I was booked in for a cardioversion having been diagnosed with atrial fibrillation and an irregular heartbeat. However, just before, the ECG showed it was regular. I was very happy about this as the cardioversion was cancelled, but then wondered how things would be managed from here on, if at all. Has anybody had this experience and did it result in more ECGs down the line to keep a check on things ? I’m still taking an anticoagulant.
Thank you.
How long had it been going on when they cancelled it?
Paroxysmal a/fib is a pest - mine wasn't that frequent and the episodes weren't even long enough for me to bother calling an ambo as the one time I did after about 2 hours and feeling REALLY grotty, it had stopped by the time I got to the ED! Before I finally had an ablation it was bothering me for up to 12 hours a day but the pacemaker showed it wasn't continuous for all that time. I'm not sure how it is monitored when you don't have a pacemaker - it will depend on what symptoms you develop and how it affects your QOL. My husband had pretty much constant a/fib but it didn't bother him a lot (in that he never complained but that might have been because he felt rubbish from other things too!) and he was on an anticoagulant anyway.
Feel tired, had and have constant palpitations and a bit of tightness around the chest, but the only thing that worried me was a period of about four weeks in which I had near fainting fits. These had ceased about 3 weeks before I was rapidly advised of the cardioversion in the New Year. My podiatrist had noticed my irregular heartbeat in May and swollen leg. She gave me a letter for the doctor who referred me for an ECG where AFib was confirmed. I originally had bad side effects from the beta blocker, so have only been taking an anticoagulant.
Sorry to hear about your husband and your health worries.
Near fainting fits for me were the sign of tachy-bradycardic syndrome. I was having tachy episodes immediately followed by bradycardias where my heart would actually not beat for up to 7 seconds - causing the wave of faintness. Here it wasn't a cardioversion which is often only a temporary solution - it was in hospital until a pacemaker was fitted a few days later!
I must say that I would prefer a direct solution, like yours, even though that might be a bit daunting. The nurse at the hospital, like you, agreed that cardioversion is often a temporary solution. I have checked my pulse, but it seems intermittent. I might ask the chemist to check it for me tomorrow. Thank you for enlightening me re: the near fainting fits. Judging by how I felt it makes perfect sense.
I can't see the point of cardioversion for patients with a proven paroxysmal a/fib, it rectifies a current rhythm but does nothing for the underlying cause. Wasn't even mentioned here but it seems to be used a lot in the ED in the UK judging by the ED programmes I watch!
I’ve had paroxysmal AF for 15 years kept under control with medication but the polymyalgia exacerbated it and I had 3 episodes in 4 days. I’ve now been referred back to the cardiologist. It’s odd how some people with AF don’t know they’ve got it whereas it wakes me up and I feel awful with it.
Sorry to hear this George. I hope that the cardiologist will be able to help you.
I was diagnosed with paroxysmal AF in 2015, PMR in 2018. Medication kept AF under control with a few episodes each month none longer than 16 hours. Ablation was mentioned but I wasn't keen. After being admitted to A &E with chest pains the medics decided to take me off flecanaide due to mild ischaemia. Wham I went straight into persistent AF and put on sotalol to control rate. I have now had a cardioversion, lasted 6 weeks. 1st Ablation, lasted 12 weeks. 2nd ablation is holding nicely, but I am now back on the medication I was on originally as a belt and braces. PMR was in remission until the 1st ablation but I am coping. I now have a diagnosed of fibromyalgia to add into the mix. I hope you get the AF sorted soon.
Hello EastMidLass,
Sorry to hear that you have had such a bad time with AFib. I hope you get yours sorted out too. Thank you.
I had three Cardio versions done (pre PMR), the first one lasted three weeks, the last one three days. I then bit the bullet and paid for a private consultation with an excellent surgeon ( the best £200 I have ever spent). He then suggested that he perform an Ablation procedure on me and I have been right as rain since😃. Wishing you well
I would see an electrophysiologist who specialises in heart arrythmias. Sounds like you have paroxysmal atrial fibrillation and therefore it will rear it's ugly head again!
Hello Karendeena,
Nobody has mentioned paroxysmal AFib to me yet, but it must be what it is. It’s difficult to keep tabs on it.
Thank you.
Hi BP1
I have had a similar experience. A fib went untreated until my 3rd visit to A and E in 2 weeks. They prescribed BISOPROLOL and then booked me in for a cardioversion. On the day my rhythm was normal again. I then had a an echocardiogram and I was in AF again but eventually the meds started to work and 🤞I’ve been ok since. If you have any problems I’d advise phoning the cardio team at yr local hospital. They were really helpful at ours.
Hello,
Thank you for your helpful reply. I should have had a cardioversion today, but a previous ECG showed that my rhythm was normal and the cardioversion was cancelled. I was very happy about this but yesterday I felt unwell and wondered if the rhythm is irregular again. I will have it checked. I tried my pulse and it seems rather strange. It could be that I’m dehydrated, hard to tell. I can’t take Bisoprolol and am just on an anticoagulant. Glad you are OK.
Good luck. Hope you get some help x
Thank you, I’m glad that you are getting on alright x😀.
Get a pulse oximeter if you don't already have one. That will show you the "shape" and rate of your heart beat and you can keep notes - it should be regular and a sinus curve shape. If it is fast and irregular or a really funny shape, get your GP to request a longer monitor. An ECG is a picture not a video/film and only shows things there and then, My ECG was usually fine but I was having bradycardia events where my heart would stop beating for up to 7 seconds and that caused a dizzy spell. When it was finally identified I said to the cardiologist "but I TOLD you there was something wrong" and she replied "bit we never saw it". Sometimes you really have to push when you are sure something is wrong.
