AFIB

[ivinsfan]

AICD hasn't shocked me ever. Nurse suggested no driving for maybe 3 months as a standard, I've held off and the gal has been duty driver. Not fun. We have things to do. OTOH, I don't want to flop while she is a passenger, and to a lesser extent I've no desire to put others at risk, so I've only done one short low speed drive to the store, solitary. Will discuss with the AICD nurse and cardiologist next Tuesday & Thursday.

I misunderstood, isn't that the purpose of the device...? You have the device and did a faceplant anyway.

I see the post now where you say it hasn't ever discharged. As you say they probably need to tweak those numbers. If the episode went on long enough for you to pass out, it should have fired.

 

[Tekward]

+1
I've often mentioned on this forum about my elite level athlete brother.
He had been diagnosed with mild/intermittent AFIB in August of '16. His doctor suggested 'keeping an eye on it' for a few months.

Four weeks later he had a massive stroke which has left him fully disabled and unable to speak. It not only has changed his life but the entire family's as well.

Thank you for sharing this. I'm a healthy 62YO guy who just started wearing a HR monitor to evaluate AFIB. On day 2 the doctor called and wants to see me. I'll update you on the visit later today.

Honestly I have had no symptoms and lean towards less interventions, but your brother's story brought me down to earth very quickly.

 

[Alan]

Thank you for sharing this. I'm a healthy 62YO guy who just started wearing a HR monitor to evaluate AFIB. On day 2 the doctor called and wants to see me. I'll update you on the visit later today.

Honestly I have had no symptoms and lean towards less interventions, but your brother's story brought me down to earth very quickly.

Let us know how you get on. I expect he will, among other things, do a CHADS2 evaluation then along with your other health conditions make recommendations.

I was put on Apixaban (Eliquis) for 6 weeks prior to ablation and for 3 months afterwards. Before that I was not on blood thinners, diagnosed paroxysmal AFib at age 60, successful ablation at age 63. Unlike some other blood thinners Apixaban was extremely easy to use. A blood test before I started then a pill in the morning with breakfast, one in the evening with dinner, no other blood tests needed, no dietary restrictions, and to come off it when given the go ahead to do so it was simply to stop taking it.

https://www.mdcalc.com/cha2ds2-vasc-score-atrial-fibrillation-stroke-risk

 

[Leroy Jones]

AFib

I was diagnosed with Afib about 5 years ago at 62. Was put on Propefanone for heart rate control. No blood thinners. Last year my cardiologist recommended ablation. For about a month before the surgery I was on Eliquis. Had the surgery one year ago today. Stayed on blood thinners for 4 months afterward. As of the end of June 2019 I was taken off all heart meds and thinners. Apparently they did a very good job at fixing things because I haven't had a single issue since the surgery. Had a stress echo last November and it was perfect according to the doc. Back to all normal activities. Hope this continues to keep working.
Leroy Jones

 

[Alan]

I was diagnosed with Afib about 5 years ago at 62. Was put on Propefanone for heart rate control. No blood thinners. Last year my cardiologist recommended ablation. For about a month before the surgery I was on Eliquis. Had the surgery one year ago today. Stayed on blood thinners for 4 months afterward. As of the end of June 2019 I was taken off all heart meds and thinners. Apparently they did a very good job at fixing things because I haven't had a single issue since the surgery. Had a stress echo last November and it was perfect according to the doc. Back to all normal activities. Hope this continues to keep working.
Leroy Jones

Congratulations, long may it continue. 17 months now since my ablation, no issues to date, it’s wonderful.

 

[Qs Laptop]

I was diagnosed with Afib about 5 years ago at 62. Was put on Propefanone for heart rate control. No blood thinners. Last year my cardiologist recommended ablation. For about a month before the surgery I was on Eliquis. Had the surgery one year ago today. Stayed on blood thinners for 4 months afterward. As of the end of June 2019 I was taken off all heart meds and thinners. Apparently they did a very good job at fixing things because I haven't had a single issue since the surgery. Had a stress echo last November and it was perfect according to the doc. Back to all normal activities. Hope this continues to keep working.
Leroy Jones

Congratulations, long may it continue. 17 months now since my ablation, no issues to date, it’s wonderful.

