Cardioversion

[Davidtol]

Have been on medication for AF for 30 yrs, with occasional paroxysmes. First on Amiodarone which kept me on NSR . As it was too toxic, my cardiologist insisted change on propanolol 2 yrs ago.But AF became permanent . Now my EP insists on cardioversion if not ablation before putting me on flecoidine . Any opinion?

[Paulbounce]

Hi David.

First, I am not a medic and hold no medical qualifications

1. Flec

2. Cardio

David, I am not a Doctor. You need to consult with your healthcare provider.

Paul

[secondtry]

As you weren't put on Flecainide first and given the brief history provided, I would say an ablation is next.

[Hidden]

I can only share my experience. I was diagnosed with lone persistent AF and my Cardiologist suggested that I should follow what I now know is common practice here in the UK. Because the main objectives of AF treatment is to control symptoms, a cardioversion is considered to be the quickest and simplest way to establish whether or not a patient can be returned to normal sinus rhythm and if so, does it make them feel significantly better. So if it works, and they feel better, they are likely to be offered an ablation which is more likely to offer a longer term solution to controlling symptoms.

I’ve only had one CV and it was no big deal. It worked and was followed with 2 ablations and I have been in NSR since although some earlier break throughs were controlled with Flecainide. Personally, I think your EP is following the normal process which certainly worked for me…..good luck

The following link might be helpful.

bhf.org.uk/informationsuppo...

[mav7]

Hi David

Often times a cardioversion will be performed and followed by a drug like Flecainide to maintain NSR. If not successful, ablation may be recommended.

[Mountainyogini]

I was diagnosed with AFIB May 2019, and I’ve been on amiodarone since then. Initially 200 mg daily, and now 100 mg daily. I’ve had 3 Cardioversions , an ablation, and a maze procedure. I’ve been NSR since April 2020. I wear an apple iWatch, and monitor myself for changes. I exercise with a rower, yoga, swimming, and light weights 5 days a week. I’m 76 and normal BMI. I’m grateful for NSR.

Sorry you were having a toxic reaction to the amiodarone, and had to change medication. What kinds of toxic symptoms were you experiencing?

I

[Spin-off]

H David

I have had paroxysmal AF for around 25 years. During that time I took amiodarone for about a year which worked a treat on the AF but effected my thyroid - so I came off it. I have had 3 ablations and 2 cardioversions. I had a serious allergic reaction to Flecanide so can’t take that at all. Unfortunately the recent AF bout was serious and wouldn’t settle. Further ablations aren’t advisable (I have had a thoracotomy and subsequently there’s lots of scar tissue around my heart). My AF would now be permanent and it’s incredibly disabling so in September 2022 I started on Amiodarone again. Lots of trepidation from me and cardio but so far so good. I have 3 monthly blood checks. I know it’s a toxic drug so if there’s an alternative take it. Ablations always worked for a few years for me whereas, for me, CV only gave me a few months. But if it ends up that Amiodarone is necessary try not to stress and make sure whatever your intolerance was previously is monitored for carefully. For me, the toxic drug is certainly way better than attempting to live with my AF.

Good luck with everything.