Cardioversion success rates.

[Ajay50]

Hi everyone, yesterday i recieved an appointment for a cardioversion this coming Monday for my A-Fib, what I would like to know is what has peoples experiences been in successfully being converted back into normal rhythm. I was officially diagnosed with A-Fib last August while attending an GP appointment for an unrelated issue. On thinking back at the symptoms I notice now I may have had A-Fib for about two years at least. My A-Fib manifests itself as being continuous 24/7 with a average pulse rate varying from 50's to 100, but an iregular iregular rhythm. I have been told the longer a person has had rhythm problems the less likely a successful result of a cardioversion will be.Thanks for any replies.

[CDreamer]

So much depends upon whether or not your AF is persistent - defined as 24/7 and you don’t self convert and for how long you have been in AF. Some people are asymptomatic for AF is only picked up in a medical centre.

Cardioversion is often done to see if you can convert to NSR and if so, further more lasting treatments such as ablation may be offered. If you can convert to NSR for even a few minutes, there is hope that a treatment may help. Cardioversion rarely is a permanent solution for those in persistent AF.

Were you offered any anti-arrhythmic drugs in preparation for the cardioversion and have you been anti-coagulated for some weeks? If not, do ring the Arrythmia clinic to ask.

My husband’s cardioversion, after the third go, lasted 30 secs however the loading of the drugs was not fulfilled early enough so he continued to take the drugs and after 3 months he finally returned to NSR but he had Paroxsymal AF (comes and goes) for many years prior to AF progressing to persistent AF.

[Ajay50 in reply to CDreamer]

Thanks for the replyYes indeed I have been on anticoagulation treatment , Apixaban, for about 5 years well before my A-Fib diagnosis due to other blood clotting issues . As for anti-arrythmic medications my GP put me on a low dose of Bisoprolol, 1.25mg, last November after episodes of light-headedness and feeling unsteady on my feet while waitingfor a cardiologists appointment, this medication has had no effect on my persistent A-Fib, only cold hands and feet. I had a echo-cardiogram last November which indicated my heart structure was OK with a caveat that my left heart chambers were slightly enlarged. As you stated I think it's going to be a case of seeing if a cardioversion can at least achieve a normal rhythm even for a short period.

[ozziebob in reply to Ajay50]

You wrote ...

As for anti-arrythmic medications my GP put me on a low dose of Bisoprolol, 1.25mg, last November after episodes of light-headedness and feeling unsteady on my feet while waiting for a cardiologists appointment, this medication has had no effect on my persistent A-Fib, only cold hands and feet.

... But Bisoprolol is not an anti-arrythmic medication! Bisoprolol is a rate control medication (ie . lowers your heart rate), so Bisoprolol would be contraindicated and likely make your existing "feeling light-headed and unsteady" worse, have no effect on your persistent A-Fib, as you said, and, in addition, likely produce your "cold hands and feet". And remember you also reported your heart rate during your continuous AF as being in the 50-100 range, which is accepted as within the normal range.

Perhaps, as your GP is unable to prescribe anti-arrythmics (which needs an EP or cardiologist), he/she prescribed the Bisoprolol as an interim heart calming medication, but it still sounds counter intuitive, and I would certainly be asking your GP about his/her reasoning, especially in the light of your ongoing side-effects.

Good luck next Monday.

[Ajay50 in reply to ozziebob]

My GP did indeed prescribed Bisoprolol as an interim measure, GP stated 1.25mg was the highest dose she could prescribe and It would be up to the cardiologists to prescribe a higher dose or an alternative.I was aware Bisoprolol was more to do with heart rate and not rhythm issues which is the main issue with my AF.

[ozziebob in reply to Ajay50]

My confusion arose as you linked arrhythmic meds with Bisoprolol in the same description. As they say, it's "the way you tell 'em". Good to know you are up to speed with the differences.

[jeanjeannie50]

Cardioversions always worked for me. They kept my heart in rhythm from one day to years. The one that lasted for a day was my fault, I walked up a very steep hill. It's important to not do anything strenuous for a week or two after the procedure and let your heart grow strong beating in it's correct rhythm.

