Odds of successful cardioversion & ablation procedures with 100% afib burden & Heart failure with low EF.

[Butterfly65]

Hello all,

I've recently binged watched some of the York Cardiologist & the EP Dr Scott Lee's content on Yt & have come to the conclusion that the odds are stacked against me of ever being free of Afib, but would like to know if there's anyone out there with constant rapid afib with 100% burden & Heart failure who has had any success.

I'm on 7 meds that I take three times daily, total of 11 pills that are causing side-effects.

The thought of me having no other option for the rest of my life is depressing me greatly - I'm 59.

Thanks - Michelle.

[Rosie1066]

Yes, I’ve been in constant rapid AF since the beginning of December 2024 and since then my AF burden has been 95% or 100% every week. I am on Bisoprolol which has now bought my heart rate down so I’m no longer in fast AF but I am still permanently in AF 24/7 with no signs of it stopping anytime soon. I am being referred for an Ablation.

[Butterfly65 in reply to Rosie1066]

Morning Rosie, so I'm guessing this will be your first ablation, do you know roughly how long you're going to have to wait for it & have you had a cardioversion yet?

[Jackiesmith7777 in reply to Butterfly65]

My husband had an ablation but it had worn off and we didn’t realise hence him having a stroke . The surgeon said at the time it isn’t a permanent solution . If he had worn an Apple Watch it would have told us it had stopped working

[Butterfly65 in reply to Jackiesmith7777]

Hello Jackie, so after your husband's ablation, am I right in assuming that he was taken off of anticoagulants, hence why he unfortunately had a stroke?

[Rosie1066 in reply to Butterfly65]

Yes, will be a first ablation if I go ahead with it, Waiting on appointment with consultant. I have spine problems at the moment which I would rather get sorted first. Not sure whether I’ve had a cardioversion or not. Had so many procedures since 2008 when I first had AF.

[CDreamer]

To be honest I doubt your chances of conversion would be very high. Have you been evaluated by an EP?

[Butterfly65 in reply to CDreamer]

Hello, no, I've never seen an EP, just a cardiologist so far.

Spoke to hf Nurse over the phone a couple of weeks ago who assured me that I've most definitely been pencilled in for a cardioversion on the 2nd of April, but to date,

I've received no official letter or written online message or document of any kind informing of an appointment date yet which I find odd & disheartening.

My husband rang them again last week asking why we hadn't received appointment date in writing yet, again we were told not to worry & that I'd definitely been pencilled in for a cardioversion on the 2nd of April.

Feel as though I'm just being fobbed off when I ring them though which obviously gives me very little confidence that a cardioversion will infact take place, or if it will work for me, if only for a few hours or days, hence why they've been stalling & fobbing me off. 🤷‍♀️

[CDreamer in reply to Butterfly65]

You have to give it a chance as it will demonstrate whether or not conversion to NSR is possible.

I tend to have everything on line, including hospital letters because I’ve had letters arrive days after the appointment - partly postal delays, partly admin backup. Keep calling!

[Butterfly65 in reply to CDreamer]

I have NHS app, plus I'm online with GP practice, it was only set up a few weeks ago but it doesn't seem to be updated. For example, I had blood test last week but there's still no results online.

I fully understand reasons for cardioversion which is why I've been pushing to have it done.

If you look at other comments you'll see Simon who was diagnosed several weeks after me but has already been scheduled for a cardioversion.

[Jackiesmith7777 in reply to Butterfly65]

My husbands cardioversion lasted 10 days . He has a very stubborn heart . We’re seeing cardiologist on Monday so we ll see what next move will be . He s in permanent Af after first ablation wore off

[Butterfly65 in reply to Jackiesmith7777]

Hello Jackie, There's plenty of info on Ep's Dr Scott Lee's YouTube where he explains why ablations often don't last.

He says afib is progressive so there's always new afib cells forming, hence why people have to go back for what they call top- up procedures.

He uses the analogy of forest fires explaining that even the youngest & less experienced of fire fighters would be able to put out the smallest of fires, but when the forest fires expand, even the most experienced of fire fighters wouldn't be able to extinguish the fire.

He talks about the heart & afib as though it's a building with walls, floor & roof that are on fire & need to be extinguished. They put out the fire on one wall & another fire starts a few months down the line on another wall.

I think this is why it's important for us to try to learn about & to understand the different types of ablation treatments that are available to us.

