I was diagnosed with A Fib last year, but have no noticeable symptoms apart from the irregular heart rate. I have been put on Edoxaban and I have also been offered the following treatments
1. Do nothing 2. Cardioversion 3. Catheter ablation
As I feel well I am reluctant to do anything. Has anyone else had a similar experience?
Hi, I was diagnosed 3 months ago, my only noticeable symptoms are I'm absolutely knackered which I think is a combination of the heart not being in rhythm and the beta blockers which control the rate. I have referral appointment next week and I'm hoping to be offered the same options as yourself. But due to the fatigue badly affecting my quality of life I will (if offered) be saying please crack on with cardioversion (which may work for anything from a few hours to a few years) and then be ready to go to ablation asap thereafter. Lots of threads on here about AF so lots of experiences (good and not so good) but I certainly want to be back in normal rhythm asap. Good luck in your decision making..
Good advice RF260. Hope the cardioversion works for you. I have had a couple which have lasted for years.
Hi
Um.
Do you why you have AF?
Are you rapid AF like I was diagnosed with, or low rate (h/R AF or low BP or high AF?
You, for starters have been put on a modern (not warfarin .
Wherever knows what they are doing.
Before anything - testing it is apparent with AF you should have an
ECHO
ECG
24hr monitor
Are you in persistent AF.
All the above questions need answering.
At hospital and at stroke diagnosis, I was diagnosed with STROKE (Embolic), rapid & persistent AF, & 4th day examining my carotid arteries via scan I was told I had a shadow on my thyroid.
Whatever tests they did I was NOT a candidate for the 3 above going forwArd, too dangerous.
It took them Dr andmy clinic until February 2021 to send me a Heart Specialist interested my case 2 years 3 months under a private H/Specialist.
The latter put me on CCB Calcoim Channel Blocker (there are several different blockers.)
I went home with the new med. I was intelligent enough to reduce Bisoprolol which was then
up to 10mg.
I reduced this med to 5mg. I took the 180 (1/2 dose) Diltiazem mg CD AM and carefully monitored my BP and rate. Heart rate went from 156 (monitored in a 24hr heart monitor) to 51. I was scared. I rung the NZ Healthline and got the Dr there on the next day. She told me to reduce Bisoprolol further.
It was on following Wed that I spoke to the Nurse at NZ Heart Foundation.
She said separate CCB and BB to AM and PM.
And as she had worked under my specialist, she rung my Dr and presumably Dr Wong, I changed to 120mg CD. My h/rate changed to 80-90s. But over time and losing 3-5kg it
dropped to 60s day but climbing to 80. Dr Wong's direction is to have another heart monitor to see if CCB and BB now reduced to 2.5mg were working well together.
CCB for heart rate
BB for BP.
As you can see from Sept - 2019 Stroke and through Feb 2020 Thyroidectomy it takes interested specialist to assist your journey.
On Metoprolol which I said NO to as it made me breathless in 2008 but I was ignored, it made me a basket case of little exertion due to H/R of 186 bpm (47 at night average), and pauses at night! Sweating.
So it was Diltiazem and my private heart specialist that was the game changer.
I'm not 100% happy with me now as I have trouble walking for more than 1/4 hour as I need to stop. Then I carry on.
Be assertive, ask ?s you have jotted down.
Where I am at now 5 years plus from stroke. Reducing the new white Bisoprolol because I am getting dizzy. I have 1/2ed the 2.5. So improved but still get slight dizziness. Trying .625!mg Bisoprolol. I remember the hospital h/specialist saying to my very poited ? "if my heart rate gets toolow?, and he said drop the bisoprolol. But it's not low h/rate but BP @ 108/62 sometimes.
I had an ECG which showed it was OK to 1/2 2.5mg.
So with me and like you it is a 'work in progress'!
I'm sure you will continue on your personal journey.
Please let us know as you and me can help others on this forum
cherio jOY. 75. (NZ)
Hi Joy. I don't know why I have AF but it I am in AF all the time , it only started in the last few months (persistent) My ECG's are always in AF. I had Carotid artery scan and head CT yesterday and they were normal. I had Echo done early November, result is on my NHS APP and shows EF at 61% , only comment I spotted is "left atrium borderline dilated". I had 24 hour holter about a month ago, not seen results yet but assume will find out at referral next week. My heart rate drops to high 30's overnight , 50's at rest in the day and only ever to about 110 when I exercise. My BP at home is 130/75 but a little higher in a medical setting. Blood tests yesterday were all in range.I'm on Ramipril 10mg, Amlodopine 10mg, Bisoprolol 2.5mg, along with clopidogrel , edoxaban, rosuvastatin, famotidine and allopurinol..
