Waiting for cardioversion

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Went to see the (very pleasant) Cardiac Nurse at the hospital for the first time on Monday and after some tests was advised that I would be a suitable candidate for cardioversion. I asked for 24 hours to think about it (also to allow me to discuss it with my wife).

After reading the pamphlets I was given by the hospital, consulting Dr Google and watching some YouTube videos of the procedure, I rang the hospital this morning to say I'd go ahead with it. I just need 3 straight weeks of good INR results now. This week's was 2.0 and that just crept in to the 2.0 to 3.0 they're looking for so hopefully the dose I'm on now (6mg) is the right one for me.

Feeling a bit nervous about it if I'm honest but watching the videos on YouTube actually helped reassure me. Although I don't suppose there would be any negative outcome videos posted as most are shot by medical staff biggrin

Looks like 3 straight weeks of good INR results would get me in for the procedure the following week so not too long to wait and find out if it's going to work. I appreciate a positive outcome may not last for ever but it's got to be worth a go.

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  • Posted

    It is a very safe and straight forward procedure and very often now done by nurses. My last one was done by a Matron and a Sister. The sedation put me out like a light and more importantly back in sinus rhythm. The previous one I had done by a doctor left a mark like an iron on my chest and it was like a painful burn for several days.

    They seem very concerned about whether you remember anything about the procedure as if they are unsure how much sedation to give you. First time I went home feeling quite normal. Last time I felt dopey and could not walk in a straight line and my wife wheeled me down to the entrace.  In the afternoon I decided to lie down for a couple of hours before dinner. I slept until 11.45 pm. It was over 48 hours before I felt that my faculties were fully back.

    My INR had gone over 3.5  and the practice nurse was not sure if they would do it. I phoned to inquire and they said they didn't care if it was well over 3.

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  • Posted

    Hi I've had numerous dc cardioversions and each time success, unfortunately it is not working for long enough so have to live with the AF!  I have rheumatic heart disease and and mechanical  mitral valve, so have a few underlying problems, I don't feel great in AF hence the cardioversions, sounds like the best solution for you though!  Good luck I'm sure it will be a sucess 
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  • Posted

    Thanks for the good wishes. 2nd of 3 INR results just in (2.0) which is just inside the required parameters. My GP has increased the warfarin dose from 6 to 6.5mg in the hope of hitting the target INR of 2.5 (I was 3.1 on 7mg). The hospital have also asked the GP to stop my digoxin and replace it with 25mg of Atenolol.
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  • Posted

    Good luck Stuart, had this done a "couple" of times now in A&E dont enjoy it but so far soo good. For me it has lasted a long time (months) each time. Hope it is as easy for you and i hope the effects are at least long lasting! My Wife was with me on both occaisions before and after the only bit they didnt let her be with me for was the actual but was with me as i was being knocked out a couple of times, once my body didnt want to go under so they took me away then... however so far so good! 
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  • Posted

    I have to go in 3   Weeks, and at the moment am messing myself,  is it dangerous ,

    and how long does it take.   No nothing about it

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    • Posted

      Hi Charles, I can only speak for the times they have done this to me in A&E... it took about 10ish minutes From administering knock out injection to coming round, may have been 20 mins but not more i dont think. My wife was there but not at the actual cardioversion, she seemed ok so... not too long i dont think. i have no memory of the actual cardioversion and felt ok afterwards, relieved that the heart was doing the right thing again... phone british heart foundation or see your gp  for more discussion i found both for me equally helpfull in unrelated things but still heart matters...
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    • Posted

      I have had about 10 cardioversions and they are very safe.The science behind it is like taking the battery out of your phone to reset it, they shock your heart,and it goes back to memory which is normal rythm.The trick is keeping it there. I have lived with chronic(fulltime afib for 25 years) and find it easier to deal with rate control than rythm control. I take an aspirin a day and eat properly and am just as fit as 95% of people my age (53)
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    • Posted

      Have they never wanted you on Warfarin? When you go back into AF how long do you normally have to wait for your cardioversion?
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    • Posted

      I have been on aspirin for 25 years ,when I first went into afib they did put me on warafin   for a little bit,but then my new cardiologist said aspirin until I'm 50 and now he says 70.if you go into afib they usually want to car divert you within 48 hours to avoid having to do a TEE on you
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    • Posted

      You must have a better hospital than I have. I went to see out of hours doctor at hospital within three hours of going into AF. He agreed AF from my pulse but said that I would be better going to my GP the next day for an ECG rather that sit till midnight in A&E to have one.