I'd like to ask you guys if the decision to have ablation surgery was a medical necessity or did you do it because you were sick and tired of taking pills and having a less than ideal heartbeat?

My AFIB is being controlled by Sotalol and I'm taking Xarelto for stroke prevention. I have an ectopic heart rhythm (faint, premature heartbeat) that is bothersome. I'm told I'm not in any danger but I don't like the palpitations I get from it.

So far, I'm OK with taking the meds because when I weigh the risk of the surgery vs. simply taking pills, the pills win out. Then there is the whole issue of selecting a surgeon. But the thought of being free of meds and not having the heart flutters is tempting.

 

[Souschef]

About a year ago, my DW had a cardioversion for AFib. Unfortunately, in November she had 3 attacks after having repeat cardioversion. She finally had a pacemaker implanted and an AV node ablation. That is the last resort of treatment for AFib.The main reason she had it done was to get off Amioderone, which has horrible long term side effects.

She is still on Xarelto, and the incision is still healing. She is relieved that she will not have to worry about another incident.

 

[Alan]

I'd like to ask you guys if the decision to have ablation surgery was a medical necessity or did you do it because you were sick and tired of taking pills and having a less than ideal heartbeat?

My AFIB is being controlled by Sotalol and I'm taking Xarelto for stroke prevention. I have an ectopic heart rhythm (faint, premature heartbeat) that is bothersome. I'm told I'm not in any danger but I don't like the palpitations I get from it.

So far, I'm OK with taking the meds because when I weigh the risk of the surgery vs. simply taking pills, the pills win out. Then there is the whole issue of selecting a surgeon. But the thought of being free of meds and not having the heart flutters is tempting.

My AFib was cramping my lifestyle and I was advised that I was a good candidate for cryoablation.

My heartbeat was regular most of the time but when it flipped into AFib I felt slightly dizzy and woozy. When hiking up hills I was badly out of breath, and I do lots of hiking. If I got excited or stressed such as watching a soccer match I was really invested in, or if I had more than 1 alcoholic drink then I was likely to go into AFib.

The length of time I was in AFib was also increasing, so for me, choosing ablation was an easy choice. I was told there was a 65% chance of it working first time, but I may need a second ablation. I was also told that it would not be considered a complete success until I was 3 years without it returning.

 

[Alan]

About a year ago, my DW had a cardioversion for AFib. Unfortunately, in November she had 3 attacks after having repeat cardioversion. She finally had a pacemaker implanted and an AV node ablation. That is the last resort of treatment for AFib.The main reason she had it done was to get off Amioderone, which has horrible long term side effects.

She is still on Xarelto, and the incision is still healing. She is relieved that she will not have to worry about another incident.

Scary stuff, but it sounds like it is now under control. My cardio physiologist explained to me the AV node ablation and pacemaker option should things get a lot worse.

 

[Tekward]

Let us know how you get on. I expect he will, among other things, do a CHADS2 evaluation then along with your other health conditions make recommendations.

It was a relatively good outcome. I had very clear AFib a couple of times over the past 2 days (the timing looks to be after the second cup of coffee), but it self corrected and my HR never really elevated.

My CHAD2 score is still zero based on no other complications. I'm <65YO, have good cholesterol, exercise (with Yoga), and eat well (lots of nuts - 20% reduction in stroke risk from studies). This morning they measured a HR of 52 and BP of 120/80.

She feels comfortable (I agree) waiting for the full month of monitoring data. We discussed blood thinners (now on aspirin) and rhythm fixes. So like everyone here, I'm mortal with limited days ahead. I'll try to make the most of them.