I was diagnosed with AF 20 years ago but believe it started long before then. I'm now in constant AF, have been for the last 6 years. My heart rate flits from 60-90bpm and I can cope with that. I've had 3 ablations and countless cardioversions. Finally I was told I wouldn't be offered any more of either of those.

Good luck in your AF journey.

Jean

[DawnTX]

I only was successful for 3 1/2 weeks but it was such a great 3 1/2 weeks. Other than that since developing a fib, I have never been in normal rhythm. They tried a second on went I was very sad because they had arranged to keep for about five days in order to put me on tikisyn which is a medication you must be monitored for at least five days around the clock. After the third try that day it was just getting me back in anyway that was important. Right after that is when it was decided about my pacemaker and my doctor began working on plans for one because they had none for me. I have mixed feelings about cardioversion. I’m always happy when I read. People have been successful and stayed there. It’s just that we are also so never knows what’s going to happen. I did like the way they did mine including TOE each time and general anesthesia. if successful, I hope you feel like I did the first time I swear I woke up with a smile lol my said it cocktail they had given me prior to it whatever it was it felt good think positive but if it doesn’t work, just remember that is not uncommon. I cried when mine didn’t work when they told me we all just hope for the best. I finally got good when I got my pacemaker when I left the hospital. It was similar to when I woke up from the cardioversion except this time I kept the good feeling.

we never know how it’s gonna turn out but they are working on great things every day for us so even though there is no cure yet hang in there Will you seem to be getting more doctors like my great one was it was all about quality of life isn’t that what we want?

[Bumpitybump]

Hi Ajay50

I acquired AFib post an aortic valve replacement in July, it settled in as persistent, HR was erratic and charging around from 70 to 110. I had a Cardioversion in Dec and so far so good. In normal sinus rhythm but I do experience more ragidy supraventricular ectopic beats than I had before but HR is steady. So fantastic to be in NSR, long may it last. Appreciate this forum, for me it encourages me to do all I can not to trip heart back into AFib. Best of luck.

[Leaney]

Cardioversion worked the second time for my husband. He has been stable for a few years now.

[Mcgandy]

I developed v similar AF to yours back n 2016, was corrected with CV 6 months later, was OK with just a couple of bouts lasting mere hours until 2024. Last year a chest infection triggered it, and this time the CV only restored rhythm for a few days. Now OK after ablation 3 months ago.

Your chances? Who knows. We're all different. Age, weight, fitness all have a bearing, but your heart team must think your chances reasonable, or they'd not be doing it. Good Luck!

[Ronnieboy]

I've only had the one, 16 years ago,and I've beek OK near enough ever since,sometimes very occasionally ,if I feel an erratic heart rate coming on ,some slow deep breathing stops it .

[30912]

I've had one cardioversion in 2017 which was successfully in stopping my AF which I had been in for about 10 days. It took them four attempts apparently to get back to NSR. This then put me on the pathway for ablation number two later.

Good luck with it.

[Ducky2003]

4 days for the first one then anything up to 2 years for subsequent ones.

[Simon_P]

I had my cardioversion on 12 March still on amiodarone and still in NSR. Got a follow up appointment in a few weeks so hopefully can come off the amiodarone. But so far so good it's been successful.

[Hallane]

So my AF is regular rate 50-80 and persistently irregular (2 years non stop)

Tried Cardioversion after a year, lasted 1 week in SR. Again 6 months ago lasted only an hour…

Due another go shortly but this time having been loaded with Amiodarone.

Good luck

[Johnspin21]

I had AF for the first time in 2021 which was treated with a Cardioversion successfully, and was fine for over 3and half years . It came back this year in January, and I’m waiting for the cardioversion again . So it does work for some people.

[OzJames]

i had my first cardioversion in Oct 2022 after being in AF for 2 months and converted first time. I was put on Flecanide prior and after the CV as the Cardiologist said it can really steady the rhythm and increase chance of CV. If you have been in AF since August it can still work and prior to that you suspect you had AF, the question no one can answer is, was it all the time in AF or were you going in and out of AF or was it Ectopics.

Ive since had a few more CV's since the first and all but one worked first time. My 2nd CV worked on the 3rd go.

Just take it easy for a few weeks after CV and stay well hydrated. Maybe ask if they think it a good idea to start Flecanide and stay on it for a month after CV to help heart get used to its normal rhythm