bettycll:

When paroxysmal AFIB progresses to more frequent or persistent AFIB, and when it can no longer be managed with medications, then doctors often look at cardioversion, with or without TEE, as the next step. Cardioversions are an intermediate treatment step between medications and ablations. Having the TEE (transesophageal echocardiogram) done at the same time allows the EP to examine the structure and function of the heart for any abnormalities. I know several people who had their cardioversions for their AFIB and never had another episode after. It saved them from having an ablation performed.

In my case, I had paroxysmal AFIB for 7 years and managed it well with daily high-dose Flecainide, Metoprolol ER and Eliquis. Then, after that my AFIB returned and became more persistent where episodes were non-stop for over a week at a time. My electrophysiologist then recommended a cardioversion which worked great. The procedure was painless as I was sedated and put me back into sinus rhythm immediately.

As time went on, my AFIB returned again and I elected to have an ablation performed 15 months ago. That procedure went very well too and I have been AFIB-free since then. I’m off the Flecainide now and reduced my dose of Metoprolol ER.

It’s wise to address your AFIB as it typically progresses for paroxysmal to persistent, and sometimes to permanent status, if it’s not properly treated. Longterm AFIB that isn’t properly managed can eventually lead to heart failure in some people. Doctors will often say “AFIB begets more AFIB”. That certainly held true in my case.