It's obvious that folk on this forum tend to prefer rhythm control - for me a no-brainer as someone whose AF is very "symptomatic" - as doctors understatedly refer to it.
I think it's worth pointing out that continuous (/permanent) AF is not necessarily as bad as we rhythm preferrers might think.
After my aortic dissection and 14 hour emergency open chest op which brought my AF back, it took some while to see a cardiologist about my post-op/return of AF. That 3 months was pretty uncomfortable on top of the surgery recovery, but after 6 or 8 weeks I noticed that the symptoms were reducing. I'd always been aware that some people have AF and are almost completely untroubled by it (we have one member of our walking group with permanent fib who manages our Scottish hills, albeit slowly). That period showed me how that might be the case. It seemed my heart and autonomic system were "settling in" for the long haul.
I'm glad I got converted and will try and stay so, but I have to try and remember that going back into continuous fib is something I need to temper my worry over.
Obviously, some with permanent AF will find it difficult, but I'm just saying permanent fib might not be the horror I and no doubt others might think.
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Cliff_G
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You are quite right. We have had many members over the years who are asymptomatic and live good lives and of course there are those sad cases who only discovered they had AF when the stroke hit.
I only recently discovered that I have afib last August when I was also diagnosed with Heart Failure, but according to my cardiologist it's the chicken & the egg scenario when I asked him If the AF caused my HF or vice-versa.
I'm still new to all of this so didn't realise there are drugs to control both heart rate & rhythm control.
My cardiologist says I'm in afib 100% of the time with 100% afib burden.
The problem I have is knowing whether it's the Afib or the HF that is causing my worst symptom of extreme fatigue, I'm only 59 but currently have no quality of life.
I'm supposed to be having a cardioversion in a few weeks but I haven't been given a date yet. Cardiologist said I wasn't to expect cardioversion to keep me in NSR for very long but hopefully long enough for them to do a CT scan & for me to see how I felt with HF symptoms minus my Afib symptoms.
Hello, I've been on meds since end of August last year.
I was in hospital for first two weeks of September then two to three weeks later I received a letter telling me I was put on cardioversion list.
I had to wait until two weeks ago for my first ever appointment with the Cardiologist I'd seen whilst in hospital, seems I might have been forgotten about because I wasn't even on appropriate blood thinners for a cardioversion.
He said I'd hopefully hear from cardio team within next couple of weeks but said because I have heart damage & I'm in afib 100% of the time, it might not be successful, but even it is, it more than likely won't last for very long & then next step would be an ablation but he couldn't tell me how long the wait would be for that, he's been trying to bring my heart rate down, it's still in the 90's, but I also have low blood pressure so it's tricky.
my EP tried everything, but he waste a lot of time because of the type of a fib not even realizing at that time all four of my chambers are involved with my issues. As far as a fib versus heart failure, my heart failure came after my a fib exhausted my heart It was only the last six months that I ended up with heart failure. It just could not of a beating because I had tachycardia on a constant basis close to 200 bpm. That being said, and the fact that I could not have any more ablations, I had had three scar tissue was severe, and the rest of me was so exhausted. He said I could not continue nor my heart the way I was. The thing I never thought I would have. I agreed to get because of my EP when you have one that educate you so you understand it makes a big difference. Just know my heart failure has reversed from a 40 ejection rate to the 70s according to my EP even people without heart failure would be grateful to have the 70s and according to him, I can pretty much do anything people without heart trouble can do. Since November I have been pretty sick, but I will tell you one thing. Heart wise I have been fine. It’s the other stuff that you could have if you were 20 from being sick.
