Hello everyone - I'm 68 and have had AF for about 2 years. Apart from a brief conversation re cardioversion and ablation when I was 1st diagnosed, none of the cardiologists I have seen have suggested that I should have cardioversion. I am currently taking 10mg of Bisoprolol a day in two 5mg tablets, morning and afternoon, 10mg Ramipril and 60mg Edoxaban. I exercise on a rowing machine, exercise bike, walk 2-3 miles most days, have lost 1/2 stone and still have AF and high normal blood pressure. I want to get back into running but have an issue with shortness of breath - not on machines but walking or running, so I think it's about carrying my weight.
If I push for cardioversion, with the present state of cardiology services in the UK, it's likely to take months just to get seen[I'm still waiting for results of a scan I had on my heart about 6 weeks ago]. So I'm tempted to go private. But as cardioversion is best done early, and the AF often comes back anyway, would I be wasting money for a disappointing result?
What particularly concerns me is reading more on the subject recently and finding that Sudden Cardiac Death ie. Cardiac Arrest is one of the biggest causes of death with AF. I am quite concerned at the idea that I may just drop dead. I just don't know what else I can do to stabilise my heart.
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Good questions which would be best directed to medical professionals who are familiar with your medical history/exam. Members here can relate their personal experiences which may differ from your needs.
Seems you have consulted with more than one cardiologist, would be good to consult with an Electrophysiologist (EP) who specialize in heart rhythm disorders.
For purpose of discussion, consider sharing how well your heart rate and blood pressure are controlled and how often you have afib.
I am a bit hesitant about posting comments because I am a 79 year old git who was diagnosed with paroxysmal AF in Jan 2010 and who ( as far as I know ) is AF free. At the time of diagnosis the NHS was a true serv ice and was in the Pre CoVid era. I was admitted to hospital via A & E with a HR of 156. Once things had been whipped into shape and I was ready for discharge the cardio consultant discussed with me the ins and outs of cardioversion and ablation. I totally rejected an ablation - unless as an absolute last resort. I agreed to cardioversion. This was offered to me a few weeks later however, on the day at the appointed time and location the cardioversion didn't proceed as my heart was back in NSR. (I guess such is paroxysmal ). Right that's a bit of background on my fun times, and your medication seems pretty much in line with what I was prescribed. By the way, I was diagnosed and treatment started in around 9 hours from known onset !!!!
Now, I've been on this forum ( and its previous incarnation with Yahoo - which was better in my view ) for 14 years. I just cannot remember now the number of references to "Sudden Cardiac Death ie. Cardiac Arrest is one of the biggest causes of death with AF. " I pay tribute to one of our regulars on this forum who says often ......... its not AF that will kill you, its the company it keeps !!!
Equally, I cannot remember the number of times I have read on here from all sorts of peeps, that AF won't kill you. Equally again, I cannot remember the number of times I've read or heard on all sorts of media in UK and Australia ( where I come from ) the number of athletes who have died from their sport ( as opposed to AF ) simply because they practiced their beloved sport while being treated for AF. There is also some anecdotal evidence to suggest fighter pilots ( as a career group ) can suffer from AF. If memory serves me correctly didn't UK have a footballer collapse this season somewhere during a game while being treated for AF. Can't remember the details, not interested in following footy.
Are you Asymptomatic ? Yep, I am which is why I qualified an earlier remark above ( as far as I know ) . If you are Asymptomatic, and you are having an AF event whilst on a 10 mile jog ..... how do you know it ( if you are in AF mode) if you have no symptoms and how do you think your heart feels ?
I can't make any suggestions what you do because I'm one of those old, cranky/grumpy, quite unfit, exercise averse, a tad overweight beings who is now AF free thanks to a diet modification and permanent medication ( as opposed to those who are advised by their cardiac professionals to practice PIP and then possibly an ablation ).
By the way - thanks to my age and DVLA requirements, my employer ( a major national bus operator ) keeps me on working part time in college term times driving double decker bus loads of up to 102 students ( teenage and young and more older ) to and from college. At the age of 65 and higher all bus drivers have to have an annual medical to meet DVLA requirements to continue the dark arts of bus driving. Probably time that age was dropped by 10 years from what I see and applied to the community at large. 😱
Gosh ! 10mg of Bisoprolol ..... When I was on 5mg of Bisoprolol I felt like the Zombie from the Land of the Living Dead after many years on it. Am now on Nebivolol, much kinder to me.
Hi. I was only in AF for a few months and the breathlessness while walking and running was the biggest problem. The cardioversion has taken that away and I am back to running and walking comfortably so it was definitely worth it;for me.
I thought it may not last long as I had a couple of incidences of AF within a couple of months of the cardioversion, but adding testosterone to my HRT seems to have stopped that and not had any more since.
I would say for me it was definitely worth it. I went private (get it through work) and was seen within 2 weeks. As you say better to get it done sooner rather than later as better chance of success. Altho EP consultant did say could have done on NHS quickly also.
