what next ?

[Spinbiker]

just had my 4th cardioversion which kept me in sinus for just a week now Afib returned was on flecainide,Nebivolo,,apaxiban - never had usual symptoms like thumping or palpitations - just tiredness - cardio tells me no point in another cardioversion or ablation - just take medication without flecainide and live with it …… should I push for further treatment or just give up - I’m 81 years old - I’ve been offered amiodorone cardioversion but don’t like the sound of its toxicity - any thoughts appreciated ……

[CDreamer]

I don’t think anyone should ‘give up’ but I would look at Amiodarone and weigh up the benefits against the risks - always risks with everything but what level of risk you are prepared to take is the real question?

If you are not thought suitable to be offered an ablation then Amiodarone is really your best easily available option of regaining NSR. My husband has been taking Amiodarone since 2018, he’s lucky as apart from mildly underactive thyroid for which he takes meds he is quite active and strong for 90. His AF burden is now less than 2%. He still gets tired but walks 5,000 steps most days and does an exercise routine every morning and naps in the afternoon.

It sounds as though apart from tiredness, in which case it’s about pacing yourself, you are asymptomatic so I can’t think of another easily obtainable treatment option other than Amiodarone that might put you back into and maintain NSR but I’m no medic and has to be your choice.

Good luck.

[Spinbiker in reply to CDreamer]

Thank you will give things some thought

[Porageface]

Maybe a different mindset would help you. Rather than “just giving up”, acceptance could be a more positive approach to a new phase of your life.

After 2 ablations for AF, I have lived with permanent AF for 6 years. I adapted fairly well, until I developed problems with a leaking heart valve more recently.

I wonder if feeling tired a lot of the time at your age of 81 is perfectly normal and healthy. I’m 76 and really enjoy a good nap. The main problem is losing my place in my audiobook when I drop off unexpectedly!

Enough with this obsession with exercise, no offence intended, a good walk into town for a decent espresso is fine ☕️

[Spinbiker in reply to Porageface]

Thank you ! That’s really good advice - I will take it onboard thanks

[mav7]

cardio tells me no point in another cardioversion or ablation - just take medication without flecainide and live with it …… should I push for further treatment or just give up

Suggest you ask for a referral to see an Electrophysiologist (EP) who specializes in arrythmias.

As BobD often says, all treatment for afib is for quality of life for the patient. That is something you will decide in consult with your medical professionals.

Would be good to have an echocardiogram if you have recently not had one.

[Spinbiker in reply to mav7]

Thank you- yes I plan to do as you say for the future - best wishes

[Eddybear in reply to Spinbiker]

Hi Spinbiker, definitely don't give up, after three cardioversions I was told no more, so went private and had one which lasted a year, another one lasted four months, and the last one 24 hours, so it was suggested I have another one to get me back into sinus rhythm and take Amiodarone to hold me in sinus rhythm until I could have an ablation which I had done seven months ago and still fine, and no bad side effects from the Amiodarone which I took for four months while waiting for the ablation.

[Spinbiker in reply to Eddybear]

Thanks for the advise will think it over

[BeeBee79]

I’ve had four failed ablations and just been given a date for cardiac surgery. Currently on Amiodarone but given the fact that I’m 45, they don’t want me on it long term - it’s already given me an underactive thyroid. In terms of living daily with it, it’s fantastic at keeping symptoms at bay. It’s helped me live an active life - go to spin classes, dog walking etc. The only thing that holds me back is fatigue from the beta blockers.

The side effects are worrying but you will get regular blood tests to check on any potential damage…

[Spinbiker in reply to BeeBee79]

Thanks for advise will think it over

[Jajarunner]

Try the amiodarone. I took it for 19 months without serious side effects to maintain nar, but I've read it can do a chemical cardioversion too. I'm off the amiodarone now as just had fourth ablation. I was too young to stay on the amiodarone for years but I'm decades your junior. Good luck 🤞

[Spinbiker in reply to Jajarunner]

Thanks for your thoughts - best wishes

[Shcldavies]

Never give up, whilst you have a condition that requires complex treatment (when I say comlex I really mean expensive and time consuming treatment for Doctors), there will be treatment out there for you. Just look at the members of this forum and what they have had to go through to get the right outcome. Your not alone and it may take years (hopefully months) to recieve the right treatment for you but if you persevier you will get it.

From a personal point of view, my condition started in 1996 and after many changes to medication, a cardioversion, an ablation and many visits to A&E (many by ambulane), it was 2019 when the Doctors finally provided the treatment that gave me back my life. It was interesting to know that it was not until my ablation did the Doctors know sufficient about my condition to provide the correct treatment (before this I was treated incorrectly which made my condition gradulally deteriorate).

I have said this before on this forum, when youy do eventually recieve the right treatment it really is better than winning the Euro Millions - it cannot feel better than to get your life back. I strongly advise you to KEEP AT THEM UNTIL YOU HAVE YOUR LIFE BACK.

[Spinbiker in reply to Shcldavies]

Thanks for these thoughts best wishes

[bayonnejoe1]

First thing, l would make a list. What's my QOL? I'd make an honest list of the pluses and minuses of pursuing, or not pursuing, more interventions of any type. Sometimes the best choice is doing nothing, rather than chasing minimal benefits.

I'm not necessarily advocating that, other posters have suggested some excellent possible paths of treatment that might work for you, just saying at a certain age even a less than great day can be better than sitting in a doctor's office. Best of luck!

[Spinbiker in reply to bayonnejoe1]

Yes good advice - will do as you suggest - best wishes

[Ducky2003]

I am on Amiodarone and it helps me maintain nsr for longer periods after cardioversion. I have been on it for some time but they may just decide to give you a loading dose for a few weeks prior to a cardioversion and for a few weeks after.

Certainly worth considering, if your current QOL is greatly affected.

[Spinbiker in reply to Ducky2003]

Thanks will consider - best wishes

[Porageface]

What persuaded you not to have an ablation when offered by your EP 5 years ago? Do you have any sense of what your AF burden has been since then? A repeat echocardiogram to compare your left atrial size now and then could influence you.

Please give us an insight into the way your thoughts are going. It could help many others in your position. If the questions are intrusive I will happily withdraw my reply.