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How Long Before Improvement?

Peakoverload profile image
15 Replies

I was diagnosed with AF a few months ago and before that only really knew something was wrong back in March when I found I got out of breath walking up a hill that normally would have been fine.

Anyway, yesterday I had my first cardioversion which was successful. Today I went out for a bit of a gentle stroll to see if activity felt any easier now that I’m in normal sinus rhythm.

I really can’t tell what if there is a difference or not. In some ways, yes. In others it’s a maybe or perhaps no.

Prior to cardioversion my main symptoms would be:

Breathing more heavily when walking/being active

Feeling hot & sweating either after drinking /eating something hot, having a hot shower or on activity

Feeling like I’m going to blackout with a very low heart rate

Feeling dizzy / lightheaded sometimes when just sat doing nothing other times when standing and moving around but always with a heart rate no lower than 65bpm and no higher than 90bpm but constantly and rapidly changing.

Feeling tired and falling asleep.

Today I felt a little dizzy when sat on the sofa before I went out. The first minute of walking felt awful, worse than at any time previously and then it just went away and I felt fine. Walking generally felt fine, but not like I suddenly felt I could run and walk for miles. Maybe 10-15% better than before cardioversion. I did however feel very hot and sweaty but then so did my wife and she said it was a hot day so maybe that was a normal response. There were times I felt a little dizzy when walking around and at one point I had to walk up a long incline which prior to the cardioversion I would have found much harder but today was easier although I did feel more out of breath than I should do.

What I’m not clear on is do you see a sudden and unchanging improvement after a cardioversion (I.e. how I feel today will be how I feel in a months time) or whether you see a gradual improvement over time and how long that typically is, or is a case of everyone is different and so both can be true?

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Peakoverload
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15 Replies
jeanjeannie50 profile image
jeanjeannie50

I wish I could have told you this before you went out walking. I always recommend not exerting yourself for a week or so after a cardioversion. I've had quite a few and learnt what to do the hard way. I once walked up a hill the day after one and immediately went back into AF.

It's best to let your heart grow strong first, beating in it's correct rhythm, before attempting something that requires effort, so easy for the heart to slip back into AF in those first few weeks.

Also no alcohol or huge meals.

Jean

Cavalierrubie profile image
Cavalierrubie

I am surprised the hospital that you attended didn’t give you instructions for the after care. I would have thought any procedure with AF needs TLC as Jean has said. Take it easy from now on and don’t push yourself. Get well soon.

ETHEL103 profile image
ETHEL103 in reply to Cavalierrubie

I had a CV and it only lasted 1 hour.I had no instructions at all on leaving.It was during the pandemic so most of the exits were closed off.As a result I had to walk for at least 10 minutes to get to hubby waiting in a car.The cath labs were the farthest away from the exit.The same when I eventually had my ablation.A good 1/4 of a mile to hospital exit.

Cavalierrubie profile image
Cavalierrubie in reply to ETHEL103

Yes, l know Ethel that there has been a lack of care in some departments at hospital with the pandemic. Peterborough is my local hospital and the last time l went l asked for a chair as l have arthritis and it was a long walk to where l had to be. They should really have wheeled you out after that. I think it’s survival of the fittest these days. 🥰

DawnTX profile image
DawnTX in reply to Cavalierrubie

I learned to ask because it seems like wherever we need to go in the hospital is the furthest point there is. I can’t breathe and they want me to follow behind someone speeding down the hallway. What the heck? Ask for the chair don’t count on them to notice you can’t breathe which really is a shame that they don’t.

My first cardioversion was like a miracle when I woke up. It only lasted 3 1/2 weeks. My second in December during Christmas week when they were also going to try a new med so I had to stay in the hospital five days. Well that one failed after three attempts at shocking me. My doctor believes That you should not keep repeating failures. I like his way of thinking. He did my pace and ablate in February. Yes it is not gone smoothly all the time our bodies need to heal. Plus I have heart failure besides. Not that long ago I finally felt. I turned a corner and have started feeling good for the most part. We have to except the fact we’re never going to have it perfect but I am grateful for what I have.

mav7 profile image
mav7

Wish for you to be the exception, but cardioversions are not a permanent resolution for many. What medications are you taking to assist in maintaining NSR ? These medicatons may be the cause of fatigue and other symptoms, especially initially.

Difficult, but patience and positivity are keys to our battle against afib.

Good advice by jean to limit or not exercise after a cardioversion. Do you have a follow up visit scheduled with your doctor ? Best to You !

Jalia profile image
Jalia

For goodness sake ! Why do all that straight after a cardioversion ?? Do rest up a bit and be kind to yourself. Let your wife spoil you!

As has been said, back off any unnecessary exercise for the next few days. A cardioversion is only a form of re-booting your heart, a bit like rebooting a pc. Nothing has been done that will change the structure or condition of your ticker, a CV is generally part of a treatment plan to see if you can revert back into NSR. Now you know it has worked but at some stage, maybe days, weeks, months or years, I’m afraid the AF is likely to return so please do not do stuff that will cause that to happen sooner rather than later. If it does return, other treatments are available which often provide longer term solutions to controlling AF symptoms…..

Peakoverload profile image
Peakoverload

I think perhaps I wasn't clear about what I did today.

