I was diagnosed with Afib January last year, I had weekly episodes 5-20 hours duration, I felt horrible while in Afib! (used flacenide to get back in rythm). Starting this year Afib duration went longer and in April flacenide stopped working and my Afib become permanent until today (tried two cardiofversions). when my permanent Afib started I felt so bad so I panicked and scheduled ablation with one of the top EP in the country for July. Now what happened since April is that currently I am not feeling the Afib at all! I can walk 5km in one hour with no problem! the only difference from normalcy is that my heart rate is higher and I am on blood thinner and beta blocker.
Is it normal to feel better when on permanent Afib? I am thinking to cancel the ablation, does it make any sense?
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zxal0000
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I declined ablation. I'm in permanent, asymptomatic AFib. I'm on no medication apart from anticoagulant. About 4 years later I'm happy with my decision.
Any and all treatmeent is only for quality of life so as long as you feel good, your heart rate is well controlled and you are anticoagaul;ated what is the point of ablation? (and this from a person who had three before AF was controlled.
So just to recap. In the past you felt "horrible" while in afib and used Flecainide as a PIP to get out of afib. In April, the Flecainide stopped working and you have been in afib 24/7 since, but now you don't feel the afib at all.
If this is correct, what was you heart rate and what medications were you on when you were in afib when you felt horrible? What is your heart rate and what medications are you on, now when you don't feel the afib at all. And lastly, how do you know that you're still in afib now? Have you had a recent ekg? Do you have a home device like Kardia that tells you if you're in afib now? Also, how old are you?
I am 66 yo, I feel the Afib but it is not bad as it was when I was with proximal Afib, I used to be jogging 5k now I can only walk because my heart rate is getting too high. If during proximal I felt my physical capacity is at 50% now I feel like it 80-90%.
Yes I am in Afib, done EKG, cardioversions and my Apple Watch is telling me that I am 100% Afib.
Is it true that the heart is adapting to Afib? But is it normal or is it going to bite me in the future if I am not doing the ablation now?
My heart rate is in the 80's used to be 58 before Afib, taking metoprolol now.
Hard to say why you're doing better in afib now than before. A lot of variables and like you say there may be some adaptation going on, but that is beyond my experience base. Afib episodes for me have always been highly symptomatic.
As far as to ablate or not, not a cut and dry decision. There are potential risks with ablation and potential risks staying in afib. One compromise might be to try daily Flecainide now, with a CV first if needed -- maybe it will work this time.
But if that won't work out, then you have to decide if what you describe as a somewhat decreased but workable quality of life is worth an ablation t make it better. If you decide not to ablate and just stay in afib, it's very important you get at least a baseline echo and work with a cardiologist who will monitor you. What you don't want happening is to start slipping into heart failure, which probably won't happen if your afib is controlled, but due diligence says to monitor things so you will get ahead of the curve.
What is 'proximal AF'? I keep reading this and I am not familiar with it.Is it a mistake? Do people mean 'paroxysmal' , or is proximal AF something different?
I am trying to understand the different incarnations of AF and this is confusing me.
I had a stroke at 59 and that brought my heart performance into debate.
I’ve since been in permanent AFib. I refused an ablation as my expert consultant gave me the choice and said he was happy to monitor me on the medication if I wanted to wait as I was in my early 60s and in his opinion quite young.
I had researched the results of ablations and heard stories from local people who had been ablated, and in those days the results were very mixed. I decided I did not want a scarred heart unless my life was unbearable in AFib. I still feel the same.
Since my original ablation decision I have been told the procedure could have knocked out my AV node as the misfirings have been found in that area. I have a pacemaker now and don’t feel my AFib although it’s always there. True I have breathless episodes and hills are a bind but that’s my choice.
I’m still doing well and feel safe on the anticoagulants and beata blockers etc. and my pacemaker is my friend.
Everyone has a different story, everyone knows their own body better than anyone else. You must do what you feel is best for you, but don’t rush into operations if you are doing well without.
It's normal to feel better in permanent AFib. I had an ablation in Dec, nsr since. Remember AFib remodels the heart and nsr is better. If an ablation can give you nsr that's better for your heart. I'm just on Xarelto, no beta blockers.
Maybe a private appointment with trusted cardiologist to discuss the effects of permanent AF. Like BobD says if QOL good no immediate need for an ablation but I would be asking my cardiologist whether perm AF has other implications eg remodelling the heart bearing in mind ACs are only 70% effective on average.
I am 62 and was in a similar situation to you last year, with early persistent AF, and decided after much deliberation of pros and cons to have an ablation in September (pulsed field) which so far has been successful (see my previous posts for more information) - it was a tough call, but ultimately as I am relatively young I wanted a shot at NSR and as I’m sure you know the longer you stay in AF the lower the chances of a successful ablation-good luck whatever you decide.
