Need Help

[afib22]

My Husband has had afib that would come and go for a couple years, always went into NSR on his own. Then beginning of January he has been is constant afib 24/7. He had a cardioversion on 2/27 and stayed in NSR for 72 hours. He has been back in 24/7 afib. He is on elliquis and a calcium channel blocker. I could not get an appointment with his EP until March 18th and this is with the nurse practitioner, if I waited for the dr it would not have been until July 19th. Is it ok for hm to be in afib continuous until the appointment? I am going to ask about an ablation but who know how far out that will be before they schedule it

[mjames1]

In general not ideal to remain in afib that long, but as long as his rate is controlled, and he's not having any chest pains or in other distress, he should be OK until the appointment.

Hopefully, at that time they will either try another electro cardioversion augmented with a daily anti-rhythmic medication to give the cardioversion a better chance of holding, until they schedule an ablation.

Jim

[mav7]

Is it ok for hm to be in afib continuous until the appointment?

If his heart rate (<100) and blood pressure are controlled and taking anticoagulants should be fine until appt to discuss further therapy.

[DevonHubby1]

Wife has been in persistent AF since March 2023. CVs failed but medication (7.5mg Nebivolol) is doing a good job controlling her rate. Arthymia nurse suggests that this is best way forward for my wife.

[hanne6263]

I was in continuous AFib for almost a year before my ablation in November 2023. I was OK ish, rate controlled with bisoprolol. I'm now in NSR.

[CDreamer]

Whilst achieving lasting NSR is the gold standard, many people live very well in permanent AFib with few symptoms as long as heart rate and symptoms are controlled. Permanent AF is when both patient and doctors agree that further treatments are unlikely to improve quality of life. As others have already said lowering risk of stroke and heart rate control are the first line treatments.

How symptomatic is your husband? Suitability for ablation varies but age and other health conditions can be a factor. Ablation works best when treated early in progression ie: whilst AF is still paroxsymal. The chances of lasting success decrease the longer AFib persists which is why seeing an EP earlier in the process is important.

Have you looked at the AFA website on treatments? May I suggest if your husband has had AF for some time that you might also look at hybrid mini-maze which seems to be gaining ground as a treatment for those in persistent AF. Very few surgeons offer the procedure and it is surgery, often with catheter ablation. Worth the research.

Many of us struggle with seeing an EP directly through the NHS and however galling it may be, I would suggest you look at a private consultation cost circa £200-300. You are often then able to transfer to the specialists NHS list for treatment. It doesn’t always speed up the time frame to treatment but just having that conversation with an expert can really help.

Best wishes

[BenHall1]

If you are resident in UK can I suggest you make an appointment with your Surgery Pharmacist ( of a local one, say Boots ) and seek some guidance on the medication options available for your husband. In my Surgery we have a resident Pharmacist and any discussions I might have with GP on meds is instantly referred to the Pharmacist anyway. My view is they are more highly qualified than GP's anyway to discuss meds.

I wouldn not want to be of AF long term as you indicate. Has your hubby had a recent ECG, to get an idea exactly what state his heart is in ?

[Ppiman]

You don't mention your husband's age. Permanent AF isn't always harmful if the heart rate is kept near normal, or at least lower than 100, while resting. Of course, the symptoms might make life uncomfortable but I gather that the heart itself is not necessarily harmed by the atrial mis-activity.

I know two people with permanent AF, one of whom having had it for very many years, and both are well.

Steve

[BevCynfelyn in reply to Ppiman]

Bit sweeping that statement.... Some people's hearts are very much damaged by months spent in persistent AF, with the left atrium increasing in size and the mitral valve being weakened or torn and thence needing open heart surgery to replace it. I know. Been in AF continuously since Oct 2022. On a cocktail of 9 medications and finally getting to see a cardiac surgeon on Monday 11th March. Not everyone has few or no symptoms.

[Ppiman in reply to BevCynfelyn]

Yes - sorry. I’ve edited it. I watched a video recently where the cardiologist said much as I had but I think a bit of context was missing. The two friends I have with permanent AF also affected my thinking.

Also, when I had permanent atrial flutter, in 2019, the cardiologist told me similar about my own situation - that it was the high rate (155bpm in my case) that had caused my temporarily weakened valve and reduced the EF, rather than the flutter itself.

Steve

[Singwell]

It sounds as though he may have moved into persistent AF. This can happen if you have AF long term. How much does he notice it? My.brother is now in persistent AF and on Bisoprolol only. He says he barely notices it.