Question for DUers on atrial fib treatments. Electric Cardioversion and medical cardioversion failed

[peacebird]

For my hubby. Next up is ablation. From what I have read afib control via ablation (cauterizing bad bits of heart) fails in first six months to year for 70% of patients. Those that make it past that have another ten percent fail rate at 2 years and another 10 percent fail at 5 years.
Do you have any experiences with afib that might be helpful with us moving forward. I am curious what sort of other treatments are available besides ablation.
Some may remember we biked from Yorktown, Va to the colorado border last year. Now hubby redlines walking up the driveway. Thanks....

[CaliforniaPeggy]

1. He's really going through it.

From time to time, I have episodes of at. fib. It's mostly controlled with Sotalol, which is a beta blocker/anti-arrhythmic medication. Your husband may have already tried that.

My doc and I have discussed the possibility of ablation, but so far, I don't need it. He also mentioned a pacemaker.

These are the options that I'm aware of. Sorry I can't be more helpful.

Best of luck to you both!

[peacebird]

2. He has tried two drugs to control it... Allergic reaction to first, second didn't work....

We wondered about pacemakers. Will ask his doc on Monday when we see her. Thank you!

[Drahthaardogs]

3. My father had ablation.

IT worked like a charm. He has had no further episodes after the ablation and it has been about six years.


ON edit I think your numbers are wrong. We were told over ninety percent success rate.

[peacebird]

4. That would be my hope! but both in-laws had ablation and it failed for them in under 2 years

I am not sure how much of afib and results to treatment is genetic. But if it is, then hubby is a bit screwed cuz both parents have it.... : (

[Drahthaardogs]

8. I think sometimes it takes a couple of rounds to fix it.

But I am pretty sure the success rates are far better than you propose.

[HappyPlace]

5. I have no helpful advice on this, but I wish you both the best!

Take care, we need you both!

[peacebird]

6. Thank you HappyPlace!

[packman]

7. California Peggy and Peacebird

I have Afib. Doctor caught it when I was in the hospital for a knee operation. I ignored his advice about a pacemaker/defib unit and went home. During rehab for the knee I was panting and sweating, I knew something was wrong. Called the cardiologist and that evening had a unit put in. I has saved my life two times - once I passed out on the bed and it shocked my heart back into a stable rhythm. Second time I passed out at the computer and it again restored normal function. Everyone cases are different, but the pacemaker/defib allows me to walk and not feel fatigued.

California Peggy - I am on 14 meds, and haven't had any problems BUT my cardiologist pulled me off Sotalol because of its interference with the Beta blocker. Highly recommend you read up on it.

[peacebird]

9. I wonder why he recc'd a defrib/pacemaker for you and we have only been told about ablation....

But I am very glad your device has saved you!

So many questions... We will ask about pacemaker on Monday when we meet with his doc...

[Syzygy321]

18. Be careful, Peacebird...

Everyone here means well, but every heart is different. What applies to someone else does not apply to your husband.

For example: a defibrillator does not treat Afib; it treats Vfib.

Factors that influence your cardiologst's decision:

- is your husband symptomatic
-- does his rate go high (rapid ventricular response, or RVR
-- does his rate go low - this is the common reason for a pacemaker
-- is his blood pressure high enough that he can take the usual rate-control medicines
-- is his ejection fraction (strength of heart contraction) normal, low, or way-low
-- is he at significant risk of stroke from embolism, and if so, is he able to safely take anticoagulants
-- doea he have a misshapen heart (for example, dilated atria or bad valves)
-- what other illnesses does he have

You are much better off talking to your cardiologist than asking for advice here. He/she will be able to answer all your questions and explain why one treatment is preferable to another.

In general, treatment options are:
-- meds for rhythm control
-- meds for rate control
-- cardioversion
-- ablation
-- Maze procedure

Pacers alone don't stop Afib.

Best wishes.

[peacebird]

20. Thanks, we have been researching the issue for a couple months and have learned looking at

Patient portals frequently gets us more questions and better ideas of things to discuss with the cardiologist. Cardioversion failed, Meds have failed, his heart is not deformed by afib, but he goes from normal heart rate of about 50 to max redlining under effort. His BP is normal except when in afib is becomes broderline high for treatment. He has no additional stroke factors.
He'll be having ablation soon, this meeting is to set that up. But since the other treatments failed, I just wondered what other DUers experiences with afib has been. In case there were other options we had not found yet.
Sounds like there really aren't. Maybe ablation will work, I hope so. We want to be able to get back on our bicycle and ride together. Perhaps some people with afib can still do that, but not in my hubbys case.