There are plenty of other medications they can use besides bisoprolol but they also need to establish how often it is happening. And you have to tell them how badly it is affecting your QOL. If you have one, a smart watch is often a great way these days of saying "I told you so!" Some are good enough for cardiologists to accept their records but even when they don't - you have backing for your request for better investigation.
Thank you, I will look into this. I’m thinking about a smart watch.
Me too - but one with a fall monitor to use as an alarm!!!
Hopefully there is one …… All the best.
Oh yes - they exist!!!
I am interested in your case as I also have atrial fibrillation and an occasionally irregular heartbeat. However, after a couple of mini strokes I was put on Anticoagulants. What is different is that nobody has suggested cardioversion. Perhaps it’s not always needed. I shall be interested to follow how you progress. G
The anticoagulation is really important - but while cardioversion might terminate the current episode, it won't prevent another one occurring.
Usually offered CV if the episode will not self terminate - they do it to see if you can go back into NSR and then look towards an ablation in the future.
If your AF is paroxysmal which comes and goes then you are not offered a CV unless it lasts for days or weeks then its classed a persistent AF.
Thank you ChoralG. It seems that you have received different treatment as I have been on anticoagulants all the time. I did have a swollen leg and they were worried about a possible blood clot. I was prescribed a beta blocker, but had trouble with the side effects. Cardioversion isn’t a permanent solution it seems. However, I’m surprised that you have not received more robust treatment after having had mini strokes. I’m sorry that you have had to go through this. I’ll keep in touch.
Join the AF board - lots of information for you.
healthunlocked.com/afassoci...
Usual treatment is beta blocker - or Calcium channel blocker for rate control
Have you had an echo? If your heart is structurally sound then you may be offered a rhythm control drug called Flecainide if your attacks become more frequent or prolonged before an ablation is offered.
If this your first attack you may not have another for years(mine was 4 years) but they get closer together and become longer as in PMRpros case.
You should be seen by a Cardiologist too, but dont expect alot of follow ups unless its gets much worse. I have had 4 and now with an EP after an ablation in 2023. Mine started in 2010 and the Cardiologist I had for the first and only appointment before he discharged me said it will get worse and he was correct
Unfortunately I now have the irregular rhythm back again according to the doctor, strange to say this was discovered on the day of my cancelled cardioversion. I could have had it. I didn’t really want it, but this paroxysmal AFib is a bit uncertain and it would have been some kind of solution. This note follows on from my original reply to you. Thank you again for the link.
I don't think cardioversion is even a short-lived solution to paroxysmal a/fib. It is like an intermittent fault that returns after rebooting the computer of TV!!!
You do learn to live with paroxysmal a/fib but if you are having these faintness episodes and the a/fib is back, you do need a multiday monitor - or smartwatch - asap that will catch all episodes because if you ARE having bradycardias that are causing symptoms they need to be caught soon. Having one at the top of stairs or while driving isn't a good look!!
Before they seemed to occur just before breakfast or on a few occasions when chatting to my sister on the phone. Stairs are not a problem as we live in a bungalow 😀, however steps might be…
Things have settled down except for tiredness, but I was amazed to find how quickly I went from a regular to an irregular heartbeat. Feeling unwell wasn’t nice, but I think that a smartwatch should keep tabs on things and from now on I will try not to dwell, there are worse things.
Oh yes - it's like a switch being flipped.
😀. Goodness me !
Sorry we did discuss using smart watches for falls, I had forgotten that. I’ve now bought a Kardia as it seems to be mainly for heart problems. Hopefully it will work with my IPad as there is a larger screen, though I have got a Samsung Galaxy if that lets me down !
But is it a continuing record or do you use it when you feel it?
It would be used when I have symptoms, but also a record once a day would be useful. The doctor has verified that my heart rhythm is irregular again, but I would like to check if I’m called for another cardioversion that it hasn’t returned to regular rhythm again as that is a waste of time for everybody, though a good thing. A record can be forwarded to the doctor. I have only just received my Kardiamobile, so will let you know how useful it is.
As promised I can tell you that the Kardiamobile is easy to set up. I’ve received an ECG and the result shows that my heartbeat is regular again. I take my pulse every day now so if that seems erratic I will check with the Kardiamobile, also if I feel unwell. I bought the 6 lead one. It’s good to have the back up and a result for the doctor if necessary. I will also note all the results in my diary, positive and negative, for the consultant.
All the best and thank you.
I'm sure it is great - it's just it won't catch any mild intermissions! And they can come and go without you noticing. Good luck with it.
Thank you Ian, this is very useful. I did have a slightly thickened valve show up on the Echo, but this is fairly general, otherwise everything was OK. I have had near fainting fits, but these stopped. Yesterday I felt a bit unwell, but it might be due to other causes. I’m going to check it out as I could have an irregular rhythm again, if not, all well and good. I’m sorry that you have had problems with the wretched AFib and hope that these will be resolved.
When you get to see a Cardiologist, they should give you a holter test lasting a couple of days to record what's happening. My GP also does these but usually for 24 hours. I have a loop recorder fitted to which gets read every 6 months, and it logs any irregular activity. Before the Flecainide daily treatment started prior to the ablation, it recorded 18 episodes of AF in a 3 week period lasting from 4 hours to 13 hours - I was also using the Flecainide as a PIP to try and stop the attacks.
I am stopping the Flec now after 18 months so fingers crossed no AF return, but I am still getting runs of tachycardia of a few seconds at a time often during the day, and ectopics regularly. Good luck with your treatment👍
Thank you Ian. I suppose I shall just have to go with the flow. I think that a longer Holter test might be the answer.
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Here I go again. !!