Only real challenge is fatigue and loss of interest in social things and anxiety.
Thanks for engaging and good luck with the "journey"
Hi
Hick you are on a lot of meds!
Your tests have been very thorough but on these meds I would ask for a 24hr Heart Monitor. To see what these meds are doing!!!!!
Your heart/rate is too low. It leans to reducing Bisoprolol for sure down to 1.25 to see how that goes. But it is up to you and your specialist.
Ramipril is an ACE med - I started on ACE back in 2008 and I coughed and coughed!
The ? is when do you take all these meds time of the day. Some of them too close gives you a definite 'spike' in the way they act.
I take thyroxin early am, then Diltiazem CCB at at least 1 hour later with food. PRADAXA 110 at 10amish. REST from meds unto 7-8 pm BB biso.... and PRADAXA 110 10pmish.
Bisoprolol has had a change in manufacture - it could be stronger.
But reducing it by even 1.25 by 1/2ing the 2.5mg made a difference.
Look at that, RF.
Keep in touch. Some of the ACE meds have a built in diarectic. That might be ditrimental to you as you lose important mineral. Also drinking too much water dilutwes them.
Keep in touch. RF.
I have severe dilution of my left atrium. Heart enlarged has settled at last ECHO.
cheri JOY. 75 (NZ)
Thanks Joy, thought of you last night as I watched NZ Vs England cricket on TV from a sunny Wellington..yes I will push the need for/dosage of Bisoprolol when I see specialist next week. The statin is just 5mg of rosuvastatin, the clopidogrel can stop in April at the 12 month anniversary of my heart attack (no need for stents, troponin was just a little elevated). I've been on the allopurinol for about 20 years but I wonder if I need it as I've changed my diet and lost about 15 kg in weight since I started on it. Keep in touch.
Hi
You are on a statin!!!!!! How much?
Statins can cause muscular aches and pains.
How young are you?
When you walk and exert, do you need to stop and wait a few seconds/minutes before carrying you on? That is me but not any breathlessness. It seems I have depleted my energy level. Do you have a similar feeling?
Please keep in touch.
cherio JOY. 75. (NZ)
would like to hear your thoughts on taking statins and blood thinners...both are scary because of side effects.
Hi
My Chemist and Natureopath studied and passed is not in favour of Statins.
My friend 82 with MS was given 40mg Avorastatin and within a couple weeks was declared prediabetes 2.
A slim lady who was told to give up her honey, 2 vogel breads morning and lunch etc etc. That made her unhappy. When she got covid she was told no to the antivirus until she stopped the statins.
Some very bad true stories.
I am on thyroxin for thyroidectomy so can't take more than 20mg Avorastatin.
So I say no to it.
BUT
anti-co.agulants like PRADAZA 110mg x twice are a necessity for stroke prevention. AF you are in danger of a clot and stroke which is what thyroid cancer gave me through AF.
So the first is not a necessity but the latter is.
You take care. Thank you for asking.
Ask me anything through my private messaging. I will set it up.
cheri JOY
yes, I agree with you on the statins. When you have high cholesterol and high LDL, it's worrisome to not take them, but it's a fact that they can lead to diabetes and also dementia. The brain needs cholesterol to function correctly. Many people on statins start complaining about forgetfulness. At the same time, high cholesterol and high LDL are also very threatening. I am also wanting to agree with you on the blood thinner but also am aware that a lot of people have had GI bleeding from taking the ones like eliquis and pradaxa even though they are supposed to be safer, so I guess everything has its side effects. Thanks for answering back.
Hi JOY2TO THE WORLD I was prescribed 80 mg Atovastatin
after a heart attack 2019! Pains in my calve muscles were often severe, especially when walking and going uphill! In October 2020 I decided I had enough of this and read that this particular Statin is a Contraindication to vascular desease 👌 I took it less and less until January I just told my GP I am stopping this medication as it's not benefiting my health! The same I did with Bisoprol 2.5 mg! I was forever tired and exhausted after work 👌
I really had to work out what was beneficial to my recovery and some doctors think that you have to take prescribed heart medication for life 🙄 Cheaper for the NHS or a health service in other countries and for you if you don't need some medication any more! Since I stopped these 2 I felt generally so much better, had more energy for life and work! My brother in Germany is a doctor and if I need some sound advice I can ask him too 🙏
But that's for me personally here! I can't speak for everyone as we all have various health problems! With some certain medications do work, for others not so much! 🥰
Hi
Getting to know your meds. PLAVIX (Clop..) is an anti clotting drug.. and you are taking Am.... as well. Your bleeding risk is double just taking 1 of them! Why take both?