[Nomis21]

Hi, had pace n ablate 2022, went into permanent AF and pacing induced heart failure not long after, upgraded to a crt pacemaker in Oct 2024 and cardioversion carried out Dec 24, now my EF is 54 and I'm AF free.Was informed I don't need anti coagulation meds any more but still on meds for HF for 2 years after

[Butterfly65 in reply to Nomis21]

Morning Nomis21.

Sorry to hear all that you've been through.

I'm still a bit confused about pacemakers & other implanted devices for afib because from what I've learned so far, I've been led to believe that they can't slow a fast heart rate, but can pace a slow one.

I'm currently taking digoxin, bisoprolol plus Apixaban anticoagulant for Afib plus four other meds for HF.

What was your EF at its lowest?

[CDreamer in reply to Butterfly65]

If you are completely PM dependent - as in P&A - then it’s the PM that controls your HR.

[Butterfly65 in reply to CDreamer]

Ok, thanks.

[Jackiesmith7777 in reply to Butterfly65]

My husbands was 33 , a year later 42 so slight improvement

[CDreamer]

I suspect that P&A may be the way to go but know it won’t stop the AF but it may help ease symptoms to improve your QOL. It will make you 100% pacemaker dependent and so doctors are very reluctant to go that route when you are so young because you would need multiple replacement boxes during your lifespan and there is a small risk involved with every operation. I had CRT pacemaker in 2018 after 2 ablations and AF returned, Improved my QOL hugely. I DID NOT have the ablation of the AV node simply because the pacemaker worked so well for me but it appears that I am relatively lucky and very few doctors seem to favour this approach - but worth asking. I believe CRT is the gold standard for AF patients with heart failure.

Success rates for ablation is quite dependent upon your fitness and co-morbidities. Mini-maze hybrid ablation is the other option but that is a bigger surgical procedure and again you would need to be fit prior to the surgery.

Go to the AFA website and research the options and learn a LOT more about your options and who to see and how to get to talk to them. Consider going to the Patient Day or the Virtual Patient Day to broaden your perspective, ablation is not suitable for everyone.

[Butterfly65 in reply to CDreamer]

Will take a look, thanks for info.

[Buffafly]

Don’t give up hope, someone on here was in a similar state to you, had a ‘failed’ ablation but after a couple of years woke up in NSR and stayed that way! I don’t think you’re being fobbed off. I just had a look at your history and considering all your problems it does look as though P&A would be the eventual solution but I don’t think any doctor would jump straight to that without trying CV + ablation first. And unfortunately for your anxiety if your average HR is below 100 they don’t need to rush because the longer it stays that way the more chance your heart has to recover before trying anything extreme and the safer and more likely to succeed such procedures will be ❤️‍🩹

[Butterfly65 in reply to Buffafly]

Hello again Buffafly & thanks for your continued replies/support to my posts. Just to be clear, I haven't had a failed ablation, I haven't even had a cardioversion yet.

It's been over 6 months now since diagnosis yet I frequently come across people who were diagnosed many weeks after me who are having/ had procedures.

I realise we're all different at varying levels & stages but I'm not the most patient person at the best of times, & perhaps my own worst enemy with overthinking & worrying.

I think it possible that I've had so many upsets & disappointments throughout my life that my brain prefers to settle on the worst case scenario to avoid future disappointment but I know that negativity can also work against me & my health.

Made sense what you've said regarding them not having to rush procedures just as long as my HR is below 100 bpm which it has been mostly since my med dosage was increased, plus my heart given more time to recover & hopefully strengthen being more likely to withstand procedures that are successful - thankyou, but it's also the side-effects that trouble me & the anxiety.

[Simon_P]

Hi I was diagnosed with permanent AFib and HF in December 2024 (59). I have been on medication since. I'm booked in for a pre assessment tomorrow and have a cardioversion planned for next Wednesday. Fingers crossed I can get back to NSR. I'll let you know how it goes.

[Butterfly65 in reply to Simon_P]

Hello Simon,

I was diagnosed end of last August but still waiting for written confirmation re Cardioversion.

When did you receive your appointment date & was it by letter?

I realise we're all different but I've seen many like you who were diagnosed many weeks later than me but are having procedures ahead of me.

I don't know if that's down to my location or something else but It's been both frustrating & worrying.

When I saw cardiologist back in early January he spoke to me as though I'd be having it within a few weeks, five weeks at most, though he did warn me that if it worked I'd probably only remain in NSR for a few days.