 

[Leroy Jones]

My decision was completely voluntary. A friend of mine told, me after my ablation, that he had AFIB also and was on the same medication. One day it stopped working and he went into AFIB and to the hospital. Took a while to get something to work to get it back under control. Hopefully things will stay under control. My initial problem was I wasn't aware of the AFIB and only found it a a physical with an EKG. Now I'm more aware of the symptoms so I know what to watch out for.
Leroy Jones

 

[Alan]

It was a relatively good outcome. I had very clear AFib a couple of times over the past 2 days (the timing looks to be after the second cup of coffee), but it self corrected and my HR never really elevated.

My CHAD2 score is still zero based on no other complications. I'm <65YO, have good cholesterol, exercise (with Yoga), and eat well (lots of nuts - 20% reduction in stroke risk from studies). This morning they measured a HR of 52 and BP of 120/80.

She feels comfortable (I agree) waiting for the full month of monitoring data. We discussed blood thinners (now on aspirin) and rhythm fixes. So like everyone here, I'm mortal with limited days ahead. I'll try to make the most of them.

That sounds remarkably like me, including the exercise and yoga.

For 3 months or more I had no caffeinated drinks and no alcohol but it made no difference.

 

[firemediceric]

I'd like to ask you guys if the decision to have ablation surgery was a medical necessity or did you do it because you were sick and tired of taking pills and having a less than ideal heartbeat?

My AFIB is being controlled by Sotalol and I'm taking Xarelto for stroke prevention. I have an ectopic heart rhythm (faint, premature heartbeat) that is bothersome. I'm told I'm not in any danger but I don't like the palpitations I get from it.

So far, I'm OK with taking the meds because when I weigh the risk of the surgery vs. simply taking pills, the pills win out. Then there is the whole issue of selecting a surgeon. But the thought of being free of meds and not having the heart flutters is tempting.

I hated the idea of taking medications if I can in any way safely avoid such. At the time I was 48 y.o and in otherwise excellent shape with only episodes of paroxysmal A-fib. The cardiologist through consultation recommended strongly that ablation was the best course of treatment for me. Although it was tough to find a Worker's Compensation electrophysiologist to do the ablation, after months of negotiations one was found. An overnight in the hospital and I've been fine since. Just an 81 mg aspirin before bedtime but otherwise no medications.

I certainly am completely thrilled that I had the ablation done and that it was such a success for me.

Interesting note is that the doctors speculate what led to my A-fib was a lifetime of pushing myself through exercise and perhaps overtraining my heart. They said the atrium was stretched and that led to a type of short circuit situation with my conduction system.

 

[Tekward]

That sounds remarkably like me, including the exercise and yoga.

For 3 months or more I had no caffeinated drinks and no alcohol but it made no difference.

I've been wrestling with eliminating caffeine & alcohol, but between your comment & my rationalization my goal will be moderation.

Honestly, I asked the doctor and she did not recommend abstaining.

 

[Qs Laptop]

I've been wrestling with eliminating caffeine & alcohol, but between your comment & my rationalization my goal will be moderation.

Honestly, I asked the doctor and she did not recommend abstaining.

When I got Afib they went through the list of possible causes--coronary heart disease, heart defects, high blood pressure, sleep apnea, COPD, and binge drinking. (I might have missed listing a couple other causes.) They could medically rule out everything except binge drinking. So that was the stated reason why I got Afib. However, I drank on weekends only, and it was usually 3 to 4 beers on Friday and Saturday nights and on Sunday afternoons. Twelve pack purchased on Friday, gone by Sunday night. Been doing that for 30 years.

I haven't had a beer since that day in 2015 they told me they suspected alcohol was the culprit.

My cardiologist says I can have a beer or two or a glass of wine now and again, but no way will I touch it. That wretched feeling of exhaustion and shortness of breath with Afib has turned me against alcohol entirely.

 

[bmcgonig]

It was a relatively good outcome. I had very clear AFib a couple of times over the past 2 days (the timing looks to be after the second cup of coffee), but it self corrected and my HR never really elevated.

My CHAD2 score is still zero based on no other complications. I'm <65YO, have good cholesterol, exercise (with Yoga), and eat well (lots of nuts - 20% reduction in stroke risk from studies). This morning they measured a HR of 52 and BP of 120/80.

