Why stay in permanent Afib? July 29, 2019 05:16PM |
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Re: Why stay in permanent Afib? July 29, 2019 07:04PM |
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Re: Why stay in permanent Afib? July 29, 2019 07:31PM |
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Re: Why stay in permanent Afib? July 29, 2019 07:37PM |
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Catherine
There has to be more to the story. Why not cardioversion or ablation? Perhaps he has some pre-existing condition that offers him no alternatives.
Re: Why stay in permanent Afib? July 29, 2019 09:48PM |
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Re: Why stay in permanent Afib? July 29, 2019 10:46PM |
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Re: Why stay in permanent Afib? July 30, 2019 05:48AM |
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Re: Why stay in permanent Afib? July 30, 2019 09:11AM |
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Carey
Many people live perfectly healthy, happy lives with persistent afib for decades. As long as there's adequate rate control, afib does not lead to heart failure or much of anything else, and if there's also appropriate anticoagulation, the stroke risk is reduced to near normal. The choice not to attempt to stop afib is a perfectly valid one and it's usually chosen only by people who are asymptomatic. There are a lot of people out there like that. They're in afib 24/7 but they feel no symptoms, they can exercise as usual, it has no effect on their quality of life, and they're well protected by two simple drugs. They live with it and go on with life. They pay no attention to afib so we don't see them on forums like this much.
If you felt no symptoms and had no risks from the afib, why would you undergo an ablation that could possibly create problems you didn't have? Cardioversions are only a temporary stopgap measure that cures nothing. Antiarrhythmic drugs are full of side effects and just not very safe. So what would you gain from trying to intervene if afib caused you no problems in your life? The answer is you would gain nothing and risk much.
That's the reasoning your friend's husband probably went through and the conclusion he arrived at. There are many others like him and it's a perfectly valid choice.
Re: Why stay in permanent Afib? July 30, 2019 09:12AM |
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MikeN
I have a colleague at work that I eat lunch with every other week or so, he is 60. He mentioned one time that he was on an anticoagulant. I usually don't pry but since I had AFIB I ask why he was on it. He said he was in permanent AFIB and has been for the last 5 years. I asked why he didn't want to try to get out of it or have an ablation. He said he barley feels it (only a little before bed) and has no trouble exercising. He asked me why he should get 'zapped' or get holes burned into his heart.
Re: Why stay in permanent Afib? July 30, 2019 10:28AM |
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Re: Why stay in permanent Afib? July 30, 2019 01:55PM |
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Re: Why stay in permanent Afib? July 30, 2019 03:52PM |
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Re: Why stay in permanent Afib? July 30, 2019 03:53PM |
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katesshadow
I understand the rate control aspect, but isn't the atria quivering a problem? It's not functioning correctly and doesn't that affect circulation, etc.?
When I had my Afib episode, after a little while, I was short of breath and lightheaded (that's when I headed to the ER). Was the rate causing that?
Re: Why stay in permanent Afib? July 30, 2019 03:57PM |
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Re: Why stay in permanent Afib? July 30, 2019 05:07PM |
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Re: Why stay in permanent Afib? July 30, 2019 05:08PM |
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Carey
I understand the rate control aspect, but isn't the atria quivering a problem? It's not functioning correctly and doesn't that affect circulation, etc.?
When I had my Afib episode, after a little while, I was short of breath and lightheaded (that's when I headed to the ER). Was the rate causing that?
When you're in afib you do lose the so-called "atrial kick," which means you might lose up to 15% of your normal cardiac output, but for most people who are asymptomatic that's not even noticeable. I know a guy who's 71 and has been in persistent afib for years. He runs in the senior Olympics and frequently wins. In fact, his afib was discovered by accident during a routine exam. Even without rate control he had no idea he was in afib. He says his afib simply doesn't affect him in any way, and for that reason he has no intention of seeking an ablation, cardioversion, or anything else. He takes a beta blocker and Pradaxa and that's it.
It's a bit of a mystery why some people are symptomatic and some aren't, but sometimes people go undiagnosed for years precisely because they're asymptomatic. They don't feel it and it just doesn't affect them, so nobody ever investigates. Sometimes those people suffer devastating strokes because of it. As an EMT I encountered one or two of these people. They would call 911 for stroke symptoms, and when I felt their pulse it was irregular, so I put them on a monitor and there it was. I'd ask if they knew they had afib and they would say no. It's amazing how many people go years or even decades without seeing a doctor who does a thorough exam, or even just feel their own pulse now and then.
Re: Why stay in permanent Afib? July 31, 2019 12:51AM |
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Re: Why stay in permanent Afib? July 31, 2019 01:48AM |
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Joe
Was worth doing in my case because i didn't like the bad symptoms and the CV lasted 18/20 months.
Re: Why stay in permanent Afib? July 31, 2019 07:12AM |
Registered: 11 years ago Posts: 615 |
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Carey
People with rate controlled afib and anticoagulation live just as long as anyone else, including people who treat their afib. It might seem like it should do harm, but it's well established that it doesn't.
Re: Why stay in permanent Afib? July 31, 2019 08:04AM |
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Re: Why stay in permanent Afib? July 31, 2019 11:02AM |
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mwcf
Carey, I certainly take and respect your point of view as per your quote and I too have known of a few folks who've lived to be 90 having had permanent AF for 30+ years, but do you 100% stick with your viewpoint as quoted even in the face of the points Shannon makes above re dementia?
Re: Why stay in permanent Afib? July 31, 2019 12:16PM |
Registered: 11 years ago Posts: 615 |
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Carey
Carey, I certainly take and respect your point of view as per your quote and I too have known of a few folks who've lived to be 90 having had permanent AF for 30+ years, but do you 100% stick with your viewpoint as quoted even in the face of the points Shannon makes above re dementia?
I do, with some reservations. The data quoted by Shannon is certainly interesting, but it's not conclusive and no one has established a causal link between well controlled afib and dementia. There are a great many confounding factors, and to my knowledge no one has conducted a study designed to control for those factors. For example, it's also well known that long-term compliance with anticoagulants is dismally low in the general population. Patients tend to take them irregularly, and eventually dwindle off and stop taking them entirely. So if you don't know how compliant someone has been over the years, you don't know how much of the observed dementia was in fact due to poor compliance. Micro clots being thrown by people with afib who aren't anticoagulated could very well explain the results observed.
My mother is likely a good example of this. She was in persistent afib for years with inadequate care from a non-cardiologist who prescribed aspirin for her instead of warfarin. It was only after several years of inadequate anticoagulation that she got proper care from a cardiologist and began warfarin. She died of Alzheimer's in 2016, and I think it's likely all those years of aspirin are to blame. That's not something anyone could prove or disprove, but it's my strong suspicion. My older sister lived with persistent afib for even longer than my mother, but she was an RN and was religiously compliant with her meds. She remained mentally sharp until her death due to unrelated caused.
Personally, I think the important message is if you're going to live with afib, you need to be religiously compliant with both anticoagulation and rate control.
Re: Why stay in permanent Afib? July 31, 2019 10:22PM |
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Re: Why stay in permanent Afib? August 04, 2019 11:23PM |
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Re: Why stay in permanent Afib? November 13, 2019 05:01PM |
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