First ?
cherio JOY. 75. (NZ)
Hi
Famotidine is an anti-acid med an over the counter product. Does your specialist or Dr know you are taking this?
I take milk or an icecream after fatty eats. I had my gall bladder finally in 2000 after years and years of acid stomach. It had disintegrated and why I always felt better on antibiotics.
When I take my PRADAXA 110 twice day I eat a piece of fruit, drink some joice but finish with water.
Your Famotidine can interfere with your meds.
You could doing a search for compatibility of each of your meds.
re indigestion I had a colonoscopy test, then mouth to stomach. Then ultra-sound which showed balls but tiny. They proved to be fur blood balls not pretty calcium balls.
I said my grandpa had his gall bladder so they decided to nove to surgery. It was removed through the tummy button! Easy but I had another 4 portholes to remove bits off other organs.
Maybe you need yours out.
Inflammation anywhere can cause AF.
cheri JOY. 75 (NZ)
Hi
Allopurinol is another anti-acid which lowers urea in the blood. Did your blood test prove that you had too much in your blood?
My bro gets gout as as a teenager my Dad brought back 24 dozen from Bluff. I did not like them.
Keeping down 'deadly nitrate foods' are better to be reduced or left out. And oysters, potatoes, tomatoes (stick to acid-free tomatoes) egg plant, coffee and other foods.
A very interesting list of meds.
I thought I had too much to take.
Happy sorting RF.
cheri JOY
Bisoprolol and the ramipril will reduce your resting and sleeping heart rate.
I showed my cardiologist my resting and sleeping heart rates ( low 40's sleep / mid 50's resting) he didn't see those as concerning.
Your BP is on the higher side considering the doses of biso and ramipril your taking have the medical team noticed that?
Good luck with whatever path you take .
In case nobody has advised, your fatique may be due to strength of Bisoprolol med.I had mine cut in half and fatique went away and HR remained below 100.
Yes 100%, that's what I thought too. Check your bisoprolol dose. What's your heart rate without it, if it's 'reasonable' you may not need to slow it down. My resting rate is 80-90.
I would agree with summary of RF260, better to be in NSR.
I was very symptomatic so it wasn’t a difficult choice for me but still, AF persisted after meds and 2 ablations.
My treatment was pacemaker which worked for me after 2 ablations and AF returned. I take no meds other than anticoagulants which are first line treatment.
Good luck.
Hi
My reply was for you BKB 9999 but it will be interesting for RF260!
I had a big day yesterday. For my elbow tennitus I had a choice starting off
Cortisone injection (contra to my thyroxine) Also I read and didn't like what I read - stays in your body for life!
A elbow brace - which relieves damage and could get the site mended)
Surgical relief. (70% of success).
I have chose to start with brace.
cherio JOY. 75 (NZ)
If you do nothing you run the risk of your persistent AF causing damage to your heart structure,and long term heart failure.Symptomatic AF and AFlutter is easier to convince ourselves we need to do something, even though I.was it took me a while to accept.
It's not how you feel today . Best wishes
Hi
Being monitored well, I beg to differ - 'it is how you feel today.'
Hard and difficult decisions on ablation in scarring your heart for life, and, even anti-arrthmic meds which are risky.
cheri JOY. 75. (NZ)
Hiya Bkb9999,
Back in 2010, aged 65, having been diagnosed with paroxysmal AF, I opted for the 'do nothing' route, except take medications for life. Under the NHS it took so long to get a cardioversion that by the time I presented for the procedure I was back in NSR - so that was abandoned. I rejected any notion of an ablation. I guess typical of being paroxysmal.
As the years rolled on I stayed with meds and let the heart slip in and out of AF and eventually it settled, still stayed with meds, and am still scoffing them ........... no sweat ! These days I get an AF/Ectopic bout every 4 or 5 years .... can live with that. I may get them more frequently, I wouldn't know as I'm tending to be asymptomatic anyway.
TBF though, my diagnosis was done in about 9 hours from onset .......... which compared to peeps post in this forum over the years was very quick. So maybe they hit my heart so quick the dodgy pathways never got the chance to get established.
John
Congrats on zero symptoms! As we say, AFib won't kill you, it's all about Quality of Life. Like you, I am symptom free except for irregular beats. I chose to do nothing except be on anticoagulants. I made that choice 8 years ago and have never regretted it.
Whatever you choose, hope it's a great fit for you.
have you had any side effects from the blood thinners...GI bleeding, dizziness?
