Much better after transfer into permanent Afib

Hi,

I had paroxsismal AF for over 15 years and the cardiologists put me on all drugs available against arythmia from Amiodoron to flecanide, rytmonorm etc etc. It never helped long and I had years of suffering with the AF coming whenever it wanted. My wife suffered with me, I could not walk fast, had problem breezing and depressions. 15 months ago my AF went permanent and I am now on Lanoxin and Perindopril for my BP and slower heart beat. I feel great and don't even feel the irregularities in my beat which have become much less than during attacks when I was paroxsiysmal.
I am reborn at least that is what i feel and wish i would have liston to my home family doctor who ever wanted to treat me from the beginning without all this other posien I had to swollow the past 15 years. My BP is normal and I feel good.
Anyone had the same experience?
Erich

I have had similar feelings after being in afib permanently for 2 months earlier this year (after many years of paroxysmal). I opted for an ablation in February for 3 reasons. First, although I functioned OK I was a little breathless at times, especially if I were playing golf and had to walk up any incline.The second reason is up for debate. Do you live as long and what is the impact on your heart (structure) long term? Lastly, I hate taking meds especially anticoagulants.So, if my ablation is successful I will have made the right decision for me, but I do relate to your post in that when I was in permanent afib I was never worried about doing something that would put me there! )

Are you considering an ablation or are you happy staying in permanent afib because you feel better?

Most information on this topic points to afib being progressive, meaning it will only get worse as time goes by. Do you know what effect it is having on your heart? Have you had your ejection fraction measured before and again recently?

Shannon has written many very lengthy responses about why it is best not to wait too long and how our own minds trick us into not treating it as soon as possible. See here for examples:

[www.afibbers.org]

[www.afibbers.org]

I know the side effects of the drugs are not pleasant......they weren't pleasant for me either. I had my Natale ablation on 1/27/15 and have been drug free since......except for the Eliquis that I must take for the full blanking period, and I fully expect to get rid of that soon!

Best wishes in your treatment and decision.

Sincerely,
Ken

Erich,

I know of others who have reported doing quite well, long term in permanent afib. Their reports are very similar to yours, comparing pre and post permanent afib.

George

The Ejection fraction would only be marginally negatively affected by being in AFIB, as long as the rate control was low enough, and that would be due to lack of "atrial kick", not weakening of the Heart muscle.

In other words, AFIB won't cause cardiomyopathy, if proper rate control is maintained.

Hi All,

Certainly persistent AFIB that is low speed and largely asymptomatic now, is much easier to live with than rocking and rolling paroxysmal AFIB with all the fits and starts and highly symptomatic extremes, and never knowing when it will come or go and interrupt one's life in such a predictably unpredictable manner.

But it's a bit of wishful thinking to assume one can just dial in easy going permanent AFIB as a preferred strategy and insure it stays that way until you die at a nice ripe old age with no consequences to speak of. That is called rolling the big dice big time or sure!

AFIB is not only about obvious or annoying symptoms and it can manifest in very individual and hard to predict ways and is subject to real changes in character over time as progression and remodeling continue unabated when the AFIB is not addressed or addressed effectively.

Without a doubt Some people 'seem' to manifest this 'apparently' more benign form of AFIB scenario for a good long period of years, not unlike some people we all know of like a second step Uncle or Aunt who could drink three fifths of Scotch a day and smoke 4 packs of cigarettes a day and lived to be 100. Though that is hardly comforting or a recommended strategy for living a successful long life.

And even in those easier periods of relative quiescence, however long they may last, underlying and not so underlying harm can very much still be brewing.

It's a nice theory that just keeping your heart rate sufficiently low will prevent all cardiomyopathy, but even 18 hours at 100 to 105 bpm can drop ejection fraction considerably and start to manifest some rate dependent cardiomyopathy symptoms in some people.

Again, even AFIB symptoms are not limited to only faster rate AFIB, and very many people feel pretty lousy even with low rate AFIB below 100bpm, its a very individual condition in how it expresses in all of us as we have seen here on this forum for 16 years.

Some others, without question, such as a few reporting here understandably find the switch to a more predictable and easier, softer low rate permanent AFIB a kind of relative major relief compared with the the uncertainty and highly symptomatic roller coaster of long term paroxysmal AFIB that was poorly managed with toxic AAR and rate control drugs. And there is no surprise why they feel that relief!

Though compared to true persistent NSR, they might then again find the relative feeling of this new found persistent AFIB that seems preferable to the paroxysmal form of the beast, to be still a relative beast compared to true long term NSR once again regained for the long term, particularly after enough reverse remodeling from a year or more of consistent NSR has set in and helped reverse much of whatever degree of low ejection fraction of mile SOB they might have experienced during their long term AFIB at whatever heart rates.

And this is without even considering the longer term stroke risk even while on long term OAC drugs from persistent AFIB allowed to rumble along even at below 100bpm rates. Whatever risks you want to pick from the various published stroke risk rates for various OAC drugs are all 'per annum' rates of stroke/TIA risk. As such, a 2%, 3% to 5% annual risk that seems pretty good year by year doesn't look nearly so good at 20 years to 30 years out for the 40 to 60 year old considering being on an oral anticoagulant for life. It's CVA risk curve of these drugs long term is not quite a linear progression of risk, but its pretty close to a linear increase over the long term.

