Afib - do I just live with it?

@kfox21 and @chickenfarmer

This post originated 5 years ago. It's September 2026 now.

Any recent updates from anyone, particularly those with atrial fibrillation lasting more than 7 days?
Any brand new reference books, 2025 or later, in particular ones reviewed by a board certified cardiologist?
Some references have been mentioned, but I wonder if any good medically reviewed books have been published after 2023? The most recent cardiology guidelines for atrial fibrillation (that I know of) came out approximately 2023-2024. https://www.jacc.org/doi/10.1016/j.jacc.2023.08.017
If I understand correctly, quite a few things evolved in 2023.

Hopefully atrial fibrillation patients are seeing a cardiologist at appropriate intervals ( every year or two?) to evaluate patient change and status using current guidelines, and evaluating any needed tests. (EKG, transthoracic echo, electrophysiology, stress test if needed, etc.).

Best wishes

@tallbackhip I agree with you, but as a Canadian living in British Columbia, it doesn't work like that here with our vaunted 'free' socialized medicine. The last time I encountered anyone for my AF was when my electrophysiologist (EP) discharged me over the phone. We actually had a good conversation, and at the end he invited me to contact his office directly any time I needed an assessment or further treatment. That was a surprise as once discharged, you normally have to commence the series of referrals all over again, from doctor or ER internist to cardiologist and then to the EP. But that was three plus years ago, and the cardiologist has never contacted me since then.

I see the same problem with patients placed on amiodarone. The drug is potentially toxic and can lead to pulmonary hypertension, vision loss, and kidney function problems. It is meant to be closely monitored for at least a few weeks to see if the patient is going to be one of those who should not take it. Some patients do well and can take it for literally years. They have to. Others develop acute toxicity or other degradations in function within a couple of weeks and the drug must be ceased immediately. But how does the EP or cardiologist know when they don't bother to inform the patient or to set up at least two follow-up assessments over the next 60 days or so? Happens so often that it is truly disconcerting.

@gloaming I stayed away from Amiodarone/Multaq. That stuff has a black label warning. People live with Afib everyday and nobody has died from Afib per my research and the internet as well as my cardiologist telling me the same thing.

I think it's a great recommendation. Just live with it vs ablation for sure. People live with Afib everyday. I just had an angioplasty and all is good, no blockage, strong heart when my cardiologist (not the surgeon) stated he was concerned about blockage due to nuclear stress test and pulmonary, none was true, all good. I have AFib and take metoprolol. Just enjoy life. Most shocks and ablations don't have a very good success rate anyway. Maybe Afib and our heart beats are the way God made us. Maybe we are supposed to go in and shock or burn off parts of the heart.

@dlptlp Very true, and I take pains to ensure people know that who come here for help. AF is not a lethal disorder. However, for those who are highly symptomatic, it can make life hardly worth living.

Treatment for AF is not going to cure it. It's a permanent diagnosis. Treatment for AF is only ever palliative: trying to keep it from getting worse (it's a progressive disorder) and trying to maintain dignity and quality of life for the person suffering with it. So, whether it's to be drugs or an ablation or six, or a combination of both, it can make life bearable and keep people productive. I would resist taking drugs if at all possible, but sometimes it's all that works.

I have had atrial tachycardia mostly dom red sign for five years. I feel well on metoprolol and eliquis. I have had for ablations and many cardio versions and tried flecanaid and then sotalol. I had terrible gastro problems on both but a final sotalol load in the hospital made my heart stop for five seconds so they stopped the drug. I agree that living in it is better than fooling with more drugs. Tycosin almost killed my sister. She ended up in torsads and has permanent heart damage from it. I won’t take Amoridalol because it is considered an end of life drug. They wanted me to try Farxiga but I don’t have diabetis or kidney disease and it impacts your urinary tract. Honestly I feel well and drugs all have side effects that can cause other problems.

@dlptlp I meant maybe we are NOT supposed to go in and shock or burn off parts of the heart.

@wews My whole point and concern is, you have had 4 ablations so I assume they did not work, correct? I don't want any ablations or shock treatment. I feel I can live a long life with AFib. I am on metoprolol and eliquis.

@dlptlp What are everyone elses thoughts on this? Just live with Afib and medication or shock and ablations that might or might not work? Seems like with family history and what I read, the shock and ablations are hit and miss when I can just live with Afib. In my case I don't even know or feel my AFib at all.

@dlptlp yes you are right, they didn’t work. But I feel well and regularly see my cardiologist to make sure my heart is remaining strong. My last ablation was the new technology pulse field technology and once again he had me in sinus at the end of the procedure and my heart went right back into atrial tachycardia. As long as I feel well I am fine with metoprolol and eliquis and LOsartin to ease the burden on the heart! Best wishes to you.