Cardioversion ?

[Ken H.]

Anyone been through (or know someone) a cardioversion for A fib? (I know at least one person here, but I let him/her decide to reveal themself or not.)

 

Worked / Didn’t?

If so for how long?

Easy to go through or a bitch?

Pros / Cons?

Would do it over again / Wouldn’t?

 

If you have any thoughts you'd prefer not to post in public, please feel free to PM me.

 

Thanks.

 

[JayW]

The success of it depends upon how long the heart has been in atrial fib, whether underlying metabolic issues (such as thyroid disease and electrolyte imbalances) have been addressed, a number of anatomical issues in the heart (especially the size of the atria), and definitely some luck. A sedative is used rendering the procedure uncomfortable, but not horrible by any means.

 

The heart was designed to be in sinus rhythm, and restoration of it is desirable for a number of reasons I won't get in to. Having said that, many people do very well in chronic atrial fib for years on end.

 

This is a complicated question that you should thorougly discuss with your doctor, but the current trend (which I agree with) is to attempt cardioversion, electrically or otherwise if there is at least a decent chance that it will be sustained.

 

Jay

[yabadabapal]

Jay, what about an ablation. Would that be the next step if the cardioversion doesn't restore normal sinus.

[AZKomet]

The success of it depends upon how long the heart has been in atrial fib, whether underlying metabolic issues (such as thyroid disease and electrolyte imbalances) have been addressed, a number of anatomical issues in the heart (especially the size of the atria), and definitely some luck. A sedative is used rendering the procedure uncomfortable, but not horrible by any means.

 

The heart was designed to be in sinus rhythm, and restoration of it is desirable for a number of reasons I won't get in to. Having said that, many people do very well in chronic atrial fib for years on end.

 

This is a complicated question that you should thorougly discuss with your doctor, but the current trend (which I agree with) is to attempt cardioversion, electrically or otherwise if there is at least a decent chance that it will be sustained.

 

Jay

 

True there are some people with chronic a-fib that do well for some time. The dangers of a-fib are stoke, heart attack and clots that form in the vascular system. There are medications that help with control, but may not eliminate the condition all together. I am sure you as a physician are aware of the dangers and controls.

 

An electro-physiologist can map out the heart's electrical system, find the abnormality then ablate (hopefully) the area with success. Cardio-version unlike defibrillation is a timed event that focuses on the R wave of the QRS complex in an effort to stop the ongoing rhythm. There has been success in doing so with some, however the misfire often returns.

 

This info is for the poster and not for you Jay. I am sure you know your stuff. And I think the best advice you can gave is see your doctor.

 

Regards, Dave

[Woodie]

Only been on the giving side of it.

 

Looks uncomfortable, but not overly so. Many procedures are.

 

It's wayyyy more comfortable than emergency defibrillation--if you're conscious.

[Les is more]

It is not particularly uncomfortable because of the miracle of Versed which robs you of all memory of the event. I was left with a rhythmic heart, a couple of red marks and a sore throat from having a sonogram camera shoved down there.

 

I have a genetic predisposition to some funky heart rhythms. My heart has what Jamie calls irritable foci. In other words there are some rhythm sending junctions that can get thrown off.

 

These funky rhythms most often occurred in times of stress, too little sleep, excessive caffeine or sugar or heavy physical activity such as hard exercise or particularly technical and extended singing.

 

My usual off rhythm was extrasystole sometimes called extra beats or skip beats or PVCs. I also had runs of ventricular fibrilation--common in my family. I had my first known or extended bout with A-fib after a noro virus which resulted in violent extended periods of vomiting. My second bout came after an hour of sobbing at Gleno's graveside. I did not require cardioversion for that one.

 

In my case, I began to notice a pairing of digestive distress and funky rhythms. I related this to the cardiologist who immediately dismissed it saying that people think that all the time but that it was completely wrong--that the two were completely unrelated.

 

Not ready to accept that diagnosis and unwilling to undergo ablation, I sought other help. It's a long story but suffice it to say that I was diagnosed with a hiatal hernia. Basically stated, there's a weakening of the tissue around the opening in the diaphragm which allows the stomach to slide up into the chest cavity. This can impact the vagal nerve and vessels containing cardiac tissue and throw off the heart rhythms especially if there is a predisposition. I have a chiropractor skilled in the art of reducing that hernia--essentially shoving my stomach back down where it belongs. Between seeing him occasionally and the simple act of drinking 16 oz. of warm water first thing in the AM to weight the empty stomach and bouncing down hard on my heels a few times when I feel things acting up, my heart and digestive symptoms are almost nil.

 

Interestingly, the other people in my family with arrhymia, also have digestive symptoms that accompany them. I'm not suggesting that this is the only cause or that it is even the cause in your case. But, if you have a tendency to acid indigestion or reflux, belching or poor digestion, pay attention to the occurrences and any confluence of those types of symptoms with the A-fib. Hiatal hernia shows up in about 15% of U.S. the population. You never know.

 

I should also add that I had heart studies done, inside and out, and no one was able to locate the source or sources of my dysrhythmias.

 

 

 

 

[yabadabapal]

Les, great insight on your part to investigate beyond what you doctor said. Its interesting and I'm becoming somewhat convinced that heart problems are sometimes not problems with the heart but more of a messenger indicating a problem somewhere else.

[Ken H.]

Thanks Leslie, and the others, good info. I don’t think digestive issues are part of the equation here, have an ‘iron stomach’ with no acid reflux, ‘heartburn’, etc. symptoms. And the a-fib condition isn’t particularly cyclic or linked to specific activities, emotional states, etc. Other than the degree of severity that varies some (especially relative to caffeine and other stimulants intake), it’s always there. EKG looks to my uneducated eye like someone was scoping an old John Deere tractor!

 

Anyway the cardiologist has me on 8 mg Warfin and 5 mg of Bisoprolol daily with a current INR of 3.2 in preperation. The whole idea of voluntarily getting zapped wigs me out a bit. Guess I’ve gotten AC shocked too many times in my life!

 

[tobyzusa]

My mother, age 73, had cardioversion last year. It was unsuccessful in restoring a normal rhythm. She is on medication to minimize the symptoms of the arrhythmia.

 

I wish for a successful outcome for you Ken, however you decide to treat it.

[Les is more]

Seriously--Versed is the bomb. Jamie even asked me a test question to see if I could remember it afterwards--NADA!

 

The thought of getting zapped is freaky but you really won't remember any of it including the fact that it may or may not have hurt like mother at the time (okay, they even shooed Jamie out of the room, so I'm sure it wasn't pretty and he had shared his "war stories with me of converting people in the field). As for me, I only had the evidence already cited that it ever happened.

 

For me it was a matter of really not wanting to be on the meds. They kicked my rear end and I wanted no part of the Coumadin Clinic. For some, that's the answer and it keeps a good many people alive and kickin'. That's how we want you too!!

 

The camera bit was to double check for pooled blood or clots before they shocked me back to a normal rhythm and really,what's a little sore throat after all.

[Paul Mihalka]

I started with atrial fibrillation like fifteen year back. First it popped up under stress, than it became permanent. Cardioversion was tried twice, but the corrected rhythm only lasted for two days. I was prescribed Pacerone which I take every day and keeps it in control. It is still lurking under the surface. When I had my last accident breaking a leg about two years ago, I felt the fibrillation for a few hours. When it got corrected with the drug, my blood pressure went up a bit, so that is under drug control too.