Is it worth going on antiarrhythmic

Sitting here with my mom following her colonoscopy watching her ❤️ on the screen. She was diagnosed with afib many years after me.

She really doesn't notice it . Only on occasion does she even feel it. Her rate is controlled with metoprolol. I've mentioned antiarrhythmic's before to her cardio but he didn't feel the need.

I know that so long as her rate is controlled and she stays on thinners that she will be fine. Bit to see here heart in this state. Especially with all the measures I have went to to achieve NSR kind of bothers me. Especially knowing that she would feel better in NSR.

Thoughts?

I know a guy who was diagnosed with afib purely by chance in a routine physical. He runs marathons and had no idea he was in afib persistently and probably had been for years. So now he takes a beta blocker and anticoagulant and continues to run marathons. Would he feel better in NSR? Maybe, but since he wasn't even aware he was in afib, it doesn't seem like it can be much of an improvement. In any case, he has no interest in doing anything about it. I think it's hard for people with symptomatic afib to understand that thinking, but if I were in his shoes I don't think I'd take an antiarrhythmic either. All the AADs have side effects, many are expensive, and every single one of them is potentially dangerous, so why bother?

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I think it's hard for people with symptomatic afib to understand that thinking, but if I were in his shoes I don't think I'd take an antiarrhythmic either.

I don't think it's hard to understand this, for it sounds perfectly logical.
The hardest thing to understand is how the hell can people have afib without being affected by it or even without being aware they have.

I would decline an AAR if I were asymptomatic. Unfortunately for me, I feel every single arrhythmic beat. Every. Single. One.

I almost envy those who don't.

Ditto what Wolfpack says about being symptomatic. I find it hard to believe that some people don't feel their afib. I wonder if body weight/mass/leanness/muscle mass play a role in being symptomatic. I have good muscle mass, I am lean, I am 6' tall and weigh 165. I have a woman friend how is asymptomatic, and is just the opposite my body type. When I am in afib, there is no way I can sleep on my left side - it's like being on a 25 cent vibrating bed (overstated a bit).

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Ken
Ditto what Wolfpack says about being symptomatic. I find it hard to believe that some people don't feel their afib. I wonder if body weight/mass/leanness/muscle mass play a role in being symptomatic. I have good muscle mass, I am lean, I am 6' tall and weigh 165. I have a woman friend how is asymptomatic, and is just the opposite my body type. When I am in afib, there is no way I can sleep on my left side - it's like being on a 25 cent vibrating bed (overstated a bit).

I think it is very individual. I know if I'm in afib, don't like it, but isn't the end of the world. When I had my 2 1/2 month episode, over 16 1/2 years ago, I did fine, or thought I did. When I converted it with flec, I had a euphoria feeling, like I was on a drug, that lasted nearly a month. I'm 6' and 168# and a DEXA a couple of years ago showed me in the bottom 1% for my age (now 65) for fat in my limbs and torso. I've had friends who are in afib and don't know it. They aren't particularly large. I'll ask them if they are in afib now, they'll say no. I'll ask permission to take their pulse and they are in afib but don't know it.

I think it is very individual. Also, the longer someone is in afib, I'm guessing they get used to it. Also, I think those with higher rates feel it more. If someone is in permanent afib, with a high (>100) rate, then they are likely to be on rate control.

Per @rocketrich's comment about putting mom on a rhythm med. I'm guessing if she's been out of rhythm for a while, the chances of the med working are fairly low. Depending on comorbidities, I might try something that isn't amiodarone.

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Ken
Ditto what Wolfpack says about being symptomatic. I find it hard to believe that some people don't feel their afib. I wonder if body weight/mass/leanness/muscle mass play a role in being symptomatic. I have good muscle mass, I am lean, I am 6' tall and weigh 165. I have a woman friend how is asymptomatic, and is just the opposite my body type. When I am in afib, there is no way I can sleep on my left side - it's like being on a 25 cent vibrating bed (overstated a bit).

I'm skinny and I feel the bumps in any body position. They feel louder while laying on my back or on my left side.
I sometimes wonder how my wife does not feel those bumps through the mattress !

Two months ago, I had a short (less than 30min) afib episode while waiting in my bed in the hospital, before being rolled into the lab for a coloscopy. The bumps were loud enough to be transmitted from the mattress, through the "arm" above my bed, to the "call for the nurse" button hanging there. I could clearly see it.

@GeorgeN : Before my first ablation, when my episodes were longer (15-24h), the bumps felt louder a the start of an episode than a dozen hours later, near the end of it. I thought it was a sign I'd soon revert to NSR, but it could be a sign that my body was adapting to the situation...

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Pompon

@GeorgeN : Before my first ablation, when my episodes were longer (15-24h), the bumps felt louder a the start of an episode than a dozen hours later, near the end of it. I thought it was a sign I'd soon revert to NSR, but it could be a sign that my body was adapting to the situation...

I felt the same way, too. AF became less noticeable (though still noticeable) longer in an episode, say, after 8 hours. I suspect that’s the ANP working to purge the sodium levels. As the electrolyte imbalance begins to resolve the “strength” of the beats reduces.