personally I think it’s how we face this and in the beginning it’s hard and it’s never gonna be easy because we will always have it now. That being said it’s not so bad. It’s uncomfortable and you have been made very aware of it. Do what your doctor tells you keep in touch with him when there’s a problem. I am still on meds, metoprolol, and Xarelto specifically for this at least with the Xarelto I will be on it for life and that’s fine with me. It means no more procedures. Hopefully we haven’t talked about metoprolol yet. I am waiting for a new EP because although I’m happy for him. My miracle Doctor Who saved my life, has been given a huge position, but it meant him leaving. His shoes are gonna be very hard to fill but he wasn’t worried about me according to him he feels sure enough that about all I’m gonna need is the battery change except under extenuating circumstances. Two years ago I was sure or I wanted. I’m not sure which to not be here anymore. It was so bad. It’s your body you need to step up ask questions and let your doctor know what’s going on because they don’t have a crystal ball I probably would not have heart failure if I had done that because with the tachycardia, I was ignored by the doctor that caused it with a procedure and unfortunately, I was exhausted mentally and just let it happen. That is why I got heart if you have tachycardia I can’t speak for other stuff then your heart is going to get damaged. I know getting medical care is difficult to where you are, but you have to do it. You need fast attention so you don’t have happen what I did. It makes me angry to think. about six months that I could’ve been healing.
get your head about a fib think of it for what it is. It’s not a deadly disease unless you let it become one.
I have been in permanent AFib for over two years now. It took a while to accept, but really I am finding it easier than when it was paroxysmal. I take apixaban and 3.75mg Bisoprolol. Mostly I feel fairly normal, can get sleepy in the afternoon. Walking briskly is no problem, though running can take my heart rate a bit high for a 70 year old.
I slow down at the top of stairs, as my legs feel drained of power. Hills are a bit more of a slog than they used to be - just the hills on daily walks. (I live in Edinburgh so it is fairly hilly.)
I did have a problem with a bleed last year, exacerbated by the anticoagulant. But it’s not like I have a choice really, it’s not like I could come off that if I went back into sinus rhythm. Much as I would dearly love being medication free!
The very fact that there are people roaming around carefree with undiagnosed AF supports your view. I went straight to perm AF without the obvious trauma the paroxysmal crew get. Which to be clear I feel a bit guilty about.
I am travelling the same path and wondering whether to ask the cardiologist whose waiting list I am on for an ablation whether I couldn't just put up with the increasingly regular but much less disabling troubles it causes me. I am far from asymptomatic, and. indeed, the two people I know who claim to be that, truly aren't, at least in the sense that any uphill exercise they do brings them to pause temporarily for breath.
I have read that many of the symptoms from AF are either worsened by fear, creating a vicious circle, or from slightly reduced heart output that an AF episode brings in its train.
you are so right I think it’s the stress of worrying. That is worse than the actual a fib. I’m not talking about a fib that is causing damage. It depends what you want to refer as. Permanent. In reality we all have permanent it can’t be cured. We have it. It’s just the difference of when it shows up. Some people hardly ever feel it. Let me rephrase we feel it. We know what it is and we just go on with life. Personally, I feel some people overreact, but that’s me being blunt again. If you were running and had palpitations, and you did not have a fib, you would barely think anything about it. Everyone a fib or not has times that their heart rate goes crazy. Before my doctor reminded me of that. I would freak out if I went from 70 to 90 after doing things around the house being busy. If I waited, I would feel it slow back down that’s what your heart does. Now this is a big difference between being in pain from a fib, breathless, etc. that was in the beginning. Don’t let a fib ruin your life roll with it. It’s not going anywhere. Learn to handle it like you do everything in life because getting upset just makes you feel worse.
I have just had a bug for about two months viral so antibiotics did not help and it has been one of the worst things I have ever had and I have had Covid, etc. It’s been painful to breathe and almost a nonstop cough. I honestly don’t remember when I have felt this bad. Finally it seems to be loosening. The one thing that made me feel better knowing it had nothing to do with my heart. I have to pericarditis. I am prone to it and I have felt like garbage since before Thanksgiving here the stress of having five friends killed within a 12 hour. Including a child did not help my I have no doubt. Try to think of yourself before you had a fib. Take it out of the equation when you aren’t feeling well. This does not mean let it continue causing you pain, etc. make sure your doctor stays on top of it to avoid heart failure. I still get flutter and a fib palpitations, and kicks once in a while if you ask anyone on here, they probably all do including Bob D who also has a pacemaker. That used to scare the heck out of me until I spoke with my doctor and found out. Yes, I will feel it.