Thanks for that. I'm glad it worked out for you. Having read many accounts of the pro's and cons of cardioversion I think that neither is likely to benefit me. I may try cardioversion but wouldn't expect a long term solution to AF. From what I understand, it is often more of a temporary fix and doesn't address the underlying issue causing AF.
I tried running yesterday and am hopeful that despite the AF I can get back into it. Thanks.
I think you might be better paying to see a private cardiologist or EP for a consult and then going on an NHS list for whatever they recommend. I imagine cardioversion privately would be pretty costly and they are often/ usually considered more of a temporary measure (and as part of assessing if ablation is viable) rather than a long term fix. At least in the UK anyway. BTW, I had AF for 18 years before having any proper intervention. Not recommended but still here and now in NSR after 3 ablations. First time in regular rhythm for 20 years!
You're right about it being costly to have cardioversion done privately. I know someone who's uncle did that and paid £20,000. That probably covered prior consultations, ECG's etc, more chats, the procedure involving several staff due to being anaesthetised, more ECG's etc. The AF can of course return the next day.
When I developed AF in 2016 I did as much research as I could and decided that the best strategy was the earliest possible ablation. There weren’t really any lifestyle modifications I could adopt. I wasn’t fat, didn’t drink or smoke and ate a good diet. I did drop caffeine but it made no difference.
I was in persistent AF from the start and it severely reduced my exercise capacity.
I had an ablation a few months later and it has been a total success. I’ve been AF free for 7 years so far. I exercise at will and take no meds.
The thought of not exercising and living a sedentary lifestyle propped up by medication is truly horrifying! I know many people are proudly overweight and sedentary. Those people are only fooling themselves. They have no idea what it feels like to be fit and healthy. They kid themselves that they feel good and they enjoy their lifestyle. If they could swap without doing the work they wouldn’t swap back.
The health benefits of exercise, both short and long term, are huge and far outweigh any risks. The facts are well established. It isn’t even close.
In your situation I would do as I did and actively push for ablation at the earliest possible time.
I did continue to exercise while in af. My cardiologist said to do what I could so I continued running at the same effort levels as before. I was much slower for the same effort levels so everything was a bit of a plod.
I’m convinced that my fitness helped with my recovery and contributed to the continued success of my ablation so I intend to continue.
Strength session this morning, half hour on the turbo this evening, 10 k run tomorrow then probably rest up before a 10 mile race on Sunday. I’m not as fit as I’d like so I won’t be fast but I’ll be a long way from last.
If only I could fix my tendency to calf injuries as easily!
Some good stuff in there Clive! A lot of people have their head in the sand, waiting for a fix, often with little desire to do anything themselves. I'm trying, with an hours indoor exercise a day and often also 2-3 miles walking, and soon I hope to get back into running. Losing weight. I'm pre-diabetic and diabetes is another risk factor, which doesn't seem to get mentioned in AF discussions. So, I'm watching the sugary stuff, and have stopped eating anything overtly sugar rich.
You're right about exercise making you feel good. It's a great feeling to be energised and physically capable.
Thank you for your reply. It is one of the more positive responses and encourages me to try the ablation route. Good luck to you in your journey, although it seems you are creating your own luck.
Thank you for sharing your post, please be reassured that AF is not life-threatening, although it can cause pain and inconvenience, it is not life-limiting, if you would like a chat or some advice, please feel free to contact our Patient Services Team: heartrhythmalliance.org/afa...
I don't agree with all the posts that say AF is not life threatening. Of course it is. If your HR goes up to 150 and higher and will not come down what do you think happens next. Well its a heart attack or a stroke, maybe both, constant AF increases the chances of both so I don't know how anyone can say its no life threatening. Its just semantics to say AF doesn't cause stroke or heart attack. It maybe some medical excuse to manipulate the figures.
I agree with this. It seems logical to me that if your heart is beating incorrectly and too fast, there is only one way for it to go if pushed too far. I have read and been told that AF makes a stroke more likely, hence blood thinners, and heart attacks more likely. Ditto for high blood pressure, which I have.
HI AFresearcher, one function of betablockers is to help the heart and lower the heart rate and this can mean excercise becomes more difficult because the heart rate naturally rises during exercises. I would talk to your doctor about lowering the bisoprolol.
I would also listen to your body when exercising on the rowing machine and cycle and don't push it too far.
And lastly I would forget about 'sudden cardiac death' it is rare and enjoy your life to the full without going over the top and having an excess of anything . I have had 2 relatives in their 50 die with cancer recently and that really concentrates the mind .
I regret not going on the list for an ablation before my highly symptomatic P-AF progressed to persistent , my quality of life none existent, and COVID appeared delaying things even more . I guess it is not so bad for those with few symptoms and for whom medication works because any treatment for AF is about reducing symptoms and increasing quality of life.