No side effects from Eliquis. But I did have a stroke before I got on them. Lost some vision. I was lucky according to the docs at Johns Hopkins who treated me. Many have AFib diagnosed after a stroke.
I went from having boats of PAF to regular AF this time last I found it easier to live the boats of path still taking medication had but lasted for 6 1/2 days felt absolutely fantastic for that always tired but otherwise able to cope with life The that if they can bring my heart rate down to below 80 beats minute when resting there’s no weed any other interventions as the cardioplasty does not always work so I’m sticking with that hoping to bring my heart rate down to below 80 when resting and just continuing with the medication
If I was you I would be having a prompt private appointment with a trusted cardiologist to try and get a reliable answer as to how long you are likely to have the current 'no noticeable symptoms' before any reduced 'QOL' issues start becoming apparent.
I would push for cardio version. I had racing heart beat in March and was put on beta blockers, digoxin and warfarin. I was knackered and unable to do much due to exhaustion and breathlessness. Just over a week ago I had one shock during cardio version and fee lm like a new woman. I’ve been given my life back. Go for cardio version. It’s worth it in my experience. 😀
Hello, how long did you have to wait for a cardioversion? I've been on the waiting list since September. I was diagnosed with AF end of August along with HF due to heart valve damage, plus damage to both ventricles.
I'm tired all of the time with no energy.
I was diagnosed on March 8th and waited till July to see a cardiologist. My cardiologist version was done on 26th November so it was a long miserable wait. I was tired and breathless Feeling unable to do much at all. I really pushed to have it done as I’m an Occupational Therapist and keen to get back to work. I had 2 out of 3 cardiology appointments cancelled. I’m in Scotland. Once it was done I feel great. Good luck and keep pushing.
Good to know that you feel great now but no so good l that you had to wait for so long. I've had one cardiologist appointment cancelled so far... didnt realise I'd be so upset when informed of cancellation.
Got a feeling it might happen again with my appointment in January.
If your wait time is what I have to go by it means I'll probably have to wait until April/May next year. Finding the anxiety, tiredness & breathlessness difficult to cope with though.
Yes the wait and not knowing is awful. My skin around my eyes broke out in a painful eczema which I’m sure was down to stress. It’s ok now.
The scary part is that with the fibrillation comes the risk of blood clots forming...then, they always want you to start on something like eliquis, a blood thinner, but the occurrences of GI bleeding on blood thinners and ending up in the hospital for that are also scary.
I’ve had Afib for over 30 years now, and like you, I started with a similar situation, heart would go out some, didn’t other me. Unfortunately, if this was the case and it never changed, I’d consider your “do nothing” option also, but Afib generally changes, it is not static. And generally it gets worse. Fact… the sooner you address it, the better your chances of effectively treating it, the earlier you get an ablation for example, the better the odds that it will be an effective ablation. If it were me, first cardiovert, the sooner the better… tomorrow if you can… then schedule an ablation as SOON as you can get in. On this second thing, you need to do your due diligence and find an Electrophysiologist that has done a TON of ablations, find the best you can find, that is CRITICAL, ablations for Afib are an art, as much as a science, and the doctor you choose to do yours will determine success, and determine your happiness after the ablation. That is my humble advice… we all would LOVE to just ignore it, but that is a bad choice. There are a lot of good options for you now that did not exist years ago… take your time make your choices well and you should have a good life with this!
An elderly friend is now 91. He's had this for years now and still ticking along, taking only what he calls a "blood thinner". My son;s colleague, now in his 70s but still teaching part time, has had five ablations and still his AF has returned. Again, he's coping well.
I am on a waiting list for an ablation, which will be my second, but I am going to ask what the future would hold without going this route.
Steve
I have been in AF since 2011 when my husband died, I have been on many meds to control BP and heart rhythm, but I’m still in AF at 80 yrs. I am symptom free so have been discharged from Cardiology leaving me feeling abandoned.my only problems have been side effects from my meds -Bisoprolol mainly - breathlessness and Macular degeneration -dry, but I’m healthy and happy . Just started on Amlodipine to control blood pressure and have no Ptolemy with it now thanks to advice from friends on here .
