fib cross road

[birdpie]

I have had A-fib for approximately 5-6 years and I am at a cross road as to treatment decisions . First some background information. In the beginning my AF attacks were only every few months. I was put on Eliquis, Metroprol and flecinaide. The flec made me feel like I was 10 years older so I was switched to Flec as PIP. Unfortunately Eliquis caused GI bleeds, some serious enough that I required transfusions and hospitalizations . My blood has several antibodies which means that it is hard to find a match for me. I finally had a watchman placed last August and that solved the GI bleed problem. A few months later I was breathless again and went to the hospital again. The end result is that a zio patch showed that I had a few very long pauses which led to the installation of a 2 lead Pace Maker a year ago. I was also diagnosed with HFpEF (heart failure with preserved ejection fraction) and put on daily flec 2 times a day and was AF free from last February until this January when my AF became persistent. I have been taken off of Flec and now need to decide what to do next. My heart rate Control is well managed for the most part and I could continue just doing that and living with AF. Or I could do an AV node ablation and since I already have a PM I could stop my med and hope for a better QOL. Or if I want to take the risk of bleeding I should consider a PFA, which requires that I go back on Eliquis for 2 or 3 months. Because of my age(81) the persistent AF plus HFpEF I would likely need to do 2 of those with only 50% success rate. Or I could find out more about and do a mini maze surgery which might give a better % outcome. But I don't know if I would have to go back on Eliquis for those surgeries. So any info or experiences that any in our group has had I would love to hear from you....in other words it may help me decide which path to follow next.

[mjames1]

I think your questions, especially regarding Eliquis, would best be answered by a top EP at a high volume ablation center such as the Cleveland Clinic. But something tells me you will find an EP who could work around it, if you wanted to go ahead with an ablation.

Jim

[birdpie in reply to mjames1]

Jim, a few weeks after the watchman placement I was switched to Plavix and aspirin and I did OK on that plus continuing baby aspirin now. I plan to message my AF PA and ask if they would do PFA using Plavix instead of Eliquis. I am under the care of a high volume Dr. at U of M in Ann Arbor, MI, USA. If I need to Cleveland Clinic is only 3 hours away but I'm not ready to reach out to them at this time.

[baba]

What symptoms do you have now from Persistent AF?

[birdpie in reply to baba]

Mostly an underlying fatigue, which can vary day to day. I feel stronger palpitations , but at other times when the heart is quieter I don't notice them much at all. My rate control is generally god and I'm dialing an increased dose of Metroprol to see if that will help me feel better....more energy. I can walk a few miles but go slowly and need rests. When at rest I feel OK.

[PrinzMongo]

Hi, birdpie, I'm sorry to hear if your travails. Although I 've taken Eliquis, and would if my cardiologist said I needed to renew it, my path is so different from yours that I don't have anything I can say beyond what mjames1 said above. All I can offer you is my concern and hope for you as you move forward

-pm

[birdpie]

Thanks for your concern, I appreciate it.