AFib and Cardioversion

[Peo935]

I have been in permanent Afib since May 23 and after adjusting to Bisoprolol have managed to maintain a reasonable lifestyle walking and running most days albeit a little slower at times. For the last month have been on Apixaban in readiness for a Cardioversion at the end of this week. I was originally quite hopeful about this but looking at the stats it’s likely that this will be a temporary reprieve at best from Afib. My thought is if Afib does return whilst this will be disappointing would I just revert to current meds ie Bisoprolol which have enabled me to maintain a decent level of exercise and fitness. My worst state was being in extended Afib episode and trying to get an appointment to get meds.

[BobD Volunteer]

A cardioversion will assess if it is possible to put you into NSR and that may enable different treatment such as ablation. If unable to obtain NSR then rate control would be the way forward.

[Peo935 in reply to BobD]

Agree. I’m my mind I am seeing the Cardioversion more as a fact finder than a treatment. If I have a few months in NSR that would be a bonus but only temporary fix.

[Hidden in reply to Peo935]

That’s a good way of looking at it. It’s normally part of a treatment plan to assess the best route forward. It’s not too scary, I’ve added a link to a BHF video and information sheet which you might find helpful…..

bhf.org.uk/informationsuppo...

Good luck……l

[mjames1]

Don't know your complete medical history, but some thoughts. First, you're not in "permanent" afib, just "persistent". And being in persistent for less than five months arguably gives you the same chance at treatment success as anyone else.

My first three cardioversions lasted ten years each. I know of a few others that have lasted longer. Many of these long lasting cardioversions will be under represented on forums like these because the person afterwards often needs no support. That was my case for over 40 years.

Should the cardioversion be successful, hopefully you can go on with as normal a life as possible. In my case, I lived a normal life, without medications for over 40 years, before my afib warranted medications. Hopefully, that will be your case. Stay positive!

Should the cardioversion not work, or should it not hold very long, then you have a number of options going forward. You could try either a rate control or rhythm control strategy, with rhythm control now being preferred, however that's really a discussion with a good ep.

Rhythm control might be either through anti-arrythmic's like Flecainidde (daily or PIP), or through ablation.

Good luck with the cardioversion and let us know how things work out. Again, be positive!

Jim

[Peo935 in reply to mjames1]

Thanks Jim that’s great to hear. You are right of course if Cardioversion proves successful and is a long lasting solution you just get on with your life and may not post on here about it but the figures I have seen on success rates didn’t particularly inspire me. That said I’m feeling positive about it and hopefully the fact that I have only been in “persistent” AF for only 5 months will work in my favour . Thanks

[mav7 in reply to Peo935]

Ask your doctor about taking an antiarrythmic drug pre or/and post the cardioversion to maintain NSR and improve success.

[mjames1 in reply to Peo935]

I doubt if there are any accurate success rates, because at least in the US, people who show up at the ER/A&E in afib are routinely given cardioversions within a day. No tracking that I'm aware of. As to the studies, success rates might be low because of the study population. For example, one such study used what was termed patients in "chronic afib" which is pretty broad, eliminating paroxysmal and possibly short term persistent like yourself. I haven't done a deep dive on the studies, but that was the one that came up first.

Jim

[ObiDyer in reply to Peo935]

Don't forget you only see the failed cardioversions on here... lots of successful ones never get visibility! My local arrhythmia clinic in Oxford states that 50% of cardioversions result in NSR being maintained in excess of 12mths.. (sadly I'm in the wrong 50%)

[CliveP]

I was in a similar age when I developed persistent afib. I had a cardioversion that lasted about a week .

I didn’t like the idea of taking medication for an extended time so I pushed for the earliest possible ablation. I’m now 6 years free from af so it turned out to be the right approach for me.

[Bodydoctor12]

Hello,

I had a CV in Feb this year and Im still in NSR. I was quite whacked by it and took extreme care for two weeks after. I also didn’t just stop the Biso - I withdrew from it really really slowly and in small increments. I had been on 3.75 and took a long slow approach to stopping it, as advised by my pharmacist. The hospital told me to just stop but the rebound to the heart could’ve been worse enough to throw me right back into AF. So I’m almost 9 months since I had it done and feeling hopeful. I felt that my AF was precipitated by a LOT of emotional stress and I have worked with a somatic therapist and acupuncturist to help me through the repercussions of that. Hope you’re successful and please please take it easy after.

[Belle11]

I stayed in normal rhythm for well over 3 1/2 years after my cardioversion, and only reverted back into AF just over 2 weeks ago. I did take note afterwards of some foods that seemed to trigger ectopics, and avoided those, which may have helped.

[GordonS]

I'm also in persistent AF and taking 2.5 Bisoprolol. I had a Cardioversion which lasted just 5 days. As my resting HR went down to 55/65 with the CV I reduced that to 1.25. Now back on 2.5 and 200mg Amiodarone in preparation for another CV. I have continued to cycle with my club albeit at lower mileage and speed. Early days with the Amiodarone so hoping for some improvement in the near future. Life goes on.

[Afibflipper]

Just saw your message - maybe you’ve had the CV by now, hope it went well