Cardioversion has failed

It looks like my Cardioversion only lasted about 3 days, I sent my pacemaker results in yesterday and today I got a call saying that I am in Afib, I am in it about 80% of the time. I was told I was in NSR for about 3 days, so its failed. She was going to talk to my EP and said either another cardioversion, an ablation and/or trying a different drug, she mentioned Tikosyn. I know some on here have been on it and it has worked for some but you have to spend a couple of days in the hospital. I also said to ask the EP about a Watchman, the AF is not affecting me too much I do get a little short of breath when I do a lot of walking and heavier work, it is not the same as being out of AF of course.

If I go for an ablation, my LAA would probably be ablated and then I have to stay on a blood thinner. At what point should you get a Watchman (that is if I can), before an ablation or after? I know you probably will say after, but my point is can an ablation still be performed and the LAA be ablated if you have a watchman? I will try another cardioversion, I am not sure about Tikosyn, it doesn't sound very good, what else could I try, the Propafenone that I have been on isn't working.

If I went for an ablation, no doubt I would need more work and have to go back. They do perform ablations here at U of Michigan. The EP that performs them when I spoke to him about how many he has performed, he said about 800, so is that good or bad?

I could stay in AF and take my blood thinner and keep trying the protocol about no Calcium and higher D or natto, to see If I can stop my AF, I could try it for a while but also get another cardio version. If the first one didn't work, would the second one suffer the same fate?

Liz

Try another cardio conversion. IMHO it’s less invasive than an ablation or staying in the hospital in a new drug. At least you know you tried. Also review your diet to see if you had alcohol or caffeine or excessive salt or sweets that could had triggered it.

Susan:

I don't drink, eat very little sweets if I do it is organic, stopped coffee about 3 months ago. I have a large garden, I raise many veggies and freeze them, I have fruit trees that I take care of. My diet is very good, it is my DNA, my mother had AF. I see my Holistic doc. twice a year and he takes a lot of blood work, I have always been good. It is this dang AF, I agree with you, I am going to try another Cardio Conversion, I will go to my ER locally, I didn't know I could do that but you said you go there and so does another poster. It is a lot closer to me than U of M. Do you have to have your doctor schedule it for you or can I just go in and they will do it?

Liz

After 6 Cardioversions in 2 years, I made the decision to do Ablations with Dr. Natale and have zero regrets. Will it hold forever? Who knows but beside the Eliquis NSR is nice. You do what your heart is telling you.

Smackman:

You said you have had more than one ablation, did he ablate your LAA? You said you are on Eliquis, that gives problems like trying to get a colonoscopy, or any kind of surgery. I want to get off bloodthinners, probably an ablation won't do that for me, only a watchman, at this point I don't know if that will be possible, I see my EP this next Wed.



Edited 1 time(s). Last edit at 02/07/2020 05:07PM by Elizabeth.

Elizabeth: if you go to the ER to be converted, they will probably ask you for your cardiologist’s name and call for permission. I suggest you call your cardiologist and prepare him by saying you are planning to visit the ER and they may call him for permission. You don’t always need prior permission. Once they called my cardiologist it was in their system so the next time it was easier. Some of the ER doctors saw my history on their computer so they used their own call on doing it. I also ask my cardiologist for a signed letter giving his permission. Quicker to go in get converted and leave with a letter if I was out of California or if it was after hours.

Hi Liz,

I have been a LAF'er for 15 years and have been watching the site for 10 plus years. I am a adrenergic LAF in good health at 67 yo. I am very scientific about identifying my triggers. I can tell you very confidently that every time I have tried to take vitamin D3 ( to raise my level) I have within a couple of days gone into afib. I avoid it like the plaque now.

In my cursory research I have come to believe that vitamin D3 helps drive calcium into the cells. Seems logical if you are trying to avoid calcium you should also avoid vitamin D. Also many of the supplements that folks are experimenting with I have tried, and almost all have invariably produced afib (e.g. fish oil, Omega 3, etc). I am a sensitive one and have adopted the philosophy of purity in my diet and lifestyle. I believe that if I give the body what is natural, it will take what it needs. The body is very intelligent and force feeding it can lead to frustrating experimentation and confusing results. Over the years my afib is much calmer and more predictable. Maybe once every couple of months - very tolerable. I hope this might help in regards to vitamin D. I get sun instead! Natural.

Be well,
Jeff W

Interesting Jeff. My PVCs are more violent in the evenings. I just realized I take d3, co-q-10, fish oil and magnesium at 5pm and by 6 I have a nightly pvc freak show. I visited my son out of the country and I skipped my supplements for 12 days to pack light and PVCs were never noticed. I returned on the 18th of January and resumed my supplements and I feel my PVCs once again. I do need D3 since I am in cancer remission so I never stop more than a week and my oncologist wants my levels higher.

