My husband who is only 40, has been in constant atrial fibrillation for almost 9 months. Which came as a surprise as he has always been a healthy fit person his whole life. He has had bloodwork and doesn't have any deficiencies. He had 2 cardioversions, both unsuccessful, only lasting a few days then he went back into afib. He is now on a 9 month waiting list for an ablation. He is on Apixaban and Bisoprolol. Nothing has seemed to help him and I'm very concerned about the long waiting list. I've also been reading how ablations aren't always successful, which is another concern. I see how much this has affected his life. He's tired most days and can't exercise like he once did. Feeling his heart skipping beats and racing is a constant stress on him, physically and mentally. Has anyone had this experience and what helped? Any stories to share? Would a pacemaker or ICD be a better option? We both just feel so hopeless and powerless waiting for the NHS. Just looking for some support or hope.
AFIB help: My husband who is only 4... - Atrial Fibrillati...
AFIB help
I'm sorry about the wait, but neither a pacemaker or ICD will fix the underlying atrial fibrillation and could complicate future interventions leaving your husband potentially dependent on a machine at such a young age.
While you're waiting for the ablation, you might speak to his doctors about optimizing his medication's not just for medical symptoms, but for quality of life.
This might include substituting a calcium channel blocker like Diltiazem for the beta blocker , Bisoprolol.
Beta blockers are notorious for causing fatigue. As to as irregular rhythm, many here have found relief with anti-rhythmic drugs, such as Flecainide.
The best person to see about all this is an electrophysiologist, as opposed to a regular cardiologist or general practitioner.
It's true not all ablations work, but for the most part they do. It may not be apparent on forums like this, but you have to understand that those that have a successful ablation tend to leave the forums and go on with their life. And those that have the problems stay on for more support.
After many years of atrial fibrillation, I finally had an ablation a year and a half ago, and other than one 3 hour episode, I've been a fib free. I'm glad I made that decision.
Jim
Thank you so much for taking the time to respond. I think the next step should definitely be to alter his meds. Also what you said about people who have had successful ablations usually move on and don't post really stuck with me and gave me hope. Glad to hear youre afib free, it's a glorious feeling.
I'm similar age to your husband (39 now) and I've always been fit and healthy. I was in persistent from March to August the past year (probably a year or over as my afib was picked randomly). I had two cardioversions in 4 months and then an ablation after 2 months from second cardioversion. I understand the waiting must be terrible! I was lucky to have private insurance, I think the wait would've impacted terribly on my mental health. My case was a bit different as I didn't have symptoms and cardioversion worked but I just wanted to give you hope for the ablation. I felt very lucky to have access to this procedure, only 20 years ago we would've been stuck with AF. Also all the statics and research is based on older patients, who probably had AF for decades before having the ablation and often have comorbidities. Most of ablations are successful and if unsuccessful it can be repeated. I'm so glad I decided to go for mine at the earliest opportunity, it gave me my life back.
Thank you so much for sharing your story and giving me hope that it will work out. I'm happy to hear you're doing better. The waiting has been hard and hopefully it will be worth it.
I wouldn’t call the cardioversions unsuccessful as they did work for a short while but just didn’t last. The fact that he could maintain sinus rhythm even for a few days could be seen as an indication that an ablation would help.
He should discuss exercise with his medics as it depends on how symptomatic his AF is and how his heart rate is controlled. The aim is to keep the rate average between 60 and 100 bpm roughly and exercise can put your rate up and make you more symptomatic. Also bisoprolol will have an effect on energy levels in my experience and I was only on a small dose.
I always say my paroxysmal AF affected me more mentally than it did physically so being persistent must be a challenge to cope with especially so young.
As others have replied, I would try and get a medication review and discuss exercise while waiting for the ablation. We’re all different and rarely one size fits all.
Best wishes
Thank you for your response amd advice. Yes the waiting and the constant afib have been particularly challenging mentally, especially when he is trying to sleep. I think the next step will have to be a medication review.
My first recorded episode of AF was in 2012. I was 31. 200mg of flecainide stopped the episode. I used flecainide to stop my AF episodes (about 2 per year) until 2021, when I had an ablation. Since the ablation I have had terrible PACs, but no AF. I still take flecainide, but for PACs. If your husband is a suitable candidate, flecainide is definitely worth a try.
What's a PAC, please?
A premature atrial contraction. It’s basically a ‘half beat’ which doesn’t reach the ventricles. They’re benign.