He spoke about it being more of a test to see if I could be reverted.

Wishing you the very best of luck for next Wednesday, & remember that as long as you are able to be reverted back into NSR, the better chance you will have of future procedures working for you.

[Butterfly65 in reply to Simon_P]

Did you go private?

[Simon_P in reply to Butterfly65]

No everything has been done on the NHS at Leighton hospital in Cheshire and I can't fault the service I have received since I presented myself at A&E with chest pain and breathlessness in December last year. I received a phone call on Tuesday and asked if I was available for the cardioversion next Wednesday so all quiet soon I think it may have been a cancellation or something I've had no appointment by letter. Hopefully you will hear something soon.

[Butterfly65 in reply to Simon_P]

Thanks for info, it's put my mind at rest re letter confirmation. I've been told I've been pencilled in for the 2nd of April.

[Butterfly65 in reply to Simon_P]

How did your cardioversion go, are you back in NSR?

[Simon_P in reply to Butterfly65]

All went well thank you I'm back in NSR and feeling well apart from some slight burn marks from the defibrillator pads. Just needed one shock to gain NSR. Let me know how you get on has your April date been confirmed

[Butterfly65 in reply to Simon_P]

Really pleased for you Simon. I've read about the burns, I think I'll probably suffer them too because I was burned whilst in hospital just being hooked up to the ECG machine for a week, (sensitive skin type unfortunately.) Hope they heal fast.

I noticed you were also prescribed amiodarone for rhythm control a few weeks prior to cardioversion, so hopefully that will help to keep you in NSR, do you know how long you'll need to take it for?

My cardiologist mentioned amiodarone to me back in January but he said because I have hashimoto's he wouldn't prescribe it.

I spoke to a hf Nurse again beginning of this week who repeated what was said previously, that I've been pencilled in for the 2nd of April but still not received written confirmation which she said she'd look into for me.

Some people, I think mainly those who just have afib with no other heart damage, have said that as soon as they woke after cardioversion they felt so much better & knew it had worked.

Did you notice an instant improvement like that? Do you feel different/ better than you felt prior to cardioversion, if so how would you describe the difference?

Thanks - Michelle

[Simon_P in reply to Butterfly65]

Hi, No I didn't feel instantly better and still had a dull ache in my chest that I hoped would have gone away. Although this has subsided now but it wasn't instant. I'd say I feel more relaxed and calm and seem to have more energy when walking the dog. Regading the Amiodarone i was told 4 to 6 weeks post cardioversion i would come off it as they dont want me on it any longer than necessary. Take care

[TM93]

I suggest you research the Wolf mini maze. They have a FB page. I do not have personal experience with it, but many have and they herald its success.

[Butterfly65 in reply to TM93]

Thanks, someone else suggested that on my previous post.

[mav7 in reply to Butterfly65]

healthunlocked.com/afassoci...

Check the above link for discussion on the maze procedure. At your age you may be an ideal candidate and Dr Hunter is in the UK. You may want to search the forum for other threads on the subject.

[DawnTX]

I had tachycardia that would not stop running close to 200 most of the time I could not walk standing effort that brought tears to my eyes because of the chest pain to try to get to the bathroom I would almost so trust me I know what you mean. You will not be free. You can’t be cured because they don’t have a cure yet. I don’t know if they ever will. There are so many to it and we are different. That being said, I have a pacemaker and it’s the best thing I ever did even though I was not thrilled when it was mentioned I had no option because I also had heart failure by then. FYI, not only did. I finally feel human and normal again but my HF has reversed. My numbers were in the 40s for ejection now in the 70s. You didn’t mention a pacemaker one way or the other I am still on my anticoagulant will be for the lifetime. I also am on losartan and metoprolol. in fact, I just had to have my losartan doubled. Things are probably going to change in the next month when I see my new EP. I’ve been sick that may be why my BP etc. have blown up my doubled it. my EP has gone away. I am going to be starting with a new one so right now I’m kind of stuck in the middle. We are never free of a fib. You are still going to get feelings even with a pacemaker, but you’re not going to have the your circulation will be been so bad that I could not walk yet leaving the hospital after the pacemaker and AV node being done I was able to get into the car on my own. There is hope it’s just not going to be perfect nothing is perfect. When it comes to I don’t think a lot of a fib is the amusing what I call a Band-Aid my EP believes in quality of life. That’s what he strives to give us. They are human. They are doctors not magicians. Best of luck.