Then we can factor in the relatively new serious risks issue that have been affirmed repeatedly in many studies now over the last 5 to 7 years with the relentless increase in low level 'asymptomatic' Silent Cerebral Ischemia' which again uses the term 'asymptomatic' strictly to mean that each individual small lesion is thought to be asymptomatic, but cumulatively it is becoming increasingly clear they are far from benign with the very strong association now well established between increased AFIB related SCI and early onset Dementia and Alzheimer's over time.

Of course, those mostly old timer cardio's who blithely recommend doing nothing for AFIB beyond a simple prescription to "just take a beta blocker and some Coumadin for life and learn to live with it' as a viable strategy don't much talk about these baked in long term risks, even assuming they have considered and understood those risks.Most never have read or considered these newer findings and discoveries and so never connected the dots between those under their care who may have developed early dementia and the AFIB that some of them undoubtable had as well.

That being said, I can fully understand and appreciate the 'born again' feeling of slipping into a near seamless AFIB that doesn't seem to bother you in the slightest for those that feel that way it's great and I'm happy for you as well that your suffering has been greatly relieved at this point and hope it continues the rest of your life. Certainly, for those whose AFIB world has converted to such an easy state to last for the long term, then just rolling with that phase as long as it last makes understandable good sense, and if you are lucky it may last the rest of your natural life and perhaps without shortening it too awfully much as well.

Just know that none of those reassuring stats that mostly old line Cardio's may break out to support such a seemingly fortuitous turn of events in one's AFIB journey to this much more preferable status of enjoying one's life in spite of AFIB.. after all none of us would argue with that outcome and I certainly do not .. but keep in mind that in their premise they are not accounting for the very real possibility of loss of effectiveness in the rate control drugs over time or growing drug side effects over time, nor the issue of slowly but increasingly more likely stroke risk increase over the long term for persistent Afibbers especially with added risk factors pile on with age and more cardiac remodeling, even with OAC drugs on board for many many years and decades. Nor are the very realistic and strong association with early onset dementia being considered when suggesting that just rolling with persistent AFIB is a viable strategy.

For some, it really does turn out to be a fortunate turn of events to develop persistent AFIB that is so benign the person winds up living a much easier life and appreciable long and fruitful life as well rather than going the drug only or mostly route. But just be very careful about assuming that any one of you, as an individual, is going to successfully engineer such a lottery winning jackpot by navigating your AFIB into the apparent safety of this kind of low speed permanent AFIB that you can easily manage and keep tame and safe the rest of your life. That is a much risker bet to bring about in real time over a very long time, and pales, in my view, as a viable strategy compared to throwing your best effort into re-estalbishing persistent NSR for the long term. I seriously doubt anything close to a majority of us are likely to get too far on the AAR drug method primarily, most all of you above have attested too as well.

Hallelujah for those who find their solution to AFIB via such a fortunate manifestation as conversion of a suffering laden paroxysmal AFIB that was poorly managed to a permanent quiet and painless AFIB without any real consequences for a life time, just as I say well done and Hallelujah for those who are able to totally put the genie back in the bottle for good with life style modification and nutrient repletion alone, both of which methods can indeed work pretty well in some cases and the later of which I am in full support of and follow religiously still myself.

However, the idea that either drug management of permanent AFIB as the core method to keep heart rates low and blood thin, or life style risk factor management 'alone' is the best path to a winning strategy for the majority of serious Afibbers to realize their best odds for the best possible long term outcome from their efforts to manage and quell the beast, is a bit of a pipe dream on both accounts from all that I have seen and learned over the last 24 years of living with AFIB in a whole host of manifestations, including total freedom from the beast now which I can tell you, without equivocation, beats all these other more equivocal ideas in which AFIB is merely managed, hands down.

Shannon

I can only tell you my experiences....and I agree with Shannon......

I was diagnosed with afib on 1/14/14. Cardioversion attempted unsuccessfully that day and rhythm meds soon followed. First ultrasound done 5/14 with reduced ejection fraction of 51%. Afib burden grew, but rate low and controlled except during exercise. In fact, after beginning the meds, I quickly developed brady, when worsened over time, with my rate frequently dipping into low 30's and staying there for an extended period.

During both holter monitor periods, the company and even doctors from the hospital would call me to check on me b/c my HR was so low.
Second ultrasound in 10/14 showed further reduced ejection fraction at 46%. HR was controlled, but this holter showed increased afib burden.
I had a nuclear stress test in early Jan 2015 which estimated ejection fraction at 45%. The local E/P said my heart would only continue to weaken (lower ejection fraction) if I didn't have an ablation. Thank God I found this forum.

When I was diagnosed with afib, my resting HR was in the 60's. Throughout my year with afib prior to ablation, my resting HR was never high--------but I did exercise a lot in afib----------and I believe today that was one of the worst things I could have done.

To summarize, my experience was that afib with low resting HR was still detrimental to my ejection fraction.
I met with my local cardiologist about 10 days ago and we agreed to do a post ablation ultrasound to measure ejection fraction at the four month mark, which will be early June. I'm looking forward to it and hoping for significantly improved results.

Just sharing my experience.........

Best wishes.

Sincerely,
Ken

Hi,

Thank you for all this qualified informations in the mail especially Shannon. I continue to be happyly in AFib cause I do not notice it and hope it will remain forever.

Warm regards
Erich