By gentle stroll I meant we walked slowly for about 25 minutes in total around a small garden. This was interspersed by a 10 minute sit down half way through and a break for lunch.

The hospital gave me no guidance on after care beyond not driving, signing legal documents or operating machinery for 24hrs. I explicitly asked them if I should avoid anything after 24hrs and they said just to do what I would normally do but not to excess. Therefore, by my thinking, walking for 10 minutes and then taking a break is not excessive but maybe that was duff advice. I have to say that whilst the staff at the hospital were superb yesterday, the administration side of things has been a bit of a shambles. I've never met anyone whose actually looking after my case, just nurses, with the exception of the anaesthetist and someone who was some kind of 'heart doctor' who just came round to explain the risks and have me sign a consent form and then I never saw them again. So far I've had three appointments (the 3rd in a weeks time) and each one I've received notification of in three different ways. The first via phone, the 2nd via a letter given to me at my first appointment and the 3rd via the NHS app. With the exception of the 2nd, nobody has explained what was going to happen at each appointment. For example in the NHS app, it says that my appointment in a weeks time is 'Face to Face'. That's it. No other detail. When I showed it to the nurse yesterday she had no idea what it was but between us we think it's for an echocardiogram.

Anyway, I digress. As for medication. Other than Rivaroxaban, I've not been prescribed anything for AF. I am however on a beta blocker, Propranalol, which I've been on for years because for the past 30 years I've suffered with ectopic heart beats (I can't remember now if they are PAC's or PVC's). My GP was never interested in doing anything about them but I refused to accept it as normal as it was driving me insane as I was getting thousands a day so I insisted on beta blockers and have taken them daily every since).

I understand that cardioversion isn't a cure. The mystery 'heart doctor' I spoke to at the hospital yesterday said that the purpose of the cardioversion was to see if returning to a normal rhythm was possible and if it improved my symptoms. Which is why my question was, does cardioversion give you an immediate improvement of your symptoms (the amount varying person to person) but that the improvement on Day 1 post cardioversion would be the same as on Day 100 (assuming you remain in NSR). Or do you see a gradual improvement in symptoms over a period of time so that on Day 1 maybe you notice a 5% improvement but by Day 30 you see a 25% improvement for example?

in reply to Peakoverload

nope, I think most would think what you have described is fine and probably no more energetic than walking out of the hospital after the procedure.👍 Regarding you question, I think it can be different for everyone. If you were asymptomatic before the CV, then you probably wouldn’t feel much benefit once the initial reaction from having it done had settled. What your cardiologist said follows the information normally received by most of us after a CV. As you know, the follow on procedure, should you go back in to AF, is an ablation, and whilst not overly serious, that comes with risks so if the benefits of not being in NSR are not that great, then they may suggest the risks are not worth taking. It’s impossible to be specific, but within less than a week of the CV and if you are still in rhythm, you will probably feel as good as you are going to get and only you can assess how good that might be. Even if it doesn’t last (which it will!!!) if I were you, I would seek to get on the waiting list because the chances are it will be about a year before you get the call so you will have plenty of time to consider your position. Pulling out at the last moment will not be a problem because there will always be someone available to fill the slot. That said, it’s rare for people to not go ahead.

I think you should try and relax and see how things pan out. Nothing will be quick unless any further treatment is undertaken privately…..l

Ppiman profile image
Ppiman in reply to Peakoverload

It sounds to me as if you were dealt with well and treated correctly. I never in the end needed a CV but from my reading, it doesn't seem that you have to put yourself into cotton wool after the procedure, just take things easy and live normally. The recurrence rate is high, with a 20-40% chance of being free at one year - not bad really considering the simplicity and safety of the procedure (catheter ablation has only 50-70% chance of success at one year, I think).

Not feeling highly energetic seems to me to be a common feature of having an arrhythmic heart, whether or not it is in NSR. I am sure each of us are slightly different owing to the efficiency of the ventricles to supply oxygenated blood, the efficiency of the atria to fill the ventricles, and so on. My own heart "feelings" tend to be very up and down, often with weeks of feeling well, followed by weeks of feeling more shaky with daily frequent palpitations; AF itself is unusual for me with months between events.

Steve

Jalia profile image
Jalia in reply to Peakoverload

Personally I found immediate improvement straight after all 24 of my dccvs

2learn profile image
2learn in reply to Peakoverload

Hi, I've had 3 cardioversions and all worked for over a year, but what I discovered after the first one was if I stayed on the beta blocker (bisoprolol) I felt awful and more or less collapsed as my heart rate went too low. So talk to your doc about the beta blocker.

LordGabriel profile image
LordGabriel

My first cardioversion was like night and day. Went there feeling like hell after 5 months of constant AF, woke up after in rhythm feeling fab!! Heaven!! It lasted 13 months.

Take it easy for 2 weeks. That’s what I did.

Ducky2003 profile image
Ducky2003

I've had 8 but 2 were during an ablation. With the 6, I felt immediately better the minute I came around from the sedation, except one as I'd got a chest infection brewing but when that cleared, all ok. I personally wouldn't have attempted an incline the day after. I rested completely for a couple of days then gradually built back up to normal activities over the next week to 10 days., despite feeling amazingly well.

There may be some residual effect from the sedation making you feel a bit weary so it may take a couple of days for that to clear.

I'd just take things very easy for a few days and hope that it settles.

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