She feels comfortable (I agree) waiting for the full month of monitoring data. We discussed blood thinners (now on aspirin) and rhythm fixes. So like everyone here, I'm mortal with limited days ahead. I'll try to make the most of them.

AFib stroke has a different cause than other strokes as it's caused by the blood pooling in the left atrium when the heart is in AFib and possibly forming a clot.

The best advice I've heard is to find yourself a good cardiologist or even better an electrophysiologist. The cardiologist is the plumber and the electrophysiologist is the electrician. You have electrical issues.

Also there's a website called afibbers.org that I think is invaluable as it has a bunch of very astute and experienced contributors, with good advice on how to find a good EP for ablation if you so choose.

Welcome to the club [emoji16]

 

[Tekward]

As my learning continues (53% increased risk):


"“Previous studies have highlighted that nonsteroidal anti-inflammatory drugs (NSAIDs) are associated with increased risk of atrial fibrillation (AF), the world’s commonest heart rhythm disorder, which in turn increases the risk of ischaemic stroke. In fact, in 2014, Liu and colleagues published a meta-analysis of existing studies, showing a 53% increased risk of AF with NSAIDs."


https://www.ncbi.nlm.nih.gov/pubmed/25260945

 

[Tekward]

Also there's a website called afibbers.org that I think is invaluable as it has a bunch of very astute and experienced contributors, with good advice on how to find a good EP for ablation if you so choose.

Welcome to the club [emoji16]

Thanks for that great website! It also referred me to a Doctor who I been watching - Dr. Gupta. But this video was new to me & very interesting.

Why I don't believe that AFib causes strokes

I teach statistics and I have said countless times, "Correlation is NOT Causation."

 

[Alan]

Thanks for the link to the video. Dr Gupta practices at York, an hour down the road from us. What he says is in line with the advice and treatment I received from the electrophysiologists at James Cook University hospital which is close to where I live and is a regional heart centre.

I was not put on blood thinners when I had Afib at age 60 because my Chads2 score was 0 . (as he says in the video the Chads2 assessment does not consider AFib). I was only put on thinners 6 weeks before ablation and 3 months afterwards at age 63 because of the actual ablationprocedure.

My EP said that my Chads2 score will go to 1 when I achieve age 65 (last week!) but will not change just because I have had AFib in the past.

 

[Qs Laptop]

I hated the idea of taking medications if I can in any way safely avoid such. At the time I was 48 y.o and in otherwise excellent shape with only episodes of paroxysmal A-fib. The cardiologist through consultation recommended strongly that ablation was the best course of treatment for me. Although it was tough to find a Worker's Compensation electrophysiologist to do the ablation, after months of negotiations one was found. An overnight in the hospital and I've been fine since. Just an 81 mg aspirin before bedtime but otherwise no medications.

I certainly am completely thrilled that I had the ablation done and that it was such a success for me.

Interesting note is that the doctors speculate what led to my A-fib was a lifetime of pushing myself through exercise and perhaps overtraining my heart. They said the atrium was stretched and that led to a type of short circuit situation with my conduction system.

[I know this is an old thread but it is fairly specialized and therefore I didn't want to start a new thread.]

I consulted with an electrophysiologist today. Many things were discussed including the ablation option.

He did say the jumbled up electrical signals inside the heart that cause afib can be caused by heart tissue that has been scarred by strenuous athletic activity over the years. It is kind of sadly ironic that vigorous athletic activity can lead to a heart condition like afib.

In February I wore a Zio heart monitor for two weeks. It showed I was in afib for 18% of the time (about 59 hours), however afib occurred primarily in a stretch of 6 days and mostly on 2 days within that stretch. For example, on those 2 days I was in afib for over 6 hours each day. For 7 consecutive days there was absolutely no afib.