[CaliforniaPeggy]

10. Sotalol works magnificently for me. And it has since I first started taking it.

I have two cardiologists, and they watch me like a hawk. I feel very comfortable with this drug. Remember, everyone responds differently to the drugs.

I know what to look for, believe me. I used to be a critical care RN, and I know what's up. Not to worry.

BTW, Sotalol IS a beta blocker.

[packman]

11. I was on two when first treated

Sotalol (twice a day) and Carvedilol (twice a day also) and the pharmacist questioned why two? Consulted with the doc and he kept me off the carvedilol.

[CaliforniaPeggy]

12. Adjustments are normally needed at first.

I went through some as well.

[Historic NY]

27. My brother had to had a pacemaker/defib unit put in after attempts to

do the ablation didn't work. He has had some medicine issues from confusion to gout but now thing seem stabilized in the last year. He spent a couple weeks in the hospital and in the heart center with various tests etc. The final conclusion was that this was genetic, which answers a lot of question about why some of our close family members suddenly were gone.

[cyberswede]

13. Has his doctor looked into cryoablation?

It uses cold instead of heat.

http://www.massgeneral.org/heartcenter/services/procedure.aspx?id=2232

http://medcom.uiowa.edu/health/irregular-heartbeat-cryoablation-stops-arrhythmias-cold/

I wish you and your husband the best.

[peacebird]

14. No, but I will ask. thank you!

[Bigmack]

15. I had a-fib a couple of times a year for about two years....

... then more often. Then more often yet.

My cardio guy put me on Metoprolol, and I simply could not take it. Felt like hammered dog shit. Then cardizem, but gradually it lost effect.

I was having a-fib about twice a week. It ALWAYS converted by itself in 8-12 hours.

Not to sound like an Important Person, but I'm retired.. and very active... and taking that much time out of a busy, active life for the quality of life I want to keep.

I nagged my cardio doc until he referred me to a doc who did ablations. Worked the first time. That was 3 years ago. Back to the active life. No drugs.

I'd do the ablation "in a heartbeat".

[peacebird]

16. Thank you! Hubby has afib almost constantly now... It definitely is destroying quality of life...

We want him to get where you are, no drugs and back to normal.
We'll be doing the ablation soon, just want more info "in the back pocket" in case it doesn't work for him. Especially since it didn't work for his parents.

[Bigmack]

17. I had a friend that needed 3 ablations... he says it was worth it. nt

[peacebird]

21. : )

Good!

[arikara]

19. My Mr has had eblation twice

to correct his afib. he's had pretty much every cardiac procedure going after surviving 3 heart attacks. The second eblation 6 or 7 yrs ago worked, he also has a pacemaker defibrillator which has never had to do its thing, and last year he had a triple bypass. I'm hoping he gets in on a trial for gene therapy, it has shown such promise.

[peacebird]

22. (Hugs) that track record has to have been hard on you both.... Fingers crossed for gene therapy!

[arikara]

28. Thank you for recognizing that

it really has been a tough go over the past 15 years. But we did... it and he's still over-doing it. The man doesn't understand the concept of pacing himself.

[meaculpa2011]

23. I was having A-Fib episodes several times...

a day back in 2003.

At first it was not diagnosed. My doctor blamed it on stress, anxiety and thalassemia.

I went to another doctor and she recognized the symptoms immediately.

Cardizem (diltiazem) took care of the problem from the first dose.

Good luck. I'll be praying for your hubby.

[peacebird]

24. Thank you!

[mnhtnbb]

25. Don't know source of your info: much different stats here

Radiofrequency ablation has a success rate of over 90 percent, a low risk of complications and the patient can resume normal activities in a few days. It causes little or no discomfort and is done under mild sedation with local anesthesia. For these reasons, it's now widely used and is the preferred treatment for many types of rapid heartbeats.


http://www.heart.org/HEARTORG/Conditions/Arrhythmia/PreventionTreatmentofArrhythmia/Ablation-for-Arrhythmias_UCM_301991_Article.jsp


Are you satisfied/confident with your cardiologist? Would hubby be going to a major heart institute for the procedure?
You can check the list here--and in your shoes I would choose a major center vs. local community hospital.
http://health.usnews.com/best-hospitals/rankings/cardiology-and-heart-surgery

[daleanime]

26. Afraid I can't help you....

Electric Cardioversion worked for me and I've been steady since that. Hopes and prayers going out for you both.