      I had ECG at GP's surgery the next day and saw a locum GP who said that she would refer me back to my cardiologist but that her letter would take two weeks to reach him.

      I phoned the cardiology secretary and had a future appointment brought forward and was seen two days later. I had another ECG and told that I would need to be on Warfarin for eight weeks before having a cardioversion. At my next cardiology appointment about six week later I found that I had not been put on the list for cardioversion and then had another nine weeks to wait.

      TEE? Are you in America? I think in the UK it is known as TOE and I think seldom routinely done prior to cardioversion. The only time I had one was when initially going into AF when in hospital after my aortic valve replacement

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    • Posted

      Hi

      I thought it was quite a safe procedure but the risks detailed in the medical waiver I had to sign (also clearly outlined by the cardiac nurse) stated a 100 to 1 risk of stroke, heart attack or death! I thought they were pretty poor odds and were probably responsible for my BP being a bit high when I was on the table and about to be put under!

      I'm sure the cardiac nurse would have given me this information when I went in for my initial review but it obviously only sunk in when I was signing on the dotted line!

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    • Posted

      when i had it done my wife and i decided 1% doing this or a lot worserer odds of the same thing without treatment... not sure but we both had most things crossed when it was done... as i have had a few done now i guess the odds are shortening, though i always work on 50 50 odds either it will work or it wont... so far so good....!!! Yeah i know really each time it is 1 in a  100 but ...
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    • Posted

      Cardioversion evidently increases the risk of a blood clot during after the procedure. Presumably that is why they want your INR over 3.0.

      Poor odds? They told me that the odds of not surviving my heart valve replacement were 12%. The alternative was death in about a year si I thought the odds were good. We were looking out over Brighton racecourse as he said it. 

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    • Posted

      Yes I am in the US. It is my experience that after the abalation you are on anti-arrhythmic and blood thinners for the 1st 6 months. If you starting going in and out of a-fib they want to do a cardioversion within 48 hours so they don't have to do a TEE to check for clots anf to get you back in NSR as soon as possible. The problem with being in chronic AFIB for 25 years in my case is the heart muscle has memorized the AFIB pattern and thats what it wants to stay in.  I am pretty asymptomatic so it was a royal pain in the butt being on warafin(rat poisoin)and flecanide (tons of side effects) and worrying about getting to the hospital in 48 hours if I went back into AFIB. After my second abalation I was in NSR for almost 2 months but really didn't notice any difference in cardiac out put because of the meds I was on. I am now on rate control (verapamil- combo blood pressure and rate control) and aspirin and don't worry about how many greens I eat like I did with warafin.Many studies have shown the same mortality rate and less hospital visits in rate control over rhythm control if you can handle being in AFIB. My father is 86 and has been in AFIB for 20 years and was very touch and go a few times with congestive heart failure. He totally gave up sugar,and anything white and is doing great. Good luck and just know that AFIB is just another hurdle we face in our lives and can be managed without tons of drugs
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    • Posted

      We can always tell our American friends on this Forum by the different terminology they use and the better care they get:-) Will Obamacare change that??

      I knew of the 48 window to get cardioversion without being on Warfarin but the system here just does not cope unless it is life threatening. There are waiting lists for cardioversion and you can't sneak into the queue.

      The difference between you and us.... I was diagnosed with severe aortic stenosis in March 2011 and had my surgery at the end of May 2012. My friend in Baltimore had the same diagnosis recently and was operated on three weeks later.  

      I don't use sugar nor eat white bread. What other whites can I give up?

      Verapamil seems to be rather out of favour here nowadays. When I moved to this area some years ago and told my new GP that I was taking Verapamil and Losartan he commented that it is not prescribed much any more. 

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    • Posted

      Derek,

      Anything pre packaged,chips,pasta,crackers, ect ect I would guess 99% of bread contains sugar,carbs,and refined flour of some sort. It  is a life stlye choice but it has changed my fathers life dramatically and I embraced it 2 months ago.My major issue with AFIB is when I would get a cold / sinus infection I would end up on antibiotics since I can't take anything with a decongestant .I ended up taking way to many antibitoics an average of 6-8 courses over a year. I discovered Master Tonic 18 months ago when I was sick and started making it and have been antibiotic free. Google master tonic the dynamic turnaround it is one of the best things I ever found. Last note on Obama care,luckily my wife is a retired teacher with an unreal health and dental insurance plan so obama care is not in our future. 

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