Pacemaker and afib

I had a pacemaker installed in May 2020.  Felt so good. Still was going in and out of afib for a day or two but not feeling bad.  Recently I have been in afib for over 3 weeks and feel lousy. . .tired, shortness of breath.  Had an echocardiogram Monday to see if things have changed since the last one a year ago.  EP is suggesting a cardio version to get me out of afib.  So discouraged after feeling so great since I got the pacemaker--a Biotronic.


4 Comments

At this stage, take every opportunity to get *out* of AFib

by crustyg - 2020-10-21 11:39:26

Eventually AFib will become established and then you're stuck with it.

If your EP doc is offering a cardioversion to get you out of AFib, then I strongly urge you to take it.  It's no guarantee of long-term sucess but if you can get back into sinus rhythm then do so.  There is *some* evidence that PM adjustment may help you stay out of AFib.

There are some contributors here who've had several cardioversions, with mixed results.  But most don't regret the attempt (except for one or two *very* unlucky ones who were fully conscious during the procedure - but you are meant to be asleep, albeit briefly).

Go for it!

AF is becoming a real pest

by Gemita - 2020-10-21 13:07:35

Heyjude,

The earlier you get out of AF as crustyg says, the better before it takes hold and starts scarring the heart, making further episodes more likely.  I had a cardioversion (3 in fact in close succession) but regrettably it didn't work for me until they gave me IV Flecainide.  It can work extremely well for some however and I would take anything on offer until they can find a better way to stop your episodes.  Have you had an ablation?  

Medication for AF like anti arrhythmics, beta blockers and calcium channel blockers all have a role to play in giving a level of control but at best I was told meds are only about 35% effective controlling AF whereas an ablation on first attempt could be as high as 70-75% successful and even higher, up to 85% successful on second attempt.  Some folks have a successful ablation on first attempt, so worth discussing with your EP your treatment options if AF becomes more troublesome.

AF has had a very detrimental effect on my well being.  I am on lifelong anticoagulation as a result and also on rate control medication which slows me down, causing brain fog, weight gain and other disturbances.  There is a high price to pay for this irregular rhythm disturbance in terms of quality of life and health costs, not to mention the risks of staying in AF permanently with all its potential health fears of developing blood clots or  heart failure.  AF is also linked to dementia, so everything we can do to nip it in the bud at the outset will be to our advantage.

Good luck 

Atrial fibrillation and pacing

by Selwyn - 2020-10-21 14:27:43

In general, a pacemaker will not stop atrial fibrillation  ( unless special circumstances), so you should not make that association. 

Cardioversion stands a reasonable chance of stopping atrial fibrillation. Worth the try if you are otherwise fit. Once you get rid of AF your ability to exercise is improved, palpitations go, you have more energy.

I have had an electrical  cardioversion ( did not work, and mild burns to the back from the pads). You can have a chemical cardioversion. 

AF is not without its health complications. I ended up with two ablations for AF ( having previously had a flutter ablation) and whilst I still get a bit of AF my quality of life with regard to exercise and not having palpitations has improved. 

Nothing ventured, nothing gained!

Best of luck .

Cardioversion

by AgentX86 - 2020-10-21 20:32:35

I've had a bunch of cardioversions, both DCCV (electrical) and chemical (ameoderone).  I'm one that Crusty was talking about who's had it all.  It's such a simple procedure that some have had a dozen or more. You're out for a minute or so.  The only way I knew it was over was there were minor burns on my chest and back.  They felt like a mild sunburn (itching mostly) and are in the shape of the pads.  Cardioversoins are no big deal at all (unless you're conscious - don't recommend that at all).

After the first, I went seven years without another Afib episode.  Then two weeks, then not long enough to get back to my room (I was hospitalized at the time).  I had a few more after ablations because the procedure didn't stop the arrhythmia immediately (not at all, really).

The bottom line is that, while not often a permanent solution, cardioversion is such a simple and safe procedure that it's worth a try.

If you go for an ablation, make sure you go with one of the best in the country, who does pretty much nothing other than ablations.  You should be looking for someone who does hundreds a year and has done thousands.  It really matters.

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