Different treatments

[TUSC53]

Hi I have been in Afib twice before over a ten year Span one of these occasions was also viral I think. Last February 2023 I woke up with a bad virus which I had all week and stupidly worked through. We also have a lot of family stress to deal with, feeling my heart was out of rhythm again this being third time I saw the GP. After a ECG confirmed what I knew already I was prescribed digoxin , riveroxiban and bishophmol fumerate.

I managed to see the cardiologist in November they put me on sotolol to see if that would convert it back but it's not so now they trying dilitzem for rate control and got a one year Access to cardiologist department if needed.

I was not offered ablation and they said I could try a cardioversion but it might just revert to Afib again and they did not want me to stay on sotalol due to side effects from long term use.

Does this sound about right ? For treatment just to carry on on a rate control medication. As I here so many that get a ablation is this for more serious AF treatment?

[etheral]

I would think a Cardioversion would be indicated. Perhaps it would convert you to NSR and if so, your medication can be adjusted from there. You should ne seeing an Electrophysiologist. etheral

[TUSC53 in reply to etheral]

Thanks That's all they have offered me at the moment. I am under the NHS in UK and apparently there is over a year waiting list for a ablation. and I think because the cause seems to be either viral or something else I suppose some treatment would be limited

[Buffafly in reply to TUSC53]

You wouldn’t be offered an ablation unless you had had a cardioversion that worked - even for a few minutes, to prove you can return to NSR. A virus may have set it off but won’t be keeping it going. Unless there are issues you haven’t mentioned they aren’t trying very hard.

[pusillanimous in reply to TUSC53]

I had one cardioversion - one quick zap and I was back in NSR. It is painless and quick - I seldom have episodes of AF now, usually brought on by illness of some sort (viral or bacterial). The Cardio's view is (we are very short of EPs in the South African Province in which I live and most Cardios are well versed in AF given how common it is) minimum invasion - I was all ready to fly to Cape Town, but he advised against it. That was 5 years ago.

[Karendeena in reply to TUSC53]

I am in the UK (Leicester) and I have waited for an ablation over a year

[Buffafly]

No it doesn’t, unless the AF isn’t bothering you? But even so, 53 is a bit young to give up on NSR. Cardiologists seem to be quick to decide you have permanent AF - personal experience. I would push for the cardioversion and in the meantime work on lifestyle as in finding ways to deal with stress, cut out alcohol, caffeine, food/drink with artificial sweeteners and preservatives or high sugar content, (Mediterranean style diet good), try to lose weight if necessary. You may say you are already living as healthy a life as possible for you, if so, great!

We have had members here who have been returned to NSR and had successful ablations after a long period in AF but it’s difficult. If you can afford it (about £250) I suggest you see an EP privately as it seems your cardiology team is trying to do as little as possible - understandable in the present circumstances but it’s your life!

[TUSC53 in reply to Buffafly]

Thankyou yes it's all by telephone conversation with the cardiologist team and then when I ask a question they seem to go off to speak to someone else. I will think about your advice .

[BobD Volunteer]

Any and all treatment is only for quality of life so as long as rate it well controlled and anticoagulation where apropriate =smiley face. OK cardioversion may enable NSR which might indicate that ablation may be useful but it is not a cure.

[Buzby62]

Treatment option information

api.heartrhythmalliance.org...

and a post you might find of interest

healthunlocked.com/afassoci...

Hope these are helpful

[Ppiman]

All treatments (i.e. by drugs or ablation) are, all else being equal (i.e. the heart is otherwise disease free), for symptom control, I gather, so the choice will depend on how often and badly you are are affected physically and emotionally by your AF. There is some evidence that keeping a heart AF free is good for it over the long term, but that remains unproven, I believe.

Steve

[JOY2THEWORLD49]

Hi

I never got rate control on BBs but CCB Diltiazem was my saver.

Some cannot have ablation etc and you too may be one of them. An ECHO will show whether you have structural damage.

Cheri JOY 75 (NZ)

[Hidden]

53 is awfully young to give up on getting you into sinus rhythm if it's possible. Just because it was triggered by a virus is no reason for it to continue once you've recovered, and is not a reason for you not to be a candidate for all treatment options. I second  Buffafly s comment that they don't seem to be trying very hard. The state of cardiology in the UK these days is shocking.

Personally I would push back. Possibly put it in writing that you are relatively young and prior to the virus you had very occasional episodes, and would like a cardioversion sooner rather than later please! 'You might go back into AFib' is no reason not to try. You might not! And, as someone else has said, if you go back into NSR, even briefly, that's a good indication that an ablation could help. There's also no reason that you shouldn't be on the waiting list for ablation - it might be a year but it'll be a lot longer if you're not on the list!

Alternatively you could go for a private appointment with a cardio/EP who also sees NHS patients. After the initial appointment they can write to your GP to ask them to refer you to the same Dr via NHS. I'm currently speaking to the Royal Bromptom to do exactly that, and was quoted 'up to £300' for initial appointment.

I see on your info that you have ADHD. Perhaps you could look into various methods of regulating your nervous system via breathing exercises, deep relaxation etc. This might be helpful for you - as an ADHD type myself I know that we can be pretty 'wired'. As others have suggested also look at other lifestyle factors to support your heart. Being overweight, stressed, eating processed food with additives and, sadly, alcohol can all be factors in AFib. Currently those that are more informed than me are saying that there's no evidence that caffeine in moderation affects AFib but alcohol definitely does.

Good luck. I hope you get some better response.

[Karendeena]

Hi there, did they say why they didn't want you on Sotalol long term - side effects?? I have been on it for 3 years and no mention of having to stop taking it because of long term side effects.I am scheduled to have an ablation at the end of March and to be honest I am nervous as I don't want mine being made worse. I have episodes every few months and my EP says there is more chance of an ablation being successful in the early stages

[1969hippy]

I have had AF for ten or more years. Never been offered any interventions just given anti coagulant. Haven't see a cardiologist since first diagnosed . I don't even know what kind of AF I have. Anyone else in a similar position?