Update on AFIB after Doctor visit

[Stetson]

Update from my Electrophylogist Doc. Yesterday. He said since the afib just started and was persistent he wanted to start slowly and start with cardio version. Will be scheduled within next two weeks. Said ekg showed afib with heart rate from 70 to 92 beats per minute. Said afib has no cure but many options are there for helping control it. Increased eliquis to 5 mg twice daily. Said after shock treatment that it may come back. Also said alcohol is a definite trigger and to have no more than two drinks per week, Never was much of big drinker in last ten years ,maybe six drinks per week so I guess for a while I will stop altogether. Said I could continue exercising at a slower pace and not hit my max heart rate.

[mav7]

Sage advice from your EP.

Continue to monitor your heart rate and blood pressure at home.

[Stetson in reply to mav7]

Will do.

[mjames1]

My only thought is why wait the two weeks? Waiting 3 days makes sense, since a good percent of afib episodes convert on their own during that period. But beyond that, if the plan is to cardiovert, the sooner the better. I'm going to assume that the wait is for the Eliquis to kick in, but if you have a Transesophageal echocardiography (TEE) -- right before the procedure, then no need to wait. Something you might want to talk to the ep about.

Are you on any rate control drugs, or is your afib just at a low rate? If the latter, then arguably they can do nothing other than keep you on Eliquis. This was the situation of someone I know about your age. This was the situation of a someone I know about your age. Very athletic, was diagnosed with afib, but his heart rate was low and pretty much asymptomatic. After passing a stress test, the ep just put him on Eliquis and told him to go live his life as before, which he did. Six months later he converted to normal rhythm and has been in normal rhythm now for over a year.

Jim

[Stetson in reply to mjames1]

Waiting on Doc. To schedule. Will try Monday to see if I can push it up. I feel nothing and my heart rate is between 70 and 90. I am having a TEE before the treatment. I am on metropopal and eliquis and have been on it for a week.

[mjames1 in reply to Stetson]

So the difference is my friend had a normal heart rate in afib without a rate control drug like metoprolol.

In your case the cardioversion definitely makes sense, and since they are already doing a TEE, the cardioversion can be done anytime. Hopefully you'll be able to push it up a bit, but if not a 2 week wait is acceptable and you might even convert on your own.

Jim

[Stetson in reply to mjames1]

Thanks

[Ppiman]

It sounds like you have a good doctor. Alcohol can bring on an episode for some I have read, but certainly not for me or two others I know well. I only drink in moderation but find it relaxing so I'd rather not have to stop. I don't know how your EP can know it is a "trigger"for you in the circumstances.

Steve

[Stetson in reply to Ppiman]

Thanks, going to try non alcoholic beer for Super Bowl. We will see.

[Omniscient1]

All sounds good to me, and he's warned you the cardioversion my not last, hence stay away from possible triggers. Best wishes.

[Stetson in reply to Omniscient1]

Thanks

[OzJames]

as the doctor said be aware of your max HR and stay below it. I set mine at 140 and exercise every day. When I’m in AF my resting HR can be anywhere between 75-90, then when I start metoprolol and Flecainide it drops to low 50’s to early 60’s. My normal HR at rest is 60-65. I’ve had a few CV’s first he waited a month, the last 2 with a couple of days. The lifestyle changes I’m sure make a difference, I only drink Zero beer, occasional sip of my wife’s wine and only decaf coffee. You can enjoy a normal life with AF especially if your rate is well controlled

[Stetson in reply to OzJames]

Thank you. I am learning that when I get close to 140 I will sit down for a few minutes until my rate gets to about 105 then I exercise more. Have noticed on my leg days my heart rate very seldom gets close to 140 but on upper torso days if gets there faster. After CV I am going to ask about flecainide.

[OzJames in reply to Stetson]

They normally only prescribe Flecainide after stress echo to make sure heart is structurally sound. In terms of your heart workload, yes it goes higher with weights etc.. mine is most controlled when we go for our daily walks. I think of it as my most important muscle and give it strength by regular exercise., hopefully that makes a difference…. I first got AF 31 years ago with episodes only once every 5 years on average up to 2022 then 4 since then. I’ve enjoyed an intense exercise regime my whole life and only backed off that intensity in 2022 to a more thoughtful and controlled exercise routine. Each person is different so go easy to work out your limits

[Stetson in reply to OzJames]

Thank you ,will see how it goes.

[RVine3]

That's what my EP did - recommended cardioversion as first step - I had it and have remained in NSR for over a year since... I hope it works for you...no guarantee how long it will last, of course not, but day by day...am on eliquis...also was warned about alcohol...good luck