Persistent AF

[Bigredhear]

Hi all,I have recently gone back In to AF and just seen my cardiologist after having an echo and 24 hour monitor.

The echo has shown the hearts looks OK with a good EF and moderate dilation of left atrium, the monitor showed my HR anywhere between low 70's and mid 120's with an average of 94!

The cardiologist doesn't seem to concerned by this and is saying its up to me whether I want to have another cardioversion or ablation (I have one of each in the past 4 years) or whether I want to try and control my AFIB with meds...

My worry is that being back in AFIB with a HR that can go up to 120ish even though I'm on 5mg bisoprolol surely must be putting a strain on my heart?

Sorry for the ramble but I'm feeling under a lot of pressure to make the right decision

Thanks

[Singwell]

I'd think your cardiologist's goal in offering meds would be to lower the HR, even though you're still in AF. If you're persistently in AF I think that's quite a common approach. My brother is in that stage and says he hardly notices his AF now. I think there are other more aggressive meds that can 'remodel' the heart's behaviour, so he/she might be considering those. I'd ask - what medication are they thinking of specifically? Then you can read up about them. The AF Association has some good leaflets.

[Bigredhear in reply to Singwell]

Hi,I'm already on bisoprolol and the cardiologist mentioned digoxin?

Thanks

[KathleenV]

Hello,

Please try not to panic and remember that no decision is a decision too. Sometimes my heart soars and does somersaults at the least physical activity but also if I get upset about something. I try to relax and wait it out.

Deep calming breaths. Smile. Sit down if you can and fill your lungs with fresh air.

Enjoy your day

Kathleen

[Bigredhear in reply to KathleenV]

Yes good advice, I seem to pass most days now not experiencing too many symptoms since change of meds but sometimes when lying down it feels like my heart is trying to pump out of my chest.I am going to work on some breathing techniques

Thanks

[Buffafly in reply to Bigredhear]

Do you lie flat? Sleeping propped up or better still on an adjustable bed might be better.

[Bigredhear in reply to Buffafly]

I do sleep fairly flat and on my side as I get back pain on my back.Sleeping on my right side does feel better

[Buffafly in reply to Bigredhear]

I was interested to find out that your heart isn’t fixed in place. So if you lie on your side - particularly left - it can be slightly pushed out of its favourite position so it can feel a bit stressed and react to that. The way to sleep on your back is to put a cushion under your knees.

[JOY2THEWORLD49]

Hi

So just add the rate controller CCB Calcium Channel Blocker Diltiazem 120 CD and separate this by taking in the morning.

Then take your Bisoprolol at night. I take 2.5mg Bisoprolol PM.

Then PRADAXA 110mg twice a day.

I've been on this regime for 2 years 6 months.

My Day H/Rate is now 60s. My Night is my normal at 47bpm. The Diltiazem slow release runs down and allows the avge 47 bpm at Night without concern. Metoprolol left me at 186, with pauses at night, Bisoprolol left me at 156, with no breathlessness or pauses, same at night.

BP 110-135. /. 69-79. Great.

cheri jOY. 75. (NZ)

After 3operations since being diagnosed I had Thyroidectomy with 2 anaesthetists & 2 Docs in op room, uncontrolled with metoprolol. Discharged after @ 135. The other 2 (not heart) with controlled heart rate.

I'm surprised at your specialist as until I was down at 60s I felt fatigued, sweated alot and had very little energy.

Below 100 is best. I lost some weight 5-6kgs over 1st year and I'm sure that helped in the mix of things.

[secondtry]

I am similar at present, awaiting cardiologist's opinion on my 48hr monitor. In the meantime, I avoid as much stress as I can and hum to get back into NSR & normal HR, the latter was endorsed surprisingly by my Cardiologist.

[Bigredhear in reply to secondtry]

I have read about the humming but to be honest my AF is constant and I don't think it will stop without a procedureThanks

[Ducky2003]

I, personally, would look at any option to get you out of AF, nit just coping with it. I can only speak from my own experience, where AF has caused my left atrium to enlarge and went from slight to severe in a couple of years . This has affected my mitral valve and I'm now currently on a waiting list for valve repair surgery with a Cox IV Maze thrown in.May be talk to your EP about being able to be referred for a hybrid convergeant ablation?

MummyLuv posts will give you more information about a similar type of procedure. She did have hers done privately but it is available on the NHS.

I was offered it but then they discovered the valve issue and were not able to do it.

[Bigredhear in reply to Ducky2003]

Hi,Yes I agree, I think long term AF has an adverse effect on my heart so I am pretty sure I will opt for a procedure.

I'm waiting to see another specialist (EP) to look at my options.

Thanks

[Dudtbin]

i have persistent af - i was put on digoxin and straight away went into nsr , am now on sotalol and entresto, among other drugs and have remained in nsr as far as im aware!

[Bigredhear in reply to Dudtbin]

That's good to hear, sounds like the meds are definitely doing there job.

[Rainfern]

I was put on digoxin while awaiting ablation for persistent AF last year. It was my wonder drug! It didn’t stop the AF but it kept the rate more steady and, because it strengthens the beat, I was less out of breath on exertion. I’m glad I had the ablation and would definitely have a second if needed. They took me off digoxin the day of the op. Good luck with whatever you decide to do.

[Bigredhear in reply to Rainfern]

Thank you, glad that it worked for you.I'm definitely leaning towards another ablation but will try another cardioversion first

[Rainfern in reply to Bigredhear]

Yes I had another CV first but got myself on the waiting list for ablation anyway, even though not quite decided. CV is generally a temporary solution and helps in deciding on the effectiveness of further procedures.

[Billblue]

I’m in the same position as yourself just had a echo and heart monitor with Dr Sanjay Gupter at York Nuffield had heart rate of over 120 on monitor average 95 he increased my bisoprolol to 5mg from 2.5 and added end digoxin 125 and made so much difference to the way I feel in persistent AF I do not feel out of breath so much now and heart rare average 60

[Bigredhear in reply to Billblue]

Hi,I have only just picked up my prescription for Didoxin as I have been away.

Did you notice any side effects with it?

I have now got an appt in 2 weeks to see an EP so I presume we will discuss CV and Ablation

[Billblue in reply to Bigredhear]

Some side effects by increase of bisoprolol is cold and numbness in feet I have been advised to slit dose to 2.5 morning and 2.5 at night that was two weeks ago and have appointment to discuss any improvement after 4 weeks but I have noticed a improvement in Bp and heart rate so I will see in the next 2/3 weeks

[Billblue]

PS Dr Gupta said bisoprolol was cause of cold feet