A success story, perhaps.

Hi Derek

I think it is a matter of seeing how you feel and react to different methods. My heartbeat needs to be slowed generally, so maybe it wouldn't matter so much when I took the doses, although I do take the Flecainide (anti-arrhythmic) twice during the day.

I can see your reasoning for not taking Bisoprolol at night, but again, it is a matter of weighing the symptoms and how you feel. Personally, I used to take 1.25 Bisoprolol in the mornings and was fine, but whilst in hospital, the dose was upped to 7.5. I felt so tired during the day, as if my limbs were weighted. I didn't want to go anywhere and had no interest in anything much. So for me, taking the dose at a time when there was no demand for me to walk or work, was the better option. I now feel more or less normal during the daytime and am even doing some gardening this afternoon - impossible only last week.

Perhaps you don't really need both drugs. After my cardioversion I queried with the Matron who had done the procedure the need for a beta blocker as well as Amiodarone. She checked with doctor who said to stop the beta blocker.

Soon my heart rate was varying between 34 and 44bpm so I stopped the Amiodarone (the worlds worst drug) Will see how they react to that when I have an ECG and consultation in four weeks.

I am indeed hoping to dispense with most if not all of the drugs after the AV node ablation, if it is successful in stopping the electrical activity (mostly AFib) from transmitting to the lower heart. I will then be completely reliant on the pacemaker but not needing the drug regime. I have heard that some patients still need some drugs, so fingers crossed. I am having this done on 24th of this month and am feeling nervous as to the outcome...

If the reason to take medication is to control the Tachycadia and the ablation is intended to stop that from happening I don't understand why one would still need medication. Anyway, very best of luck with the ablation. Come back and tell us how it went.

It may be on this thread or another but I told of a friend who had a pacemaker fitted many years ago. He had a very slow heart rate and kept on falling backwards resulting in a broken arm and twice a fractured skull before they took any notice of him.

Even with the pacemaker they wanted him to take Amiodarone for life. For once in his life he did not follow doctors orders and they did not pus it or prescribe an alternative. In the last 8 years he has had his pacemaker adjusted and at least twice had new batteries.

I am waiting for an Ablation but after reading comments on this forum am becoming more and more concerned about the success rate of the operation. My Cardiologist advised me that the success rate was 95% plus. I am 78 years old and up to September last year was in good physical health but after just one episode of AF have become so concerned I feel like cancelling the operation and to stop taking my medication just to see what would happen. I have been advised that I will have to wait another nine months before the op. so I have plenty of time to consider my options. Comparing my own condition with others I find so much confusing detail particularly about the different medications the GPs prescribe that one wonders if they are all working from the same song sheet. As Josephine 32 says 'on and on it goes' !

Generally speaking having an ablation is a "last resort" ie when all other treatments have not succeeded. Not certain if the procedure has been refined from (using a military comparison) area bombardment to smart bomb able to be directed to a particular window.

I did read that it had but not kept up to date.

As for the 95% success - think this might be similar to cardioversion where it is successful...for a time but then one reverts into AF. I have had 2 cardioversions but some have had up to 7 most have reverted to AF

All cardiologists should follow a set of protocols but they don't. Some pursue their own agendas.

Suggest you question yours about alternatives and

Hello Joiner

I hope I haven't given you cause for worry. Like I said, different results from the same procedure shouldn't put you off giving it a try in hope. My husband is 79 (I am now 71) and he was in permanent AFib for three years with only Warfarin treatment. Six months ago, he decided he had nothing to lose by trying an ablation. This went well and he has been in strong sinus rhythm ever since and is very happy with this. It could fail later back into AFib but we live in hopes it won't. As you say, the majority have a success, which means it is more likely than not that this could be you.

I had a very different story and my AFib just wouldn't respond to anything for long as I had multiple circuits firing off in the atria and they probably couldn't ablate the faulty ones. Two completely different outcomes for the same procedure, so give it a go - age has no effect on ablation and you stand the same chance as a younger person.

Hi joiner

Some reading for you

http://www.cochrane.org/about-us

http://summaries.cochrane.org/CD007101/catheter-ablation-would-be-an-alternative-to-inhibit-recurrence-of-paroxysmal-or-persistent-atrial-fibrillation

billhopefull

My INR went from 2.1 to 3.7 after the first four days on Amiodarone. By the next week it was 3.9. Slight reduction in warfarin dosage over six weeks and it was 3.1 last week. There was blip in week four when it dropped to 2.6.

Doing more research on UK hospital sites and the U.S. Department of Health I came up with much information and guidelines that seems to be not known, ignored or overlooked at my local hospital. My INR has puzzled the practice nurse over recent weeks so obviously she does not know the warfarin/amiodarone connection. I am going to see my GP tomorrow and will check his knowledge on the matter.

Anticoagulants:

** Potentiation of warfarin-type (CYP2C9 and CYP3A4 substrate) anticoagulant response is almost always seen in patients receiving amiodarone and can result in serious or fatal bleeding. Since the concomitant administration of warfarin with amiodarone increases the prothrombin time by 100% after 3 to 4 days, the dose of the anticoagulant should be reduced by one-third to one-half, and prothrombin times should be monitored closely.

Clopidogrel, an inactive thienopyridine prodrug, is metabolized in the liver by CYP3A4 to an active metabolite. A potential interaction between clopidogrel and amiodarone resulting in ineffective inhibition of platelet aggregation has been reported **

Having had ECGs over the past 14 years no one had ever used the expression Sinus Bradycardia until after starting Amiodarone in February. It was always in sinus rhythm or in AF.

The "target range" for my INR is 2.0-3.0 and for the last 12/18 months it has been in that range.

My dosage of warfarin has been 6.5mg for most of that time.

The INR does vary dependant on my diet. With dark green veg. (vitamin K) but everything in moderation.

Cannot remember what happened to my INR when I was on Ami and Dronedarone but nothing requiring urgent/any treatment

Just glad I insisted on stopping ami when I did. My GP encouraged me to insist and happily it was the time that dronedarone was being "trialled" in the UK. so my consultant moved to that until NICE stopped it for those with persistent AF.

Personally my AF was much reduced and I never felt better than when I was on dronedarone. In the US and some countries in Europe it is still prescribed ahead of amiodarone.

Whilst on dronedarone my heart rate remained at 59 for the duration.

Have a feeling you will know more than your GP unless he is the parctice's heart specialist.

When I had prostate problems (BPH) my then GP said that I knew more about it than he did.

Strangely at my present practice none of the GP's list any specialities apart from working as few hours as possible.

Dronedarone is evidently contra indicated for Bradycardia