I had occasional bout of AF up to 2016 when my AFturned to persistent and in agreement with my AF specialist no invasion treatment would be necessary...at that time my AF became permanent. That was back in 2016 I am lucky I still don't have any symptoms and my resting heart rate is low sixties my blood pressure is around 120/70 without any medication, I take Apixiban and Bisoporol 1.25 mg twice daily. I am now 77 year old male and still symptoms free. I have lost perhaps the top 10% of my exercise ability but more importantly I still cycle, swim and can still chase my grandchildren about. I don't regret my decision to not have an Ablation. Would I prefer to be in NSR without doubt I would. We are all different so good luck with your decision. Take care
My AF is sooo symptomatic it gets scary when i go into AF. The heart rate jumps straight into 120+ and i first had my AF in my early 20s which was really scary.. however i got an ablation and it sorted it out for about 10 years however a year ago it come back after a wild night out. So i got my second ablation 3 months ago and i am hoping it has worked as my consultant told me 95% chance i am now AF free. Anyone who can feel the AF i recommend get ablation ASAP and also if you are young.
How old are you now Ozzie ? I was 52 when I started with AF , 59 now . I can’t imagine having it in my 20 ‘s and I do empathise with you X
i was about 22 when it first happen after i went out with friends and had a lot of drinks… i was first told it was to do with alcohol and it shouldn't happen again but a year on it happened after a cough.. thats when they decided i will need surgery and they didnt ever say to me lets keep you on meds they said your too young and you need a surgery. It helped for 10 years however not long ago it happened again after going out to drink and mine seems to trigger after i throw up :/ so i went back and found the same consultant and got my second ablation and he recommended ablation again no other options. I had a very experienced consultant who is one of the best in the country so i am really lucky! AF made my life hell at young age and as i started getting the confidence back it came back! Lets hope its sorted it out now fingers crossed.
Fingers crossed . I have had 3 ablations , so I’m hoping 3rd time lucky !
Wishing you all the best Ozzie
Get the cardioversion, I had one in 2016 and it worked for 8 years.
Worth doing, if it works you may even persuade yourcardio you can come off Edoxaban I did.
I'm now in a different situation, after AF was retriggered, so ablation etc being considered. but For you. I'd suggest cardioversion is a no brainer, Doing nothing must, I would think, leave the path open to ventricular dilation in the future. Get it done, would be my advice.
Absolutely the cardioversion at this stage, imho. I was left too long at various stages of AF and have ended up on a waiting list for mitral valve surgery, as my left atrium has enlarged due to the AF. I've had about 9 cardioversions now which have lasted anywhere between 4 days and 2 years. Get yourself back into rhythm as soon as you can would be my advice.
First of all, it's good you don't have any symptoms and that you have been put on blood thinners to prevent harmful blood clots.
You may ask your cardiologist to give you Flecainide -a drug to control your arrhythmia as opposed to beta blockers which slow down your heart rate.
Tried the drugs route which stabilized but didn't completely resolve things so went for ablation which (so far!) has worked completely, and... wasn't anywhere near as bad as I anticipated.
I was diagnosed with AFIB Fall 2022. Since then I have have a pace maker installed, ablation (failed) and a watchman implanted. I also am on Entresto, Jardiance, Metoprolol, Verquvo and a baby aspirin. I consulted with four more cardiologists, ending with a surgeon who performs the convergent ablation - he looked at my history, including generally asymptomatic, and suggested that I was doing what I could and that further surgery would not be advised at this point. I generally feel good, with fatigue being the worse thing, with some night sweats.
I have had AFIB since 2015. The only interruption to my life has been Metoprolol and Xarelto and Atorvastatin. No procedures for me. 74 years old. God will take me in his own time. Oh - I have a chronic cough for 3 years I’m convinced is caused by the meds.
I recommend cardioversion followed by a visit to a trusted EP for ablation evaluation. My (symptomatic) AF started at 53, I'm 67 now and while the ablation was not 100% effective, the QOL difference since my first ablation is dramatically better than pre ablation, and I take minimal meds. Sage advice received from my EP was: "the longer you are in AF, the more likely it is to return and be persistent". Ablation at my age was the only logical choice for me, and it was not difficult or dangerous! (take the catheter insertion sites seriously for the first week, and you should do great!). I wanted to avoid the meds and the AF as much as possible.
Hi Bkb999.
I assume your aFib is persistent since they don't offer cardioversion for paroxysmal (occasional) aFib. If you feel comfortable, with doing nothing except take anti-coagulants, please do that! I think aFib does change your heart structure a bit over time, though I'm sure no expert. Experts say stroke is the biggest risk, and that's taken care of. Go with your gut!
If you are a candidate for an ablation, I would definitely get it. I've had three over the last 20 years and each one has gotten less stressful and lasted longer.
Atrial fibrillation 
Treatment for Atrial Fibrillation 
Atrial fibrillation 
ATRIAL FIBRILLATION
Xanax and Atrial Fibrillation
