So, had a private consultation with a Cardiologist yesterday to investigate my AF and subsequent shortness of breath. I had previously had 2 separate lung function tests and seen a respiratory consultant twice as well. The net result was that my lungs were normal, and a low key level of emphysema was not a contributory factor towards my breathlessness, particularly when the oximeter reading was 99%. My pitch, therefore, was that there was enough oxygen in the blood, but the AF was causing the heart to pump the blood around ineffectively. So far, so good.
On arrival, I had an ECG which showed me to be in AF with a heart rate of 143 BPM, but I was not aware of this. At this point, I should mention that I am on 120mg Diltiazem and 20mg Rivaroxaban. I also have stage 4 prostate cancer, but let's not complicate things. Anyway, the cardiologist thinks my AF has now progressed from being paroxysmal to permanent. In order to establish this, he is organising ECG monitoring for 5 days.
Now to the good bit. He also talked about my having a DC Cardioversion. On the face of it, this seems to be a good idea so, of course, I did a bit of checking. The BMJ carried out a study and found that 37% of patients were still free of AF at 6 months, and 24% at 1 year. Not too impressive, I thought.
So, good people, I would appreciate any feedback from those who have had DC Cardioversion. What was the whole experience like? Did it stop your AF? If so, for how long? Was it worth it?
Thank you. I really appreciate it
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Well, you're talking to the right person, having had a total of 28 cardioversions over 30 years and 3 already this. year. Mine have lasted variously from 4/6 months to 3/4+ years , with 12 months being quite common.
The actual procedure is really nothing to worry about although if you've never had one it does sound a little frightening. You will be well sedated so will know nothing about it .....probably 'asleep' for about 10 minutes. Some people get a slight burn mark on the chest area but I've never had this apart from in the early days when equipment was a little different.
Certainly worth having in my opinion.
Best wishes
J
PS....just read your bio....you've certainly been through the mill! A cardioversion will be just like a walk to the corner shop. ( My husband has permanent AF , is in remission from prostate cancer and has Parkinson's). Sounds like your coping very well.
Thanks so much for you reply Jalia. You have given me some cause for optimism inasmuch as the time spent in normal sinus after a cardioversion is maybe longer than I might have thought. Also, that you can keep on having them when AF returns. I'm quite impressed by your score - surely you deserve some sort of trophy. Long may your husband stay in remission from his PC, and I wish you both the very best.
DCCV is not a cure for anything but a useful tool in finding out if a patient can be converted back to NSR (Normal sinus rhythm).That can sign post other treatment plans.
Thanks BobD. I understand that DCCV is not a cure. I am simply looking for a period of stability so that I can investigate other available medications - and maybe find something that doesn't react with my cancer medication and cause me to be breathless. Sometimes, it's not much fun being old.
Had one cardioversion 6 years ago after 7 continuous days of AF. It was done under general anaesthetic. Had to partially swallow what felt like a Lego brick which was a device to check for clots before they started. It took them 4 attempts before my heart returned to NSR. Consequently, I ended up with a scorch mark on my chest in the shape of a clothes iron.
This was my experience but others may differ. So was it worth it? Oh yes! Please don't be put off.
Did it prevent my AF from returning? - No, but I never had a prolonged episode like that again, just back to the odd bout that self converted and finally ended up about six months later with an ablation.
A HR of 195 must have been really frightening. I would imagine you would grab at anything to make that go away. Glad to see that you have made progress since then. I really don't feel my AF these days and that's both good and bad. It's a benefit not to feel the high heart rate and the arrhythmia, but then, a regular or constant period of high HR can't be good for long term health. Time to dip my toe in the water.
I had a DCCV in 2017 and it lasted 7 years, excepting a couple brief (hours) episodes. free of drugs too for much of that time. Had my 2nd afeter going into AF in march. but this one lasted only 5 days. They now say ablation is the answer.
