for an ablation next week and the cardiologist said he only wants me on the Amiodarone for the shortest possible time. I think that’s why he’s got me fitted in for the ablation fast.
I’m very concerned about this drug and I can’t wait to get off it - although it’s got an extraordinarily long ‘half life’ and it can take 3-6 months to clear it out of your body. 😟
How did your ablation go? I'm in July 26...hope it went well!
It went very well thanks. I’ll just say that I’m 65 with a healthy heart and no other health issues. Discharge paperwork states “acutely successful ablation” and Doc said he was confident they “got it all”. I went into hospital in AFib, so I don’t know if that helped them at all. Apart from a slightly elevated HR running about 10bpm higher than usual, I feel fine! Oh, and a zombie-like tiredness in the afternoon, which makes me get on the sofa and doze, but apparently that’ll all settle down in a week or so. Generally I feel more energetic than I have done for months when not in AFib. That’s something you may have to be aware of as there can be a tendency to overdo it.
I hope the video helps and you won’t have an “Oh, crikey, Wow!” moment (or words to that effect! 😂) I like I did when they took me into the cath lab. It’s not at all like a normal operating theatre. There so many people bustling about with equipment and stuff! It felt like they were all over me like ants sticking wires on and putting needles in my hands. It was all a bit overwhelming to be honest and I’m not easily overwhelmed. But! I knew I was in good, experienced hands.
Good luck with your’s on 26th!!
hi Rosie. My first cardioversion was in 2021 whilst waiting for my 5th valve replacement surgery. I was given an amiodorone IV initially (which brought my heart rate down quite quickly) and then went onto tablets. The doseage was gradually increased but I didn’t really suffer any serious side effects (perhaps felt a little strange for a while) and had my cardioversion probably 3 weeks after that. The amiodorone was stopped (gradually) and I’ve been ok since with a few short bursts of AF. However, this weekend, I was in AF consistently with a heart rate of 125-130 and went into A&E on the request of my GP. They gave me another cardioversion there and then and my heart has again gone back down to my norm of about 75-80 bpm. No more amiodorone this time. As everyone is saying here, everyone is different. There are many reasons why you go into AF and there is no magic cure. It seemed to me this weekend that they were reluctant to give me more amiodorone but that’s maybe due to my complex history. I was Certa8nly surprised that they went straight for a cardioversion whilst in A&E. maybe they see that as a quicker route to put your heart back into rhythm whereas amiodorone is a more long term option? I don’t know.
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