Many thanks. Sometimes these posts are like reading code, for newbies !
apatsyf , maybe this post of abbreviations will help healthunlocked.com/afassoci...
You can also find it in “Pinned Posts” and expand to “see all”
Best wishes
Similar position, 53, permanent AF, HF, SOB, unable to carry out any physical exercise, get exhausted and tired, I have a pacemaker after undergoing pace and ablate.Pacemaker upper limit set at 70bpm, my heart rate doesn't go any higher even when I exert myself as it makes the AF worse.
Had a consultation 6 weeks ago and not heard a thing since.
Guessing it could take months before I get a treatment plan.
Meds: ramipril, dapagliflozin, bisoprolol, apixabam
Suppose I'm not an emergency case and the docs believe the meds are managing the condition in the meantime but the physical and mental stress really takes it out of me.
Fit and healthy doesn't really come into it with AF unfortunately, in fact exercise may be a cause (holds hand up in shame). On the tiredness, it will be worth you investigating the bisoprolol dosage and time he takes it. Beta blockers can really crater your life, make you feel tired and lethargic.... AF itself probably won't.
Firstly, anxiety is a key issue so take all the action you can early to reduce other stress factors so you can manage better the extra AF stress.
Flecainide 200mgs may be worth a try. It worked for me at 60yo for 11 yrs albeit with many lifestyle changes.
Being so young, the medics may favour ablation to avoid 'pills for life'. The converse argument here is that after the ablation you may still have to take the pills. Also the pills may buy some time to stabilise his life and wait for an improved ablation procedure - I was quoted a 70% chance of success with another ablation likely, so declined.
Lastly, I am grateful to AF for forcing me to adopt a more sensible life plan and overall I am enjoying life more 😁.
may I suggest counselling in the meantime to help his mindset. Good luck.
There are some really informative responses here. I was 29 when I first experienced AF. Had it for 20 years now and only 3 years ago was offered cardioversion and ablation.Like your husband cardioversion only lasted about a day and a half but that was enough for them to agree to ablation.
I had 3 ablations and have (somewhat miraculously given the duration of my AF and given I went back jnto persistent AF straight after all ablations) now been in normal rhythm for 15 months. This has reversed the heart failure that had developed from the years of AF. Ablations aren't permanent and my Cardiologist and EP keep reminding me it'll be back at some point but I'm taking this respite as a gift and I'd have another ablation if and when AF returns.
Bisoprolol can be great for some but is also notorious for causing fatigue and breathlessness for others. I couldn't tolerate even a very small dose.
Good idea to get meds reviewed and try that route first.
There is also the option of a private consult. Going private for interventions will cost thousands but a private consultation with a Cardiologist or EP is around £250... something to consider if you feel another opinion would be helpful.
Thanks so much for taking the time to respond and your information reply. I'm thinking the next step will be a medication review. And I didnt realise a private consult was an option for that price, I thought it would be more expensive ( it's still pricy, but it is doable and worth it) You are a strong person to have to go through the constant afib and I'm so happy for you are finally feeling the pleasure of a normal heart rhythm. Amazing story, thanks for sharing, you've given me hope!
Sorry to hear about your husband’s trouble. It is the start of a journey he didn’t choose to go on. Many on here will say learn as much as possible to understand the condition and what you might do to manage it better. It’s the usual: diet (mostly plant based, reduce/abandon alcohol, exercise, weight if needed). I read a book called the Afib Cure; a misnomer but lots of info about what you can do. Good luck!
Thanks for the book recommendation!
Just to add about the ablation - I've had two and they have given me back a good quality of life for years after. Whilst the procedure is not a total cure for some, it has really helped me. I wouldn't hesitate to do it again. Even though 6 years post ablation I'm starting to have a few issues again. I too was officially diagnosed at 40 and similarly healthy so I sympathise with the journey he is about to take. Good luck.
Thanks for sharing, that gives me hope. Even if it gives him a few years at a time without constant afib that would be life changing.
Investigate D-Ribose for arrythmias.
Hi
My experience was that BBs like Bisoprolol did not control my Day Heart Rate 185 with pauses at night. Normal Night H/Rate avge 47bpm.
A 24hr Heart Monitor is best to see the proof in Day and Night Heart Rate.
BP controlled my BP and was cut down from 10mg to 2.5mg.
I've been on this regime of meds for 2.1/2 years.