From what I have been told, you were very fortunate to get 7 years of good sinus rhythm after your first DCCV. I think 3-4 years would do for me and, because of other factors in play, I don't think ablation would be anywhere near the top of my list
As was mentioned, a DCCV isn't a cure for Afib, but it resets the rhythm of the heart hopefully back to NSR. I've had one done and it was a breeze. It may be an opportunity to try an AAD (anti -arrhythmic drug) to keep you in NSR after the DCCV. Obviously your Doctor would need to approve the AAD as being OK in combination with your other health issues.
BB and CCB are meant to bring your heartrate down, not necessarily get you in rhythm or keep you in rhythm. AAD's like Flecainide, Sotolol, Multaq, Amiodarone, etc are meant to do that. It all depends on if they are OK with your other health issues and medications.
Some people take AADs while waiting for an ablation, some take AADs long term and no other intervention, some just live with permanent Afib (as long as their heartrate is kept below 100 at rest and they are anticoagulated).
Thanks for the follow up up BB. I had not appreciated the difference fully between AAD's and BB's and CCB's. I would certainly be looking to take an anti-arrhythmic drug following a DCCV but would need to check out side effects and interaction with all my other medication. This could be a watershed moment. If it is accepted that my cancer medication (Abiraterone) caused AF in the first place, or even facilitated it, then I would not want to go back on it.
I will certainly be checking out antiarrhythmic drugs. When I have a cardioversion, I will be careful to avoid trigger points where I can, but I also need to keep any returning AF in check. Starting AAD's before the procedure will also be looked into
I’m scheduled for my 8th DCCV in 2 years this coming Wednesday. I see them as a way of maintaining my QOL while I’m awaiting an ablation.
The first one lasted a year. The others from 3 months to 5 days.
At one point, I had 6 DCCV’s in 5 months while my “EP Care Team” dragged their feet (my view) on getting me scheduled in the ablation queue. An ablation at the time it was needed would have saved me at least 3 and maybe 5 DCCV’s.
I knew I needed a second ablation, but instead of getting me scheduled, they put me on drugs drugs drugs, which made me feel crummy and did not control my Aflutter. Only an ablation fixed that.
The first ablation fixed my AF. The second fixed my AFL. My last CAM Monitor showed zero AF or AFL. But it showed AT, Atrial Tachycardia, whose etiology is different from the other two and can result from, be a side effect , if you will, of an ablation.
Where I’m headed is that this time around I choose DCCV ASAP and no drugs as I await the AT ablation I’m lobbying for.
Once I get in the ablation queue, I’ll opt for DCCv’s as often as necessary to keep me in NSR as I wait.
I will not take temporizing drugs that make my life miserable, usually keeping me in soul-sapping bradycardia, fatigued all day long, dispirited, lightheaded and foggy-brained, feeling like my brain is sloshing around as I slog my way through the mud of just daily life. Amiodarone is the worst.
My advice (obviously): Go for the DCCV! It’s the best interim solution, at least for me, as one awaits an ablation, which offers the possibility of an actual substrate cure—something neither drugs nor a DCCV can do.
I’m sure others have had this experience: Often I walk out of the hospital after a DCCV and feel miraculously myself again. Being back in NSR changes me from a dishrag back to the confident and happy person I know. I’ll take that NSR feeling however long it lasts, with gratitude.
From being a dishrag to a confident and happy person is certainly a great recommendation for having a DCCV and I am all for it. It's all about QOL for me, and the DCCV is a quick fix, which is what I am looking for, although I hope I get more than 5 days out of it. The clash between my AF and cancer drugs just brings me down and there must be more to life than this
Anyway, thanks for your response, and all the very best to you
Thanks for that 2learn. Where I am now, I would settle for 12 months respite. I am aged 78, so have learned to take it as it comes. Did you have any breathlessness when you were out of NSR? That 's not a word that has come up much in the answers to my post, so I'm wondering if I am just unlucky.
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