What next? Afib advice please - Atrial Fibrillati...

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What next? Afib advice please

Cazjay profile image
17 Replies

Flecainide and Bisoprolol were not managing my Afib, so I had a cryo ablation in February which worked for a few days but then Afib came back with a flutter friend! Have now had a cardioversion which hasn’t worked. I don’t know if it’s the Afib or the drugs that are making me feel so rotten but advice and suggestions would be very welcome. I should add that until the ablation I was working full time as a special needs teacher and although the Afib could be a nuisance I coped.

Thank you 😊

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Cazjay profile image
Cazjay
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17 Replies
bigking profile image
bigking

Sorry to hear about your flutter. I had an ablation in January for AFIB. Within two weeks I developed a flutter (must happen a lot). Doctor suggested and had second ablation in March as flutter bothered me even worse than the AFIB. Thus far no recurrence of either. Stopped the flecainide yesterday, so we shall see.

Cazjay profile image
Cazjay in reply tobigking

Thanks for your reply. I understand what you mean re the flutter, its like a humming bird in your chest 🥴 I’m due back in Papworth soon so we shall see what they suggest. I hope you continue to feel well 👍

Given your timescales, I am guessing you are in the USA?

A second ablation often fixes things but it is only 3 months since your ablation.

I guess you will know if it is the AFL/AF or the meds making you unwell, after the cardioversion. What are you taking now?

Cazjay profile image
Cazjay in reply to

Hi thank you for your reply. Would you believe I’m in the UK. I think things have progressed quickly because the Afib has been making me feel so rubbish.

I forgot to say that I was re admitted to hospital a week after the ablation because my heart was going crazy and they readjusted my meds. I had the cardioversion yesterday and went back into normal rhythm but unfortunately an hour later Afib was back. I’m taking 2.5 Bisoprolol once a day, 150mg Flecainide twice a day and 20mg Rivaroxaban.

Globe-J profile image
Globe-J

Perhaps the Maze Procedure may be the answer. It was for me, for what's worth

J

Cazjay profile image
Cazjay in reply toGlobe-J

Thank you for your reply, I’m not familiar with that so will check it out 👍

Nanopiano profile image
Nanopiano in reply toCazjay

Your Afib journey so far sounds like mine. None of the antiarrythmics worked, several cardioversions resulted in NSR for about three days, two ablations lasted about a week. So like Globe-J, I finally decided to have a maze procedure. Had it done about a month ago and so far am still in NSR! The only post-op concern was that I was on a heart-lung machine for longer than anyone thought I would need to be, so I had to go to a rehab center for a couple weeks since I wasn't quite ready to go home from the hospital. But all in all, I would definitely do this option again when nothing else seemed to work and the Afib was full-time. PS. My procedure was done robotically!

Cazjay profile image
Cazjay in reply toNanopiano

Yes I agree that our journeys are very similar, and it’s great to hear that a new procedure has had a positive result. How long did it take for you to be offered the maze procedure?

Are you taking any meds to maintain nsr? 😊

Nanopiano profile image
Nanopiano in reply toCazjay

I think I'd been in Afib for years, but was only referred to a cardiologist about two years ago. All the procedures (cardioversions, ablations, etc.) I had took place in those two years before my cardiologist referred me to a guy in St. Louis for a maze procedure. Since I didn't want to travel out of my area (Portland, OR), I found a thoracic surgeon here in town who performs the procedure with the use of a robot. For the time being, I'm taking Eliquis, Amiodarone and Metropolol...but the plan is in about six months (if all continues to go well), I'll be off all of them.

Cazjay profile image
Cazjay in reply toNanopiano

That’s excellent that your needs were dealt with promptly. I hope you continue to make good progress and can soon be meds free 😊

Ojsmpson profile image
Ojsmpson

Hi. Try the watchman devise. It works

Cazjay profile image
Cazjay

Thank you I’ll check it out ☺️

56-er profile image
56-er

Could be that you are taking too much meds. Why do you need both Flecanide and Bisoprolol? I was switched from Bisoprolol to Metaprolol and gradually reduced the amount to 1/2 of 50 mg twice daily. Even once daily would be enough to control the AF, but my BP was edging-up with only one half.

Cazjay profile image
Cazjay

That’s an interesting question. I’m told the Flecainide is to control the arrhythmia but as it doesn’t really work perfectly the beta blocker helps to bring it down. However, neither work brilliantly. I’m exploring alternative therapies now so that I can try to regain control - fingers crossed 😊

KMRobbo profile image
KMRobbo

What type of a flutter do you have. ?

I had afib thythm controlled by flecainide and rate controlled by diltiazem. I did not like being on the drugs esp the diltiazem owing to the side effects. I had a pvi cryo ablation (left atria) 29th jan2018. Apparently successful. 9 days later I got a

A flutter. I was asymtomatic in AF even over 200 bpm, but the flutter was at 140Bpm rate limited by the diltiazem, and I was breathless just walking Into the kitchen for a brew. Was diagnosed eventually as having reentrant flutter in my right atria. My EPs registrar advised i did not have any signs of flutter pre ablation or else they would have sorted it at the same time as the cryo. He advised it may have been promoted by the flecainide I was still taking post ablation. Anyway owing to the fairly severe symptoms I got a right atria RF flutter ablation on the

26th Feb 2018 which stopped it there and then. Good news is the right atria flutter ABLATION is less risky than the left atria ablation, is 90% succesful and once done rarely returns in that form, again according the my EPs registrar. I Have not had either AF or flutter since then , and I have been off all drugs since May 15th 2018, which is great. I do get what i think are ectopics from time to time, rarely last more than minutes although have been a few hours on a few occasions but I ignore them!

The Right atria ablation is shorter procedure than the pvi cryo and is less painful although I thought that neither were much of an issue. The pain of the RF is felt in the right shoulder. I am 58 with no other health problems.

If you have the same type flutter as i , and no other issues, then don't be afraid of a second ablation and get it sorted. I don't think anything was worse for having two ablations in a month. What knackered me was 140 bpm for 3 weeks and just lying down doing nothing for the same period.

Best wishes

Cazjay profile image
Cazjay in reply toKMRobbo

My flutter was diagnosed after the ablation for afib. They’ve suggested an ablation for the right atria so I guess going on your experience it could be worthwhile. I’ll keep you posted 😊

Cazjay profile image
Cazjay

Umm that’s what suggested so we shall see 😊

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