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1Jwalkup3836
Hi Liz,

I have been a LAF'er for 15 years and have been watching the site for 10 plus years. I am a adrenergic LAF in good health at 67 yo. I am very scientific about identifying my triggers. I can tell you very confidently that every time I have tried to take vitamin D3 ( to raise my level) I have within a couple of days gone into afib. I avoid it like the plaque now.

In my cursory research I have come to believe that vitamin D3 helps drive calcium into the cells. Seems logical if you are trying to avoid calcium you should also avoid vitamin D. Also many of the supplements that folks are experimenting with I have tried, and almost all have invariably produced afib (e.g. fish oil, Omega 3, etc). I am a sensitive one and have adopted the philosophy of purity in my diet and lifestyle. I believe that if I give the body what is natural, it will take what it needs. The body is very intelligent and force feeding it can lead to frustrating experimentation and confusing results. Over the years my afib is much calmer and more predictable. Maybe once every couple of months - very tolerable. I hope this might help in regards to vitamin D. I get sun instead! Natural.

Be well,
Jeff W

It’s helpful to combine the D3 with Vitamin K2-MK7. The D3 increases gut absorption of calcium. The K2 helps direct the calcium into the bones, where it’s beneficial, and not into the arteries and muscles, where it is harmful.

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wolfpack
It’s helpful to combine the D3 with Vitamin K2-MK7. The D3 increases gut absorption of calcium. The K2 helps direct the calcium into the bones, where it’s beneficial, and not into the arteries and muscles, where it is harmful.

That is what I am doing and haven't noticed any increase in ectopics or Afib. But, when I tried fish oil, that definitely increased my PACs--I tried starting it and stopping it several times and, for me, there was an association with PACs.

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wolfpack
It’s helpful to combine the D3 with Vitamin K2-MK7. The D3 increases gut absorption of calcium. The K2 helps direct the calcium into the bones, where it’s beneficial, and not into the arteries and muscles, where it is harmful.

Can you take K while on Eliquis?

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Elizabeth
Smackman:

You said you have had more than one ablation, did he ablate your LAA? You said you are on Eliquis, that gives problems like trying to get a colonoscopy, or any kind of surgery. I want to get off bloodthinners, probably an ablation won't do that for me, only a watchman, at this point I don't know if that will be possible, I see my EP this next Wed.

I had 2 Ablations; The 2nd one my LAA was isolated and I have no P wave now whatever that means. Whatever the case, I was told by the best to remain on low dosage Eliquis and it is a pain in the Arse when it comes to procedures or surgeries. I will call my Nurse Case Manager Monday about the Lovenox protocol. I hope it’s as simple as some say to get other specialists onboard.

Jwalkup3836:

I stopped vit D early last summer, I too get it as rule from the sun, but I live in a cold climate (hardly any sun) and last Nov. I went into permanent AF. I first got AF around 1998, I usually got only a few/year for quite a few years, this past year I started getting more episodes until Nov. of last year when I went into permanent AF. I believe this was caused by my thyroid being a little on the hyper side and at that time I wasn't taking any Vit D. So, I was thinking that perhaps that is also a reason that I went into permanent AF.

If you visit this site, do you also go to the General Health Forum? There is quite a bit of discussion about Calcium and Vit D by Steve Carr, he says he has stopped his AF by eating very little Cal. and he has increased his Vit D greatly as has George N. who posts on this forum. Steve Carr does say that Vit D drives Calcium into our bones, so I suppose it also goes into our cells. Anyway, I thought I would give it a try, I haven't taken very much Vit. D so that may be why I have not had any luck in stopping my AF.

It is very interesting that Vit. D causes an episode of AF for you, I have read on this forum about another person who says Vit D has caused problems for him. I will keep trying the protocol of low calcium and vit. D and if it doesn't work then I will stop it. I will keep in mind what you have said and thank you for telling me.

Liz

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smackman
I will call my Nurse Case Manager Monday about the Lovenox protocol. I hope it’s as simple as some say to get other specialists onboard.

Just so you know, it is a subcutaneous injection in the lower stomach (as I remember, twice a day). The syringes come pre-filled and the injection is really easy.

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susan.d

Can you take K while on Eliquis?

Yes. Vitamin K is contraindicated while on Warfarin, but not Eliquis. Eliquis has no known dietary restrictions. Even on Warfarin K2-MK7 may be OK, but I’m not going to get into the nitty-gritty of it.

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smackman
I will call my Nurse Case Manager Monday about the Lovenox protocol. I hope it’s as simple as some say to get other specialists onboard.