Only a thought, has your diet changed, less alcohol and coffee, both can be triggers for some people, have you lost weight, usually helps. I've had 3 cardioversions and 3 ablations,all workedfor varying lengths of time. For me when not in Afib I'm always concerned that something I do or eat will start it up, whereas when in Afib if its manageable and life isn't too bad it feels like you are more in control.
hi, when considering to have an ablation just as my AF had gone permanent, my EP said he couldn’t guarantee he could make me feel better by being in sinus rhythm, but fortunately, a year on from cryoblation, I do, apart from some post exercise recovery issues. We were having an healthy heart to heart conversation and I asked would there be any long term issues with my heart if I decided not to have an ablation and manage the perm AF with meds - he said my heart would go saggy. I thought that’s all my research on is your left atria diameter a good indicator of ablation success etc😀 I didn’t probe him any further and decided to have the ablation. If your meds keep you in NSR, I’m not sure why your heart would go saggy? But with feeling tired etc on the Bisoprolol, it was enough to make me opt for the ablation and i’m glad I did…He’s a top experienced EP and he could tell I wanted to know the reality, so I was pleased he told me 😀…..I find when they tell you the way it is, it’s best to listen….
Can I assume you are having the ablation privately as waiting lists are usually very long.In which case you should be able to get it done at a relatively short notice if you change your mind.Whilst waiting for mine I had good periods and bad & eventually just got worse & the unpredictability was the worse thing.I had my ablation 22 nd of Feb.All went well and I had the usual blanking period probs.Still trying to get as fit as I would like but just this morning I was thinking how light & open my chest feels.
I was only given 50% chance of success as 2 years Persistent but so glad I did it & would happily have a repeat.
Some people have no symptoms of AF and live a normal active life. I was told to concentrate on the symptoms…how I felt. HR was high & low, again not the numbers but the symptoms. Think this is a discussion to be had with the Dr.
Comments from my cardiologist - HR never above 85 so AF not a major concern. So far not considered ablation but....
XX came to see me today and he is now in a phase where he is having quite frequent episodes of sustained atrial fibrillation that can last several days. He is aware of this but they are not particularly incapacitating.
His echocardiogram continues to show excellent heart function. We have concluded that his symptoms are not intrusive enough to warrant escalation to possible radiofrequency ablation and I suspect that he will never get to the stage where this bothers him enough to follow that route. I also suspect he will at some point go into persistent atrial fibrillation which paradoxically might be easier for him.
Like you I went from occasional AFib to persistent. It was very tolerable, I could hike etc. I took metoprolo for rate control and if the thumps got too bad at night I would take a second one.
I had a cardioversion, nsr lasted a week. After that my AFib was much worst. I had to catch my breath after slowly going up stairs. Hiking was hard. So...
Two years ago I had an ablation, I'm 100% in sinus and only take one pill, Eliquis. It is great working out, hiking, and gardening and feeling good.
I have a friend who has persistent AFib, he is content to live with it. It is only due to an occasional EKG that he knows he has it.
AFib is a spectrum, you have to decide where you are on it.
Ablation really helped me . I use to have episodes last few hours , now , i have them , but it only lasts few minutes. I feel much better after ablation. I hade it year ago. Good luck!
Had ablation in 2011 at age 53. While I still get short 4-12 hour afib episodes maybe once or twice a year, the decision for the ablation was absolutely the right one for me. Afib made me very tired and lethargic, and my EP's advice was "the longer you are in Afib, the more likely it is to become persistent or permanent". I could not imagine a life with permanent Afib. In addition, I believe that the ablation has allowed me to reduce cardiac meds to bare minimums, EP's wish was to get off cardiac meds completely but Afib usually returns within a few months after I stop Toprol XL "25-50mg per day". I also take Rhythmol and Xarelto as needed (ie. start of an Afib episode). I strongly recommend ablation if you and your EP believe your risk profile is appropriate. Good luck!
Everyone has different reasons for wanting to go the ablation route. For me, I didn't want to be a slave to medication for the rest of my life. Also as mentioned before on this blog, when your heart isn't in rhythm, the muscle fibers change. Sort of like if your wheels are out of alignment on your car. Certain areas of tread get worn sooner than the rest of the tire. It's a very personal choice because not everyone judges this decision the same way. Good luck, I'm sure you will do what's best for you. 🙂
I would encourage you to have the ablation but i’m not a Dr. I had my first ablation in 2011. I had zero episodes for 10 years. In 2021I again started having occasional episodes marked by very irregular but not terribly high HR (140bpm). My Dr put me on daily Flecainide which worked very well for a couple of years. But my paroxysmal afib returned in spring of 22. I then went on Eliquis for 6 months but decided to have another Ablation in Nov 2022. Went very well with much faster and easier recovery than first one. Been off eliquis and flecainide since March. No issues. I’m turning 67 on 7/5. I workout vigorously 5-6 days per week and feel great.
My last advice is to find a Cardiologist who has a lot of experience in ablations. Mine has been doing them for 20 years and does over 100/ year. I trust him with my life. Best of luck to you.
I have been in AFIB the longest 47 hours and you do feel terrible ! I took flecanide too and hated it , it did not make me feel normal! So far I am not on nothing so far, some of the meds I tried makes me dizzy and bothers my eyes!
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