Failed Electric Cardioversion now Flecainide Before Another Attempt? Need advice.

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Hi,

First time in this group and appreciate you being here. I've had 4 or 5 episodes of Afib since my 40's. Now age 71. Each time I was electro controverted successfully, except this time.  Doc tried twice and said both times my heart converted but right away slipped back into Afib. He said he used max current and I can believe it based on how sore my chest feels!

He offered three approaches. 1) Ablation; 2)stay as I am now which is on Diltiazem for rate control; 3) Take Flecainde 50mg 2x/day for a week and then come back and try electrical cardioversion again.

I am not ready at this point to consider ablation given my history of successful electrical cardioversions although I realize they tend to work less with time. 

1. Does a week of Flecainde and another electrical cardioversion make sense?

2. Do you think it would make any difference if I waited more than a week given the holidays and frankly I'm a bit worn out over this whole thing and could use some time off?

2. Doc said if I convert next time he wants me to stay on Flecainde. Does this make sense or in the event the cardioversion works should I go off the Flecainde in a month or so and see if things hold? (this would be my choice)

3. Any other suggestions.

Thanks for any help here.

Jim

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  • Posted

    I personally would not want multiple cardio versions. I am older than you by several years and have had to ablation surgery, the first one did not work but the second one nine months later appears to have been successful and I’ve been in remission for my a fib for a year. I was also able to get off all the terrible medications that I was taking and I’m now only on Eliquis.  The worst thing about the ablation was the stress leading up to it. I would seriously consider it if I were you. Good luck. 
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    • Posted

      Hi Suzanne,

      I am happy that your ablation surgery worked out so well! Is there a reason you still are on Eliquis as I've read that thinners aren't always necessary after a successful ablation.

      I'm certainly not against ablation, and it may indeed be in the cards, I just figured that cardioversion has worked so well for me for the past 30 years -- each time holding for around 7 years -- that maybe it deserves at least another attempt.

      Jim

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  • Posted

    Dear Jim,

    I had afib quite a lot in past 6 weeks and doctor did a Cardiac Ablation on me 4 weeks ago said to check on me in 3 months but 2 weeks ago I had a bad episode and went to ER and ER doctor said my heart was stopping in between beats I'm also 71 so they put a pacemaker in last week and 100% improvement! Hope this helps your decision! Good luck!

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    • Posted

      Hi BJ,

      Glad the pacemaker fixed things. Did they ablate your AV node? I've read that often results in a pace maker later on.

      Jim

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    • Posted

      Dear Jim, they did ablate but it wasn't enough! My doctor said usually it works but in my case it didn't.

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  • Posted

    Hi Jim I've been on flecainide for over 2 years on the same dose. I have no side effects. I would also try the FODMAP diet. It might help especially around this time. Flecainide takes a few weeks to really start to work to its full capacity. I've had 2 Ablations and I've had many cardioversions probably 10 or so in the past 2.5 years. And they always work first go. I won't go for another ablation as I can control my A Fib the best with the FODMAP diet.

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    • Posted

      Hi Sandi,

      I'm glad the Flecainide agrees with you. I'm assuming you're taking it because the ablation didn't work? I will look into the FODMAP diet. Not sure if it's related, but lately I've switched to a very low fat, high carb, vegetable based diet to get my cholesterol down. Well, my cholesterol did come down, but now this!

      Jim

      Jim

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  • Posted

    Hi Jim,  I had my first conversion in Dec 2015 it lasted 10 days.  I was put on Flecainide for ten days before my second conversion.  The second one took 4 attempts over 8 hours and I was given additional medication ( which to this day I don’t remeber what it was not the EP had to be present while 2 nurses one counting off seconds and the other injecting it into my IV over a minute or so.).  Once it was in they knocked me out again and I converted. That was January 2016.  My Ep had stated before starting those second attempts I had an ablation in my future, I have been in NSR since.  I took the Flecainide till April of this year I started getting side effects but so far I’m still in Rhythm. Since that second conversion I have started taking more magnesium and did a sleep study and found I had sleep apnea and have been on CPAP since August 2016.  So go me the Flecainide was worth it and worked but I think getting my sleep apnea treated was probably the single most important thing. Good luck Jim. 

    Roy

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    • Posted

      Hi Roy,

      Glad it is working out so far and glad you found that sleep apnea was a trigger so you could treat it. In my case, the afib trigger had always been a very cold drink like a soda, but this time I didn't drink anything cold, so I'm guessing maybe it was because I had more than my normal amount of coffee that day.

      Not sure I understand how the four attempts in 8 hours worked. Do you mean they pushed the button 4 times or made four attempts with multiple pushes? How many times in the 8 hours did you have to be put asleep?

      Jim

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    • Posted

      Hey Jim,  what happened was they put me to sleep and tried three shots I didn’t convert. My EP then gave me the choice of waiting another 6 hours get the additional med and try one more time.  He said three attempts is max unless you wait a minimum of 6 hours.  My other choice was to be admitted for three days and started on amoricore. I did Not want that! So it was 4 shocks in total. 

      Roy

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    • Posted

      Got it. Thanks. I wish my guys had the patience/perseverance. I was just given the choice to go home and try again in a week. Were you an inpatient or outpatient. Mine was being done as an outpatient so maybe they just had to move me out. Wondering if the drug they gave you was Flecanide. When you said you didn't convert, does that mean you never converted or that you converted and went right back into afib. In my case, I converted both times but slipped into afib fairly quickly. I'm guessing that's why they didn't do the third shock.

      Jim

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    • Posted

      Hey Jim. I was started on Flecainide 10 days before i went for my second conversion.  I was an outpatient and it was my understanding that the first three shocks I never convert to NSR in any of them. All I know is I ended up with 4 different red pad marks from the first three shocks and then the final one. Have to say my chest did kinda hurt as in bad sunburn for a couple of days.  As Sandiishealth stated it was probably Adenosine that I was given intravenously just before the last conversion attempt.  All I know is that they injected the med and put me to sleep as fast as possible and convert me. I woke in NSR and fortunately still am. 

      Roy

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    • Posted

      Hi guys, my doctor gave a choice for electrical shock or ablation and I choose ablation which didn't work!

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    • Posted

      After reading your story I just wish my guys didn't give up so easily! I just sent  you a private message.

      Jim

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    • Posted

      Sometimes you have to have more than one ablation to work. My first one didn’t t but the second one 9 months later done last December appears to have been successful and I’ve been in remission ever since 
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