Lovenox bridge is a piece of cake. I've done it twice. Once for colonoscopy and the other for a nerve block

I had my LAA Isolation almost 4 years ago, no more afib,
Just had wrist surgery, carpal tunnel endoscopic, barely bled and never discontinued Xarelto as instructed by my surgeon.
I’ve also cut deep myself many times, don’t seem to have anything uncontrollable.
Nonetheless Im waiting to get a watchman when called by Natale’s office.

McHale



Edited 1 time(s). Last edit at 02/08/2020 01:00AM by McHale.

"I will go to my ER locally, I didn't know I could do that but you said you go there and so does another poster. It is a lot closer to me than U of M. "

Liz:

I don't know how much farther you would have to go to get a scheduled out-patient Cardioversion, but I think that is the route to go in your circumstance. Most of the Cardiology Practices I have dealt with serve multiple Hospitals, perhaps they can do it closer than you think. There are many reasons I say this, here are just several:

1) A scheduled EVC has a much, much better chance of going smoothly with much more experienced staff.
2) You more likely to get the procedure done and over within with a set amount of time. (usually 3-4 hours),
whereas in an ER, it could take longer, it is uncertain. You are waiting there not sure how fast they will act, and since your not very Symptomatic, they may very well shy away from doing it. Sometimes the Ambulances roll in, and the Staff has to deal with more critical patients. Again more uncertainty.
3) Since you are relatively new to this, an out-patient ECV is better, and your Cardiologist who you are familiar with is responsible, verses some ER Doctor you've never met before.

When I went to the ER, is was to get Cardioverted within 48 hours of AFIB onset, in order to get back in NSR before a Clot might potentially form, and to avoid Anti-Coagulation. The other circumstance I did it was when my Cardiologists office couldn't get it scheduled fast enough, and I didn't want to wait 10-14 days.

Liz,

I don't think natto will help your afib much because if sounds like you are too far advanced. In saying that natto is very high in vitamin K2 and has lots of other benifits.
I wouldn't be over doing vitamin D unless you get a test done first. I think Dr John Day advice on vitamin D is good advise.

Colindo:

I know what my vit. D level is, it is rather low, 30 ng/ml it is right at the low end of the scale, so I could probably use a little more Vit. D. But, would never use the amount that Steve recommends that is way too much.

Also, you say that my AF is too far advanced, I went into permanent AF about 3 months ago, George N was in permanent AF for about 2 /2 months and he got back into NSR with his protocol. You may be right but I will keep trying.

Liz

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Elizabeth
Also, you say that my AF is too far advanced, I went into permanent AF about 3 months ago, George N was in permanent AF for about 2 /2 months and he got back into NSR with his protocol. You may be right but I will keep trying.

Terminology, I'd say I was in persistent afib for 2.5 months, permanent won't convert period. Also, I converted out of that episode with 300 mg flecainide. After that, my protocol has been what has kept me in relative afib remission for all these years. Just clarifying that it wasn't my electrolytes and other parts of my protocol that converted me, it was the flec.

George:

What is the difference between persistent afib and permanent Afib? Perhaps I have misspoke I have been told I am in AF about 80%. Are you saying that you have gone in and out of AF during your 2.5 months?

Liz

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Elizabeth
George:

What is the difference between persistent afib and permanent Afib? Perhaps I have misspoke I have been told I am in AF about 80%. Are you saying that you have gone in and out of AF during your 2.5 months?

Liz

I was out of rhythm the entire time. Here are the definitions from the Heart Rhythm Society: <[www.hrsonline.org]

"Paroxysmal AF - AFib that occurs sometimes and then stops. AFib stops by itself and the heart returns to normal rhythm. AFib may last for seconds, minutes, hours, or days before the heart returns to its normal rhythm. People with this type of AFib usually have more symptoms than others. As the heart goes in and out of AFib, the pulse rate may change from slow to fast and back again in short periods of time.

Persistent AF - AFib that does not stop by itself. Medications or a special type of electrical shock (called cardioversion) is used to help the heart return to normal rhythm. If no treatment is given, the heart will stay out of rhythm.

Long Standing Persistent AF (formerly known as Permanent AF) - AFib that cannot be corrected. Medications and controlled electrical shock cannot help return the heart to normal rhythm."

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Liz
Perhaps I have misspoke I have been told I am in AF about 80%

If you are in rhythm some of the time (converting on your own), then it seems (at least in my opinion) that cardioversion may not be that useful as you will likely go back in and out of rhythm as you have been. The trick would be to come up with a plan, pharmacological or otherwise, to extend the time in NSR.

George:

On Dec. 11, in a post Carey said this:

Persistent is afib lasting more than seven days. Permanent afib is persistent afib that you don't intend to try to stop.

Liz