Some do and some don't

[Lifford]

I was diagnosed with AF and slightly enlarged heart chambers, earlier this year, which has turned out to be permanent AF 24hrs every day. On reading posts it seems different procedures are given for AF with varying success. I have been prescribed Apixaban in addition to bisoprolol. My pulse seems to be controlled with resting at about 60bpm. My question is, should I be pressing for further treatment to try and bring my heart back to sinus rhythm? I'm in the UK.

[BobD Volunteer]

Treatment is mainly about quality of life (QOL) provided rate is well controlled and you are anticoagulated so it is all about how you feel. If attempts such as electrical cardioversion have failed then ablation may not be offered but as I said its all about QOL.

[CDreamer]

There are treatments you could push for all of which come with risks and benefits, there are no imperatives. Bob has explained very well, more about how you feel.

Age is also big factor, if under 50, in your place, I probably would want to discuss treatments and would be asking about mini-maze, hybrid ablation which is not easily available on NHS but seems to be having better results with persistent AF - for some patients who meet the criteria.

[Rambler398]

So you’re a fit 72 year old with persistent (not permanent) AFib diagnosed in the last few months. You have had an echocardiogram and have also been diagnosed with heart block.

In your position I would self refer for a private, opinion only, consult with an electrophysiologist for further advice.

[mav7 in reply to Rambler398]

Lifford Good advice by Rambler

It is best to press for further treatment at the early stages of afib even though at this point your heart rate and symptoms are controlled.

[ozziebob in reply to Rambler398]

Not sure why you wrote "So you’re a fit 72 year old with persistent (not permanent) AFib", when the OP said "permanent AF 24hrs every day"? Perhaps your advice is still relevant, but the error will be noticed by the OP.

[javo123j]

I was told I wasn't suitable for an ablation by my EP because of an enlarged left atrium. He said it's a well known risk factor for ablation failure. I'm also in permanent AF at the moment with no real health issues although I'd love to be back in sinus rhythm.

[Paulbounce]

Hi Lifford.

I would keep keep pushing TBH. Research is key here. Many people in AFib have enlarged heart chambers - it tends to be part of the condition.

Your HR at rest of 60 bpm is good news.

Paul

[Blade77777]

Wolf mini maze surgery get back in sinus rythym. Its important to get back in rhytym sinus. Research wolf mini maze can get get rid of af for good . Patients are going on 20 yrs af free

[JOY2THEWORLD49]

Hi

My enlarged heart showed after 1 year 4 months of rapid persistent heart rate 186 on Metoprolol Day with 47bpm Night and pauses. Changed to Bisoprolol by Heart Specialist and left for 9 months, 156 day and 47bpm at night no pauses.

Both reported through 24hr Heart Monitor.

New Locum referred me to a PRIVATE specialist.

Introduced to cCB Calcium Channel Blocker Diltiazem with 1/2 dose 180 too high. Tweaked to 120mg AM.

And 2.5mg Bisoprolol for BP at Night.

Last years eCHO showed no enlarged heart.

Control using meds best.

Enlarged heart would not do a n ablation anyway or have anti-arrhymic meds anyway.

I was diagnosed with rapid persistent AF. But now controlled have a slower persistent @ 60s day H/Rate and Night 47avg.

I have severe dialation of Left Atrium which my Locum who has had AF will improve on Bisoprolol. The H/Specialist says NO. He is young and my Locum is in her 80s.

cheri JOY. 75. (NZ)

[Alphakiwi]

Depends how you feel mostly. But i do want more . I want to get back to riding my bike again and enjoying it even if not competitive . I want to sleep right through the night without waking from large palpitations. I want to sleep right through and wake without having nausea. I want to get up in my chair in the lounge without feeling lousy and shaky. I could go on but these are some of the thongs i and many others put up with most days of the week. Today was one of those that i did not experience much of this and its like being reborn. Lots have been tried to find out why The thing that ha helped me so far was dropping some of the meds as well as implanting a pacemaker. I was to have had AV node ablation as well but i improved lots. Three years down the track i have been pressing my GP to look at the node ablation again but she wants to keep trying to find the right drug again.