Electrical/pharmaceutucal conversion in PAF

When in PAF one reverts to SR naturally. Why then attempt a "forced" conversion when the result is eventually the same? Is there a difference in quality between the two?

[BobD Volunteer]

Many people do not revert un-assisted by either drugs or electrical cardioversion. DCCV shows a) if this is possible and b) if that person feels better in NSR which can then sign post other treatments.

[Hidden in reply to BobD]

OK, but my question was about the people who do revert without drugs or electrical cardioversion. Are these procedures worthwhile in PAF?

[BobD Volunteer in reply to Hidden]

If you spontaneously revert there is no need. As I say it is more a test than a treatment as far as I am concerned.

[etheral in reply to Hidden]

If the rapid rate is causing symptoms such as chest pain, shortness of breath, etc, DCCV is indicated.

[Cookie24 in reply to Hidden]

I feel terrible in afib and I think worse in flutter because heart rate just stays high in flutter. I have had prolonged episodes (over 7 days) and I asked for DCCV. I am on meds already. Two times I was scheduled for cardioversion but converted a day or two before my appointment. Told my EP nurse I am not meaning to cry wolf. She said it happens all the time. lol

[jeanjeannie50]

There have been times when I've been in AF for months while waiting for a cardioversion. It was hell as I felt absolutely dreadful.

We all only know PAF as bad as we have experienced it ourselves. Some people drift in and out of consciousness, some have chest pain, while others have hardly any symptoms at all.

I once spent a week in hospital with AF and was then cardioverted after drugs failed to do that. Two consultants and an anaesthetist came in one Saturday morning especially to do it. Was my first and I thought it was going to be a big deal. When they suggested doing it at the hospital bedside I thought, Oh no why have I let them do this, do they really know what they're doing! I was taken to a side room and given a GA, woke in normal rhythm a few minutes later and from then on have loved having them. Such a relief to feel normal again.

Jean

[Ppiman in reply to jeanjeannie50]

Hi Jeannie - I'm sure you've told me already so please excuse my memory, but when you are in AF, do you know whether it is the AF or the tachycardia that makes you feel so bad? I most frequently get mild tachycardia (~90-125bpm) and it makes me feel just the same as when there is AF or runs of, or multiple ectopic beats present. Fortunately, unlike you, this isn't so much awful, but still rather shaky and very anxious.

Steve

[jeanjeannie50 in reply to Ppiman]

I don't keep checking what my heart is doing these days and mostly I feel ok. I used to feel far worse with tachycardia.

[Ppiman in reply to jeanjeannie50]

Thanks. I'm glad you're well these days!

Steve

[CDreamer]

Are these procedures worthwhile in PAF?

- if you are very symptomatic and wanting to know if treatment would help - definitely.

If you revert to NSR without intervention what would be the point?

These would be procedures only done in hospital emergency for people who had been in AF for 7 days or more or who were admitted in particular distress. You both procedures you would need specialists and for CV an anaesthetist and they are not always available in UK A&E departments.