I'm leaning toward having the ablation procedure. I don't like treating symptoms if I can (hopefully) eliminate the problem altogether. Thinking of not being a daily slave to Sotalol and Xarelto sounds liberating to me. The thing is, my cardiologist is advocating the medicine route and the electrophysiologist is touting the ablation procedure. The EP says I'm an ideal candidate, since I am paroxysmal afib and relatively young (63). He says the afib burden, or percent of time I'm in afib, will only increase from 18% as I get older. The cardiologist makes it sound like ablation is a somewhat risky procedure and the EP makes it sound routine.

I ask again, for those that got the ablation procedure, what was the turning point that clinched the decision for you?

 

[Souschef]

About a year ago, my DW had a cardioversion for AFib. Unfortunately, in November she had 3 attacks after having repeat cardioversion. She finally had a pacemaker implanted and an AV node ablation. That is the last resort of treatment for AFib.The main reason she had it done was to get off Amioderone, which has horrible long term side effects.

She is still on Xarelto, and the incision is still healing. She is relieved that she will not have to worry about another incident.

Update over a year later. She is doing fine with the pacemaker, and has a heart monitor by her bedside table, but not alerts, thank goodness.
I hope to have many more happy years with her.

 

[Keim]

The tipping point for me going the ablation route: I had undesirable medicinal side effects from some, and others lost their efficacy.

Ablation is fairly low risk and has about an 85% success rate. Given my young age at the time i was an excellent candidate. Unfortunately for me it also has a 15% failure rate ..

 

[Alan]

I monitored my instances of AFib on a spreadsheet. I always knew when I was in AFib as I felt a little dizzy and when it happened while hiking then I badly got out of breath going up steep inclines. The frequency and length of time I was in AFib increased over the 3.5 years before I had ablation surgery. My first instance was 6 weeks after age 60. I couldn’t drink more than a single unit of alcohol (one small glass of wine), or eat a very heavy meal and I stopped watching live football games that I was emotionally involved in because alcohol or stress was certain to trigger AFib episodes.

The EP was confident that I was an excellent candidate. Both he and my cardiologist in Houston, before I had returned to the UK, told me that I would be amazed how many athletes they had on their lists with AFib.

In my case the surgery was easy and I haven’t had a single instance of AFib that I am aware of in almost 3 years since the surgery. I check every day when I do my BP, and wear an Apple Watch that monitors for AFib. I can now enjoy a couple of pints, watch stressful football matches, and never worry about running out of breath when hiking. For me ablation has been wonderful.

 

[Car-Guy]

I've been on 50mg of Toprol for 15+ years now for my AFIB... Mine was getting bad enough that I could feel it happening multiple times a day and particularly when at rest.

My mail order drug insurance paid for the band name (Toprol XL) until a few years ago and said I needed to start using a generic (a lot cheaper). I tried a generic and the AFIB return in just a few days so I went back on the brand name... Now they refuse to pay for the brand name because I didn't stay on the generic long enough. My doctor has even documented the generic doesn't work for me... Seems like the drug company is practicing medicine to me. Now they won't even sell me the brand name "even" if I pay 100% of the cost. So I end up paying full price at a local pharmacy instead.


Oh, and the Toprol has done a good job controlling my BP too...

 

[Walt34]

...My doctor has even documented the generic doesn't work for me... Seems like the drug company is practicing medicine to me. Now they won't even sell me the brand name "even" if I pay 100% of the cost. So I end up paying full price at a local pharmacy instead.

Contacting the state insurance regulators where you live may help. Can't hurt. If that doesn't work perhaps a chat with an attorney is in order - it does no harm to find out what your options are and a nastygram on legal letterhead may get the attention of someone who has some sense. Sounds like it would be worth the expense/hassle to do at least that.

Back on topic, I had to "fail" two drug tries before Medicare would pay for the cardiac ablation. It worked first try and I've had one episode of afib since then. The ER doc said I was low on potassium and an every-other-day dose of over the counter potassium has fixed the problem.

OTOH, a longtime family friend has has seven cardiac ablations and none of them worked. However she is what the doctors call a "lousy patient" because she does not follow directions well or at all so I'd be hesitant to blame the docs or the procedure.