Persistant AF and non-connected surgical procedures.

[Sorre1]

I had paroxysmal AF for a number of years become more frequent and more symptomatic over time.

On 28 November last year I had Cryo-ablation and had meds changed from Sotolol (which clearly wasn't working) to Amiodarone.

unfortunately the ablation does not appear to have been effective as after one week in sinus rhythm I flipped into AF again and that is still the case. Rate doesn't seem too high - around 100 with a few spells at 120 but it's irregular.

I'm due a telephone review at the end of the month (I assume it's by phone as the hospital that performed the procedure is some distance away.

Last month I was in my local hospital with a very painful inflamed gall bladder and put on the waiting list for keyhole surgery.

I had a telephone pre-op 10 days ago and when I explained I had a pacemaker and was in AF the nurse said she was cancelling the procedure until after my AF review at the end of April. I'm at a loss to see what difference this will make as the rate of AF seems controlled by meds.

Has anyone else had a similar situation

[Sorre1]

sorry, pressed enter too soon.

Has anyone else had a similar issue? Does my persistent AF mean I can't have any other surgical procedure?

[10gingercats in reply to Sorre1]

I had a hip replacement with perm. Afib.(I was 78 at the time) so no it does not exclude other surgery but I guess each case is to be looked at on its own need and urgency.

[Morges]

Hi Sorre1.I am in a very similar situation to you. I was chucked off the operating list when I went for the pre op - this was Feb 5 with op planned for Feb 19. (Hip replacement) The care assistant did an ECG which showed AF. I had no symptoms and I didn't believe I had anything wrong - I put it all down to the coffee I had an hour previously and also rushing around getting in some shopping and then in a panic as no parking spaces at the hospital. I didn't know I was going to have an ECG otherwise I would have been more careful.

So I was sent off to see the GP who dished out the px for Apaxaban - also a beta blocker which I declined - and sent a referral to the cardio dept at the NHS hospital - and they wrote back to say they wouldn't see me as the GP had put me on anti coagulants - job done!

Then my hip surgeon said he wouldn't do the operation until I'd been seen by a cardiologist. The GP referred me again to cardiology and again they wouldn't see me. So I booked an appointment privately and was seen within the week by an electro cardiologist who did an echogram and now I am officially in asymptomatic AF with a few other problems added on. But I have a letter from him saying I should go ahead with the surgery! Sorry such a long post.

I do appreciate the hospital being super careful - it's a private hospital which does some NHS work but it has no ICU so the risk assessment is important.

Is your hospital a main one? Can you get a confirmation from your cardiologist that it's ok to have the surgery?

Hope you sort it out - and from my experience it is up to you to sort it out. All the best.

[Sorre1 in reply to Morges]

Thanks, very helpful. As you say they are being ultra cautious. My ablation was performed at the Lancashire Cardiac Centre in Blackpool but my Cardiologist is at Wigan RAE, and that's where I have my pacemaker checks done.

One good thing is the op has not been cancelled fully, just postponed. I have to ring the Pre-op nurse once I've had the review. Just no idea what difference that will make.

[Morges in reply to Sorre1]

Yes I too was told to let them know when sorted with cardio issues and they will slot me in rather than start at the bottom of the waiting list. The secretary told me (for hip op) that will be in June. Probably!

[Murderfan58]

My brother has permanent AF and has had done for nearly 20 years . He had a hip socket replaced on 18th last month . He knew last year it would need to doing so lost 7st in weight and went swimming every morning at 6.30am doing 50 lengths . And walked 5 miles a day to get fit The operation took 3.5 hours he had a spinal block and sedatives and slept through the operation.

I don't see why your surgeon couldn't have done the same for you using a spinal block and sedatives. As the operation was being done via key hole and not a open operation like my brother . He has a scar from his hip to nearly his knee as they needed to check on the rod in his thigh bone.

I would see your GP and get a referral back to your surgeon. As you need the surgery.

Don't know if this has helped.

[10gingercats in reply to Murderfan58]

spinal blocks are becoming more and more common when anaestetic may be dangerous/age or other comorbidities. A friend in london has been offered one for a hip replace and a friend here in oxford had one for a kneww replace.

[Bellisa]

Hello Sorre1,

I am very sorry to hear about your health and I will share with you my own experience with Amiodarone, hope it helps.

I have a heart condition and over the last year I had 3-5 AF episodes, 3 lasted 1 week to 20 days, and two lasted a few hours.

Because I have a Fitbit watch, I could see my Irregular Rhythm Notifications and last time it was sometimes between 36 – 181 bpm; most of the time up to 145bpm. By the time the cardiologist saw me and prescribed Amiodarone, it was fluttering badly, so I had 200mg x 3 times a day. Luckily in 2 1/2 days my AF finally stopped, after 20 days.

While taking Amiodarone, only 2-3 days, I had bad taste in my mouth, I was bloated, stools were reddish and like diarrhoea. I could not wait to stop it for good. It was way to strong for me as i am slim built and 66 years old.

I am now taking Bisoprolol 2.5 mg x 2 a day and feel like my heart has a normal sinus rhythm. Although still mitral stenosis and the valve is not closing well.

hope this help and i wish you all the best,

[Lurchergirl]

Hi Sorrel

How long did you have Paroxysmal AF before it became persistent? I have had PAF for 8 years and now have more frequent episodes and wondering if mine is progressing into persistent. I am due a Pacemaker but been waiting for months so not hopeful that will be anytime soon. Not sure I want one anyway.