Husband in permanent afib, is cardioversion worthwhile?

My husband started with afib back in September. Turned out it was due to a leaking mitral valve which he has since had repaired. The doctor wants him to try cardioversion, but from what I've been reading, the odds of this working for someone who has been in permanent afib for this long aren't great, although the cardiologist quoted us odds of 60% success rate? My husband isn't very keen to have it done, and is thinking that he would prefer to cut his losses and just stay on metoprolol. Due to his age, results of his angiogram and lifestyle he isn't required to go on to Dabigatran as his chances of having a stroke are so low. 

He's feeling pretty rough on the Amiodarone and Dabigatran,  but has to stay on these until 4 weeks after the cardioversion if he has it done. Has anyone here had a cardioversion done after being in permanent afib for this long which has worked first time? 

I've had lots of cardioversions although I'm not in permanent A Fib. I'm on a low dose of flecanide and nothing else. It works great for me and I don't mind it at all. I feel so much better after. I'm in and out of ER in usually 2 hours or less and have no ill effects. Are you sure it a cardioversion and not an ablation they want him to have?

Hi, yes definitely electrical cardioversion. When you say you feel better after, is that after each cardioversion?

What I really want to know is how likely he is to return to normal rhythm when he has been in permanent A Fib for so long.

Thanks for the reply

Well I think your doctor will give you the best odds on that. Yes I feel great after each one. My sinus rhythm goes right back to normal and off I go lol. It might be worth a try at least once. The relief is instant for me and has always been worth it.

I had the same, I ended up having a cardioversion felt fantastic, next checkup was told I needed another one, I thought well he knows what he is doing so had another one bad move,  after the cardioversion at the hospital he changed my pills from Metoprolil to Amiodarone,  only managed to take the first days then I was really ill.   Have they told you that if you are taking a blood thinner they can interact and not in a good way,  I was totally allergic to the Amiodarone, rashes all over the body, hands swollen, nearly total brain fade then the skin started peeling off my hands, So I would say if your  husband doesn't want it done it might be a good idea,  Sorry the reaction I had to the Amiodarone knocked me around for months.  By the way the my own doctor says it is one the the black drugs to wouldn't it pay to check it out,  just do a search on Google and you will get all the info about it.

Thanks Moira, he has been on Amiodarone for the last few weeks, in preparation for the cardioversion, then will have them for four weeks after that. From what I can gather he won't be on them long term. He can cope with the side effects he has (photosensitivity mainly) if the cardioversion is worth having, he's just unconvinced about how successful it will be long term, as from reading these forums it seems lots of people seem to go back into A Fib after a while anyway and require repeats and then possible abaltion. 

I'm not in permanent afib but I do suffer from it a great deal. There are things that can be done to help it. If you belong to FB look for some groups ( atrial fibrillation information exchange) that can really answer your questions as there are some very knowledgable people who have really done their research who also suffer from atrial fibrillation. OMG they are also very supportive. They have helped me a great deal with my questions also just by reading their posts and info people post.

It really does suck having afib and even more so when you lack the knowledge or guidance regarding it. Sometimes you need to hear from more than a handful.

The waiting time for cardioversion at my local hospital is 12/14 weeks so I've twice waited that long. The first one lasted 15 months until another procedure stimulated my vagal nerve and  put me back in AF. The next lasted 10 months until a similar incident. 

He should go for it.

Google the 'history of amiodarone'

ER is America and that is very different to A&E in the UK where they would seldom do a cardioversion. I have twice gone as soon as in AF and had a cardiology appointment two days later but still the Amiodarone was used while I waited weeks for it.

I even tried to get it done privately but few hospitals can arrange it quickly,

Hi Derek, we're in New Zealand so bonus of having a small population is short waiting times smile Were you on Amiodarone for 12 weeks before your cardioversion or did you just start them a month before? 

My husband was feeling OK when he was just on metoprolol, but since he started the Amiodorone again he doesnt feel so good. 

He's started with a kind of wheezy cough and after reading the side effects of this drug I'm a bit concerend it could be serious. I've got him to ring the cardiology department at the hospital today to see if he can get some advice. 

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I was on Amiodarone for three months before and about the same after each time .It gave my hands a tremor and gave me floaters and deposits on my eyes but the worst part was disequilibrium. My balance was so badly affected that I could not do small turning movements. In the shower I had to have a hand against the wall and wash with the other one. The sort of turning movements you make in the kitchen became dangerous. Walking normally was OK but stopping before crossing the road and starting again was a problem. 

A friend who was on it before I had heard of it was coming towards me and it looked as if he had a birthmark on his face and neck as it had turned a blue/grey colour due to sunlight.  

Perhaps I should have another trip to NZ as the cardiologist said that you have reciprocal health care for British visitors.

Re the cough, it is well documented that it can affect the lungs.

I use to take metoprolol (which controls the rate). After my ablations my rate wasn't so dangerously high only 250 when going into afib and did not really help with the afib. I've been on amiodarone (controls your rythem) almost 4 months now and was told I'll be a lifer but it is helping. I still have some issues with afib and other things but it's not affecting physically like it was prior to amiodarone. before taking amiodarone I was passing out from the afib and could not function physically. They are trying to keep me from needing a pace maker this early in my life. I've had 2 cardio versions and they are only a measure to snap your heart out of the bad rythem and there is no telling when the afib will return. However being in afib constantly is not good. I hope your husband is on a blood thinner to prevent stroke.

Cardio versions are not a bad thing and if I were him I would give it a go. The amiodarone? Hmmm well I've been on it for 4 months and while it is helping I'm also experiencing issues with my vision as my eyesight seems worse, and my co-ordination seems off but if he's not expected to be on it long I don't know what his issues might be from it if any. I'm told it takes almost 4- 5 weeks to get into the system and almost twice as long to come out. However as with any med it's going to have a different effect on everyone.

Thanks derek, my husband is also having the same side effect re the turning/balance issue. Appreciate your reply smile

Hi derek already did when it happened but the damage had already been done.   It took a long time to feel better.

 

Thanks, yes trying to weigh up whether to have the cardioversion is difficult as it seems so often to ony have a temporary effect, before the person goes back into afib. Not sure whether its worth staying on amiodarone and suffering the side effects or whether to just put up with the afib and keep taking the meoprolol. Huisband is on dabigatran but only as a prelude to having the cardioversion. The cardiologist says he doesnt need a blood thinner other wise as his CHADS2 score is low. 

Amiodarone hastened my need for cataract surgery. I was told that I would not need them doing for at least another six years. The year after having been on amiodarone for about six months I was told that it was then needed much sooner.

After the problems I had with it the first time the registrar cardiologist said that I could just take bisoprolol instead. At the next appointment with another stupid registrar (that my GP wrote a letter of complaint about) she said that I could not have another cardioversion as I did not want to take amidoarone making it an ultimation.

Actually for me bisoprolol gives me worse immediate side effects but at least not such long term ones. 

I was also getting a vertigo effect when laying down

As it said some side effects can come out years later and so are not associated with it.

The only way to know is to have and hope that it works. Many people have several.