AF no longer a problem?

[Bridges4]

My first episode of AF was in 2014. The ambulance crew came to my house and clearly recorded atrial fibrillation which was confirmed after I was taken to hospital. The Cardiologist/Electrophysiologist put me on Apixaban. I was discharged a year later from his care.

A year later I had a short hospital stay because of chest discomfort. Tests showed severe LV impairment with global hypokinesia and very low ejection fraction (EF) (20%). I was started on three drugs one of which was new "Entresto". This drug has worked really well and my RF is now normal (58%) and my AF seems to have "disappeared" over the last 7 years or so.

My question is should I still declare my AF for health insurance? Having been clear of any symptoms or events has my AF gone? Has anybody been free of AF for a long period and as a consequence feel they no longer have AF?

[BenHall1]

Hi, yes I fit that description . Been free at least 18 months, probably as long as 4 years. That said I was originally diagnosed as asymptomatic. I always declare I have AF. I always tell the enquirer they can phone my Gp ...she has never treated me for AF since she took over my healthcare in Sept 2012. I have also told my Gp she can discuss my health record. I have made the same declaration to DVLA as I hold a PCV Licence.

John

[BobD Volunteer]

There is no "cure" for AF with all treatment merely for symptom control so probably best to not "undeclare it". Seems to make no difference to eitherdriving or insurance anyway so why risk it. ?

[Hidden in reply to BobD]

With the greatest respect to my elders (only just) and betters (without question) and before any one else decides to put you right, I think Bridges was referring to health insurance and possibly even travel insurance which definitely would be affected in terms of potential cost. I believe the same principle applies though, once you have been diagnosed with AF you have got it for life.

However, nothing to stop anyone from checking direct with their insurers and if you get a better response than expected, make sure you get it confirmed in writing…….

[Autumn_Leaves]

In your situation AF may well have been a consequence of the other cardiac problems that were identified and by managing these conditions your AF may have been mitigated. Whether you can be “undiagnosed” is probably a discussion you should have with your cardiologist or cardiac nurse (if you have one), or whoever is monitoring your conditions but I doubt anyone could say you are effectively permanently cured of AF. It’s better to view your situation as being well-managed. I hope you can remain AF indefinitely.

[Bridges4 in reply to Autumn_Leaves]

Thank you. A good reply. I have decided to discuss with my cardio when I see him in a few weeks and will be guided by him.

Travel insurance in particular is a difficult area. My wife reported to the insurers that she was waiting for a benign wart to be removed in outpatients and they cancelled cover for all other declared conditions until they received written confirmation from the hospital and then they would reinstate! It seems to me that if one doesn't follow the rules exactly it can invalidate the insurance. It's a minefield🤨

[pd63]

If not officially cleared medically it would be unwise not to declare it 'cos you wouldn't be covered.For the cost of a few quid why risk it

[secondtry]

Yes an interesting one.

If you take drugs for high blood pressure, which work....do you still have high blood pressure for travel/health insurance etc ? No doubt the same Q on many other health situations.

I have been AF free for 10+ years on Flecainide (save 2 very short under one hour episodes) and my cardiologist 3 years ago wanted to discharge me from his care. So I regard myself as not having AF.

I don't have health or travel insurance but I do drive - is there something definitive to report to DVLA 🤔?

[Hidden in reply to secondtry]

It’s commonly known that AF is a condition which should notified to both the DVLA and your insurers. Provided you do not experience blackouts and take prescribed medication, neither insurance premiums or your driving licence should be affected………

[Buzby62 in reply to Hidden]

Hi FJ, discussed this a few times before, I don’t want to hijack the post but for the benefit of the browsers reading, here is the DVLA link

gov.uk/arrhythmia-and-driving

The way I read this is if you don’t have dizzy spells and your AF doesn’t affect your car driving then you don’t need to inform them. The confusion then comes in when you try to report via that online link, the system will not accept AF report online and asks you to download the form to post in. This form I believe is not actually a declaration, rather it is for someone to check your answers to see if a declaration is required. If the answers indicate your AF doesn’t affect your driving then nothing is declared. I would expect the fact that you’ve asked the question might be kept on file but I don’t know.

This is how I see it and hope my opinion helps others.

I haven’t looked in to health insurance but would make sense that once you have AF you are tagged with it for life.

PS ablation for today cancelled waiting reschedule.

[Hidden in reply to Buzby62]

I know it has been very confusing, I declared mine in 2014 and received a letter from the DVLA confirming I was ok to drive and copies were sent to our insurers.

So sorry to hear about the ablation, where are you having it done?

[secondtry in reply to Buzby62]

Thank you!!

[Bridges4 in reply to secondtry]

Thanks to the link provided by "Busby 62" I have checked with the DVLA guidelines. One only has to advise the DVLA if it is felt that AF affects your driving.

[secondtry in reply to Bridges4]

Thank you that is good to know and my recollection when I checked some years ago.

[wilsond]

I agree with second try,I was just about to reply regarding high blood pressure. Although mine is really well controlled (better numbers than several people I know who are not medicated!) I am still classed as a patient veins treated for high blood pressure . Under stress,it can rise still.In the same way,AF is being treated for you and I with medication, keeping us stable. I'm hoping to come off medication in due course after an ablation but will remain on Anticoagulants for life.

Perhaps ask your insurers of their opinion,get confirmation of response by email or letter?

Best wishes

[frazeej]

I am particularly interested in your ongoing treatment of CHF and it's possible relation to AF occurrences. Similar to yourself I have and am being treated for my PAF of > 3 years duration. Recently I had an "episode" of heart failure (all the classic symptoms of edema, breathlessness, weight gain, etc.) and while in this "crisis", of course was having an AF episode with HR >140. My echo at that time was similarly a disaster with EF 15%, and was started on Entresto, Farxiga and Lasix (wonder drug!). The Lasix of course gave immediate relief, and the AF episode converted to NSR that evening, and has yet to return, and I lost >20lbs water weight. Awaiting a followup ECHO, but I can guarantee that the EF will be substantially higher than 15% as I feel like a new man, with no AF episodes since (currently knocking on wood)

With that long preamble, I guess my question is of the chicken/egg variety: Does CHF beget AF or does AF beget CHF? Do I dare hope that the reduction in AF burden MIGHT be a real thing?

[Bridges4 in reply to frazeej]

Thanks for your post. My understanding is that HF is a chronic progressive disease and my treatment has been carried out on that basis. I have not had "episodes" such as you have described and it is just getting slightly worse year by year. We are both lucky to have shed the regular episodes of AF which, unfortunately, many people suffer.

I think you have a point with your chicken/egg question. Who knows what the answer is?! It may well be that my AF was caused by an underlying HF condition which was only diagnosed a year or so later. When treatment for this started my AF "disappeared". Only time will tell if it will return but fingers and toes crossed!

[Teresa156]

I have yearly episodes currently, but when I had my first episode of AF in 2005 ( I didn’t know it was AF) I didn’t have another episode for many years after, probably 6-7 years, perhaps more.

It’s probably worth declaring it, as not worth the risk.