I've been in and out of AF for years and for last 4 years as permanent. The first cardioversion gave me a year in SR, the next 6 months and the last 3 months which was Feb this year. I've been short of breath going up hills, walking fast and tying my shoe laces and had episodes of complete exhaustion for last 14 months.A recent heart scan shows I have a dilated left atrium. I don't get to see the consultant for another month (if it doesn't get postponed with the strikes) so I'm wondering what likely happens next.
Thank you all
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JackyMac
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The dilated left atrium is a common side effect of uncontrolled AF. You should be on something (bete blocker?) to keep your heart rate down as well as an anticoagulant for stroke prevention if you have any co morbidities or are over 65 yoa. Since you do not mention a drug regime this will be the next step most likely.
Don't worry too much about the left atrium as it is common for this to return to a more normal size once control is restored. Remember AF alone won't kill you, it just feel like it sometimes.
Left atrial enlargement commonly occurs in people with mitral valve regurgitation, and not all people with mitral valve disease and LAE develop AF, although this is often the “root cause” for many people with AF.
All I’m saying here is we can’t jump to conclusions based on one finding on an echocardiogram. It’s the context in which these findings occur that can give a clearer explanation.
Hello Jacky, having looked at your bio I see you have been prescribed Amiodarone in the past so I guess you must have had quite a bit of specialised treatment over the years. I know it’s not polite to talk about age with a female, but it can have a bearing on what might be the best treatment moving forward. What you describe is a classic example of how AF can progress over years although we often hear that some (many) experience a stable level of symptoms once their AF becomes persistent/permanent, provided rate levels are controlled with medication. As Bob says, beta blockers or calcium channel blockers will help to control symptoms and provided your heart rate is maintained near to normal range, your left atrium should return to near normal size.
Amiodarone is a potent medication and if taken for long periods, can have serious side effects, so you ought to make sure you have blood tests to check your thyroid function. Problems with the thyroid could contribute to some of the symptoms you mention, so it’s worth having it checked. Unfortunately, most of us here in the UK are, at the moment, finding it different to get the medical aid we need. Your bio refers to CV which you had privately so you are not averse to seeking private treatment although it should not be necessary but currently, times are difficult. Depending on what happens with your appointment next month, you may want to consider seeing an Electrophysiologist (EP) privately because they are cardiologists who specialise in arrhythmias and are more likely to work with you to establish a treatment plan specific to your needs. Just make sure that they understand that if it’s your wish, any ongoing treatment is to be undertaken by the NHS. Hope this helps, good luck for next month…..
Sorry what's going on. First, you're not in "permanent" afib unless you want to be. That's not a condition, but a decision not to try and restore normal rhythm.
Hard to tell from your post, whether your symptoms are from an uncontrolled heart rate, medications, or other heart issues.
Has anyone offered you ablation before? It's a reasonable option, especially if anti-arrythmic's haven't worked in the past and it may even reverse the dilation in your left atrium.
You might also want to seek out another opinion from Dr. Steven Hunter at Northern General in Sheffield. He does both the mini maze and convergent procedures, which may give you a better chance than catheter ablation, given your enlarged left atrium.
MummyLuv a member here, has had a Mini Maze with Dr. Hunter and can provide more information.
Jacky, please don’t be too worried about this. It’s a very common finding with people with or without AF. It’s often seen in people who have some degree of mitral valve regurgitation which is very common as people get older.
My understanding is that the back flow of blood into the left atrium caused by the leaking valve causes the heart to compensate by enlarging. This can over time lead to the development of palpitations and arrhythmia, and in some people it will lead to AF. As AF progresses the changes in the atria perpetuate AF. I hope that makes sense!
Left atrial enlargement can be reduced to some extent by addressing the AF (or by repairing the mitral valve if the regurgitation becomes severe). My cardiologist told me it doesn’t always progress, and some people here have seen improvements with the right treatment. I expect that your cardiologist will recommend an echocardiogram every two years or so if there are any concerns, just to keep an eye on it.
Please ring the BHF nurse helpline if you are worried. They are very helpful.
Thank you everybody who responded. All helpful stuff! I did take amiodarone and when AF restarted I did the customary triple dose for the first week, dropping down 2nd and 3rd. My heart didn't go back into NSR so I stopped taking them. No point in poisoning yourself for nothing. I take anticoagulants and vitamins.I will try and see out at. EP but I have never heard the cardiologist mention one.
I would just like to be able to run a little. I'm 75 by the way.
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