doctors are doctors. They are not Harry Potter the magician they don’t have a magic wand to make everything all better forever but I know mine did a heck of a job making me feel normal.
take a deep breath get yourself a meditation program lay down try to listen to that and relax again, all of this is helpful for you to relax it’s not gonna make a fib go away just the feelings hopefully
don’t let it run your life or ruin your life at our age and most of us are older. I am pretty sure we have been through worse this thing as a pain in the neck and angry at a fib. That’s the way I have decided to deal with it. How come in into our life when we should be having fun. That being said it is what it is.
best of luck everyone learning to deal with it. That’s the most important part. If you have other issues like I did it is not just a fib. It’s not a rhythm thing there is more going on. That’s why you have a doctor all of us out here have different things. We understand how you feel but we can’t tell you what it is that you have wrong. There is not a day that goes by. I am not grateful to my EP Cardiologist. I can put my dog on his leash like I just did a little while ago and take him out. I couldn’t do that before my pacemaker.
we are all in this together. You are right about that, but we are not the same.
With me a 'no brainer' to control my heart rate as against rhythm control.
Metoprolol 186 Day average and a 24hr heart monitor showed pauses at night. Sweating and breathless on it 23.75 x 3! No thanks - a continuous NQOL situation. But I had to wait for tests done re my Papillary diagnosed Thyroid Cancer. A shadow on my thyroid shown on a carotid arteries scan which showed them as clear. Stroke Sept 2019 with rapid and persistent AF.
Thyroidectomy was done in February 2020 at the commencement of COVID here in NZ.
Changed to Bisoprolol in February 2021 when now under a cardiacologist and although brought down H/R day to 156 on 24hr heart monitor, H/R not controlled. Sweating uncontrollably improved and no breathless or pauses at night. Fatigued and sleeping still a highlight and stopping whilst walking for more energy.
I was furious being left there.
Talking a new locum at my clinic who had had AF and been successfully ablated in Australia, asked me to attend a private session with a well known private person.
So in December 2021 a had a private consultation with a cardiologist. History reviewed he immediately took my H/R at rest and found it well over 120 having taken Bisoprolol 5 mg the evening prior to seeing him. The other 5mg before I came as the appointment was at 11am.
I started the introduction of CCB Calcium Channel Blocker 180mg Diltiazem CD on the Saturday and I decided to reduce the Biso... to only 5mg at night.
Help, my H.R plummered to 51 within 2 hours AM noticed on Day 2.
With help from our NZ Healthline I reduced Biso to 2.5mg Night.
Lightheaded and with my Night H.R of 47avge normal for me, I rung NZ Heart Foundation who had worked with this specialist and told me to have Dilriazem reduced to 120mg CD. Also that a BB and a CCB med need to be separated by 12 hrs.
I rung the Dr and I think the nurse rung the Dr so it was smooth sailing reducing Dilt.... to 120mg CD. Then Pharmac changed the brand.
In the end my H/R day settled at 60s going up to 80s in the late afternoon.
Apparently we individually 'use up' our med after taking it. Whilst Dilt... should be over 24 hours CD type mine is used up as above but allows the Night Low H.R to remain at 47avge over night.
Biso... has a 12 hour cover.
The CCB is controlling my H.R Day and the private consult asked for another 24hr heart monitor to be done. Also it acts as a low action on BP.
The BP acts mostly on BP.
Overall CCB Diltiazem acts as the safest anti-rhymnic med.
That works for me.
In persistent I don't know when my heart goes in and out of AF. But all ECGs show AF.
I understand at the first diagnosis of AF a cardiac specialist makes the call whether and after ECHO or CT scan to go down the track of anti-arrhymic procedures or to concentrate on controlling the heart rate. Mine being RAPID.
The structural damage in the left atrium - severely dilated, means that a cardioverson, ablation or an anti-arrhymic med like flec.. are NOT SAFE to proceed.
Persistent means to NOT proceed with any of the above but in Diltiazem I have the slowing down of the irregular heart beat from rapid as an anti-arrhymic med.
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