Failed cardioversion

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Had Cardioversion 9 days ago - today AFIB returned !

Any comments from those of you who have had similar experiences would be great . Is it worth trying again or should I head for ablation ??

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  • Posted

    Hi Deirdre,

    Was admitted with heart failure back in Dec.2014. Daignosiis was a tachycardia(rapid heartbeat) induced cardiomyopathy(severely enlarged left ventricle) with an ejection fraction of only 25%. I was also in atrial fibrillation; probably for some, which caused my left ventricle to become enlarged. I just thought I had a nasty virus or similar and just kept 'soldiering on', and after a couple of weeks ended up in the cardiac unit.

    Anyway, first cardioversion lasted two or three days, was then put on amioderone(an potentially very nasty, but also very effective antiarrithmia) and cardioverted again three wekks later (once amioderone levels had built up sufficiently).

    Second cardioversion worked well; after a month of being in sinus rhythm my left ventricle shrunk back down to almost normal size and i had an EF of 54%(and currently it is 63% -so very happy!). The Amioderone 'dug me out of the hole'  that i was in at the time, but it is not a long term option for staying in rhythm (it can have several fatal side efects, and takes a long time to get out of your system!).

    so stopped taking it after six months. Once the amioderone wore off (about five months after I stopped taking it) I went back into AF ( so 2nd cardioversion lasted 11 months) and was cardioverted for the third time.

    The third time lasted a month, then the fourth last two weeks, and the fifth lasted weeks!

    Decided to have the ablation in April this year(and so far, so good), as AF was getting too regular to live with (could live with being cardioverted once or twice a year).

    Once i had decided on an ablation, my cardiologist refered me to an electrophisiologist of MY choosing (did a lot of 'homework' to find out who was the inn town as the expertise of the Dr. doing the ablation procedure has a big influence on the success rates (and you want the best possible chance of an AF free future right?).

    My electrophysiologist is interntionally recognised in the AF field ( and has some some very enlightening online interviews discussing AF management that i can diect you to if you like?). He claims to have an 85% succes rate at the five year mark PROVIDED (and he repeated this word), provided you address all you risk factors (which for me was severe sleep apnoea, excessive alcohol consumption(not that I thought my alcohol consumtion was excessive-but apparently it was by AF standards!) and and excess weight ( which puts extra strain your heart).

    So i now have a CPAP machine for my sleep apnoea, drink no more than 3 standrd drinks per week, and have dropped 17kgs.

    I suspect that all this just buys me more time before AF returns, but after googling this topic to death and reading numerours research articles on AF, I firmly believe that my future AF status lies largely in my own hands. Currernt research now suggests that AF is more of a lifestyle 'symptom' rather than disease in it's own right.

    In most cases, the AF patient can have a significant inpact, on their AF status.

    Apologies for the long response,

    Hope that helps?



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    • Posted

      Wow ! Simon THANKS ! Your answer really got my attention .

      I need better evaluation than I am presently getting and have been thinking of going to Mayo Clinic even though I live in Pirtland ,Or .

      You are so right that the answer is in our hands - we have to fight to get proper diagnosis and treatment .

      Again - thank you and good health, sincerely, Didi

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    • Posted

      Hi again Deirdre, yes does really help if you have relatives, friends and even 'friends of friends' who work in the medical profession and can advise you on who the best people in the field are. I am fortunate enough to have two sisters who are nurses, a bother who is an acident & emergency  specialist (think it's know as the'ER" in the states), a sister-in-law who's a pharmacologist and a friends sister who's a cardiologist.

      So all those opinions, in combination with myy original cardiologist's opinion guiged me to choose the electrophysiologist that i'm seeing.I also did a lot of online Googling of his name(a bit 'stalker like' i know, but given what these guys are going to be doing to you, I reckon it justified lol wink.

      Good luck with it all, whatever you decide.

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    • Posted

      Yes indeed you are lucky to have all those in your family to advise you !

      I feel so alone at times and just feel the best I can do is trust my gut feeling and seek out best no matter where .

      My Electrophisiolgist leaves a lot to be desired in the communication area! This AFIB requires great communication and trust in your doc - I hope you have that -- I don't ! 

      Thanks for great reply, Didi

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    • Posted

      Hi Simon, would you be able to direct me to the online interviews you mention? My husband has just been diagnosed and I'm wanting to read as much as I can. 



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  • Posted

    Yes, a lot of people have cardioversion and ultimately go back into Afib -- BUT please know that ablation is also not 100% effetive.  They give you a 70-80% success rate -- well I had mine back in March at a well respected hospital -- and it has failed!  I now have a pacemaker and I'm praying one of the meds will work -- otherwise they are telling me I should consider a second abation.  So please know that just because you have ablation, it doesn't necessarily work the first time, sometimes it does -- and then doesn't after a period of time.  The whole thing is a crapshoot!!

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    • Posted

      Great comments! I just had a second Cardioversion followed by Tikosyn treatment . 

      Sometimes many cardioversions are necessary to achieve positive results .

      Ablations require more than one try also most times to achieve results . 

      Some don't respond to either - so truely it is a crap shoot .

      Best to shoot crap in hands of top notch Electrophisiolgist though !!

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    • Posted

      Yep, I think ablations help to buy you a bit more time. But how much time they buy you can often depend on how well you address your risk factors, and how good the ablation was in the first place.
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