I have had an ablation which partially worked and am in NSR with the help of flecainide and will probably be having a second ablation .
"What particularly concerns me is reading more on the subject recently and finding that Sudden Cardiac Death i.e. Cardiac Arrest is one of the biggest causes of death with AF.
Dying "with AF" is not the same as dying from AF.
The real question is how much does having AF increase your risk of sudden cardiac death?
I don't know the answer and not sure anyone does. I suspect AF is probably a factor (I'm not a medical professional), but also suspect there's much bigger causes/contributors than AF of sudden cardiac death e.g. diets, blood pressure, inactivity, high BMI, smoking, alcohol, stress etc. You should ask your doctor if you are concerned about it.
I didn't say it was 'dying from AF'. As for 'how much does having AF increase your risk of sudden cardiac death' and not being 'sure that anyone knows the answer'. However we are talking about an erratic elevated heart rate and where does your heart go from there?See ahajournals.org/doi/10.1161... which concludes that 'SCD is the most common cause of cardiovascular death in patients with AF and has several distinct predictors, some of which are modifiable. These findings may be considered in planning treatment strategies and future research for patients with AF'.
There are other papers from research with data from patients with AF.
Link comes up with a "Page 404 not found" for me.I'm not sure what your concern is then. Do you think that you're at significant risk of SCD because you have AF, because it's the biggest cause of death of people with AF?
You're not sure what my concern is? Although I am not 'worried' about SCD, I am obviously aware that it something that can result from having AF, so call that a concern. Significant in the non zero incidence sense - what is 'significant''? Certainly significant if it happens to you. This discussion is done with for me.
Well being helpful is good, but I found your approach a little patronising because you were asking me to explain myself. I don't need to do that. I also said that I wanted to draw a line under the conversation because that is not what I want. That is my prerogative. You shouldn't get petulant about that.
3 members "liked" my 1st response to you but you thought it was patronising. Do you think you might have taken it the wrong way?And no, you didn't say you wanted to "draw a line under the conversation", you said you were "done with it"."What does I'm done with mean?
Usually in slang, it means: "I can't handle anymore of this," or maybe more accurately, "I'm done with this topic/with you." It can be used in a negative, serious way, or in a more lighthearted, humorous way -- it just depends on the context of the conversation."
I took it in the negative, serious way....
as it was clearly intended. As i said, I was only trying to help and why would i bother to do so if that's what i get in response. Now add being called petulant.
The intention of this group is to help each other by sharing our knowledge and experiences. If in doubt you should assume that's what people are doing when they respond to your posts.
I agree that I'd look at the bisoprolol dose.. it really reduces my capacity to exercise.
There's a case for doing nothing if you're OK on the meds. Lots of people live with AF quite happily. Cardioversion has mixed success and involves adding Amiodarone to the mix, something which gave me lots of side effects. Stating the obvious but the medics will look at causes, symptoms, risks and any other heart or circulatory issues.
My AF came with Covid so I've learnt to really rest if I get an infection. Finally my GP was a star pushing the cardiologists to get me seen through backlogs and strikes. I know not everyone is that lucky and I was ready to pay to see someone privately to discuss best treatment options (with a view to treatment on the NHS).
I don't think the Bisoprolol affected my ability to exercise but I've dropped it to 5mg anyway. I am tempted to leave cardioversion or ablation as I'm functioning OK as is, but do wonder if I should get one or both because after all your heart is supposed to beat in a regular fashion.
I hadn't heard of Amiodarone but after looking it up don't think I'd want to take it anyway. If I understand you correctly, it's prescribed if you have cardioversion?
I'm not sure how I got AF but not Covid related as I got that about a month after my AF diagnosis. I think high BP possibly caused it. I have been waiting for 3 months for results re a CAT scan and angiogram, so maybe I need a GP like yours.
Yes I was put on Amiodarone ahead of a cardioversion and stayed on it afterwards, 12 months altogether. Although it improves the success if cardioversion the cardiologist didn't want me on it any longer than necessary due to its cumulative, frankly toxic, effects. It can mess with your thyroid, liver, lungs and eyes and increases skin sensitivity to UV. It wrecked my sleep, I couldn't go out in the sun and I'm glad I'm off it. Three months since I stopped, still in sinus rhythm, but it stays in your system a long time. Bisoprolol makes me tired easily, doctor said because it controls your heart rate exercise can be more difficult. I do what I can but hope an ablation works and I can stop taking that one too to get proper fitness back.
Thank you for your concern. I'm not sure what too much is, but currently I am doing 30mins rowing, then 30 mins exercise bike, and often a walk of 2-3 miles. As long as I can exercise at a good level I will for several reasons. Because as a pre-diabetic I'm trying to burn glucose and also drive my blood pressure down. Weight loss is another priority but that needs calorie restriction as well . Some days I do very little.
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My first cardioversion. Couple of questions. Thanks.
Cardioversion question
1st Cardioversion- reduced Meds