AM 120mg Diltiazem CD to control H/Rate Day 156 (On Bisoprolol)
PM 2.5mg Bisoprolol to control BP especially Systolic Level
110mg PRADAXA x twice day
Is he stressed about something or is it the AF causing the stress.
Unfortunately overactive athletics can end up with AF. But they usually have low B/P and heart rate.
Now my Day H/Rate is 60s.
BP 110-135 /. 69-79
cheri JOY. 75. (NZ)
hi wifey, sorry to hear about your husband but bisoprolol is a well known contributor to lethargy in some people including myself. I take a total of 11.25 mg of it daily and I could sleep on galloping hedgehog some days.!! As for ablations I was told from my EP(ablation person) that it’s very common for us to undergo a second ablation at a later date to tidy things up. I was once thinking my life was over because of Afib and got very depressed and anxious about it but please let your husband know he will eventually get there and feel a lot better. 👍
Thanks for sharing, and your statement about sleeping on a galloping hedgehog made me laugh, my hubby would probably agree with you. You've given me hope and I'm so glad you are feeling better!
👍 x
Pacemakers are for pacing issues, not arrhythmias. ie if your husband had a very slow heart rate or sinus tachy. It won’t help with AF.
This is wrong Ennasti; pace and ablate is one of the treatment options for AF. Many on this forum have had that procedure to address their AF.
In the context of what the OP wrote, it’s not incorrect. The OP is referring to a pacemaker as an alternative to ablations which aren’t working.
A pace an ablate is different. It’s when they specifically ablate the AV node itself rendering it unable to regulate rhythm, and they have to put in a permanent pacemaker to take over the action.
So a pacemaker is different to a pacemaker? The OP's context was treatment options for AF and they were quite right to ask about a pacemaker as one.
The ablation of the AV node does not cancel out the fact that a pacemaker is fitted.
Incidentally, there are members on this forum who have had a pacemaker fitted with the intention of ablating the AV node at a later date but never had the second phase done. The pacemaker alone is correcting the AF.
Some people just gotta argue, hey! Ok, if you think a pacemaker is used to correct AF, then it must be correct.
The point of this forum, I'm sure you'll agree, is to share knowledge, to inform and if at all possible to reassure.
The OP reached out to ask about possible treatment options for her husband and had one of her suggested options dismissed.
I challenged that not because I wish to argue, but because I want to the OP to be encouraged that a pacemaker remains a possible future treatment option for her poor husband.
Instead of telling her that yes, a pacemaker is an option but be aware that the AV node would be ablated as part of the procedure, you chose to tell her it was no option at all because pacemakers are for other conditions, not AF.
I do hope she is now reassured that there is a little more light at the end of the tunnel we've all been in.
Regardless of your overly long winded responses, aimed at trying to belittle and discredit me, a pacemaker is not typically used as the primary treatment to control AF because it doesn’t directly treat the irregular, rapid rhythms of AF in the atria!! If the person has other conditions, such as bradycardia or AV block, then a pacemaker may be warranted. The ONLY other time a pacemaker would be used as a treatment for AF is for a pace and ablate to replace the function of the AV node.
Now you can carry on all you like and talk down to me and I will tell you, you’re leading the OP up the garden path because a pacemaker won’t her help husband if he is having issues only with AF.
The normal procedure is they will try to manage it with medication and ablations and if he has complications such as bradycardia or even a deadly arrhythmia like VT, then they will look at a pacemaker. If they can’t control his AF and it is too damaging for him, they may opt for a pace and ablate not otherwise they will not offer a pacemaker to control AF!
Here is the info sheet for Pace and Ablate, it’s very much a last resort for the treatment of AF when all other treatments fail and you are then completely dependent on the pacemaker for your heart to beat.
link api.heartrhythmalliance.org...
The more common use of a pacemaker is to help your natural heart beat and would only kick in when your rate drops below a set rate like 60bpm or whatever the cardiologist decides. In this case it does nothing to treat AF unless your AF is triggered by bradycardia (low heart rate)
Best wishes
Thank you for the info, This is a whole new world to us and having people like you in this forum have helped ease my mind and pointed my frazzled mind in the right direction.
There’s so much to learn in the beginning, we’ve all been there but knowledge is the key to a suitable treatment plan, this forum is great for reassurance and you can ask anything you’re not sure about.
Here is a link to all the reading material, heartrhythmalliance.org/afa...
I would start with the AF fact file.
Coming off Bisoprolol
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