Afib leads to heart failure

I am not a cardiologist but want to point out that a diagnosis of heart failure is NOT a death sentence.

For those who have been diagnosed with it should know their EF and which symptoms are related to HF. EF is determined during a ecocardiogram. This is a subjective test though and heart failure doctors will tell you a lot of determination on what level of failure you are at is based on how you feel, what you are able to do, and symptoms you have (swelling in limbs, lung congestion, fatigue, breathlessness, hospitalizations, etc.).

Again I am not a cardiologist and NO expert on this but the term heart failure Is NOT that the heart has failed. It means it's functioning has been reduced. Many things can cause that. Heart attacks, cardiomyopathy, viruses, electrical problems, high blood pressure, etc. I am being treated at Mayo Clinic Jacksonville by the division head of the heart failure/transplant division. I have been his patient since 2006. Yes I am in good hands!

I want to be completely clear a diagnosis of heart failure is serious. My personal opinion though is the name should be changed to something like reduced heart function. Then the term heart failure used when you are hospitalized and your heart has and is failing.

I saw one poster said her mother lived a long life with it and died at age 93. I have had diagnosis of HF for 23 years and I am 76 years old who does Sprint Triathlons. My HF nurse told me they have individuals doing construction work with an EF of 10%. I have a low EF but told my body had compensated for the reduce blood flow very well and thus very little symptoms.

There are different levels of heart failure. I was told it was from 1-4. I am listed a 1-2 level. I take medications for my heart failure (entresto and carvedidol spell?) but have never been hospitalized for heart failure. I have an ICD/Pacemaker as electrical problems with heart is how mine started with cardiomyopathy.

There are excellent medications and treatments for heart failure. I was diagnosed in 2000 with heart failure. It is now 2023. One of the worst things is not treating high blood pressure. It can cause undue stress on heart and cause it to get larger. As it gets larger it starts losing its contraction ability (EF). Many treatments have been shown to improve EF and/or maintain it from getting worse.

“The CDC estimates that about 6.2 million adults in the United States live with heart failure. A 2022 American Heart Association report (PDF) showed that heart failure accounted for nearly 10 percent of cardiovascular disease deaths in the United States in 2019.

Life expectancy with congestive heart failure varies depending on the severity of the condition, genetics, age, and other factors. A review of 125 heart failure studies published in 2022 in BMJ indicated that on average, about a quarter of all patients diagnosed with heart failure died within a year. The result matched up fairly closely with a separate paper, published in 2019 in BMJ, based on nearly 60,000 heart failure patients showing that survival rates in patients were 75.9 percent at one year, 45.5 percent at five years, 24.5 percent at 10 years, and 12.7 percent at 15 years.”

Think about that…25% fatality in the first year! Imagine any disease having that high a fatality rate! I can only hope I am better than the average.

The hospital did an echocardiogram and other tests on me yesterday. There is heart changes…ie..measurable thickening of the heart walls. I’ll meet with the doc in a few days and get an explanation of the rest of the test results,

“The CDC estimates that about 6.2 million adults in the United States live with heart failure. A 2022 American Heart Association report (PDF) showed that heart failure accounted for nearly 10 percent of cardiovascular disease deaths in the United States in 2019.

Life expectancy with congestive heart failure varies depending on the severity of the condition, genetics, age, and other factors. A review of 125 heart failure studies published in 2022 in BMJ indicated that on average, about a quarter of all patients diagnosed with heart failure died within a year. The result matched up fairly closely with a separate paper, published in 2019 in BMJ, based on nearly 60,000 heart failure patients showing that survival rates in patients were 75.9 percent at one year, 45.5 percent at five years, 24.5 percent at 10 years, and 12.7 percent at 15 years.”

Think about that…25% fatality in the first year! Imagine any disease having that high a fatality rate! I can only hope I am better than the average.

The hospital did an echocardiogram and other tests on me yesterday. There is heart changes…ie..measurable thickening of the heart walls. I’ll meet with the doc in a few days and get an explanation of the rest of the test results,

You can take up to 400 mg/diem of metoprolol if you are in heart failure. Those with AF are normally topped out at 200 mg, but my own EP in Canada said you might need up to 300 for AF. At that point, a mechanical intervention is definitely indicated. IOW, a catheter ablation. When drugs don't work (anymore). what's left?

AF won't kill you. Many live for decades with it. However, you are highly unlikely to live long with the AF allowed to go untreated....which is the key. It must be managed. If left unchecked, it progresses almost universally across patients, and it becomes more and more untreatable, often leading to heart failure...which will kill you.

My own EP performed an ablation and sent me home with instructions. A week later, I was in the local ER and I never did get through the 'blanking period' of eight weeks Scott-free. In fact, he later took as evidence that his original effort had failed from my Galaxy watch. His outreach nurse, when she listened to me, asked if I could send her a graphic depiction of the ECG my watch had recorded when I knew I was again in AF, now 14 weeks out from the ablation. As soon as he looked at what my Galaxy watch recorded, he immediately saw that it was AF (no discernible P waves, and the R-R intervals were unevenly spaced). He called me himself and we agreed he should take another stab at me...so to speak.

As far as I know, those who have the latest smart watches ought to have accompanying apps on their phones that manage the watch's functions. They all, I'm pretty sure, record AF when the wearer makes the effort to run the ECG applet. This record is held on the phone's side, and you can look at it. It should...SHOULD... show a proper twin-lead ECG with the squiggles on the graph paper depiction. My Galaxy does, at least. Twin lead because I must place the tip of a finger against the 'back' button when recording an ECG.

My posts are long...sorry. One other, and last, bit of exceedingly important information. Over at apneaboard.com, we see people all the time with the absolutely wrong machines delivering the wrong therapy. Every day, five or more people who were misdiagnosed, given the wrong prescription, or given a machine that can't properly splint them so that they can rest and sleep well. One common problem is that people don't necessarily only have obstructive apnea. They may have, or may develop, 'complex' sleep apnea where central apnea is the main culprit. Most bipap machines are incapable of properly treating complex apnea or fully central apnea. In those cases, the patient needs what is called an ASV, an adaptive servo-ventilator. The insurers won't like having to pay through the nose for those costly machines, but if that's all that will work..!! Also, the prescribing individual will often duly try to work you through elevated levels of PAP therapy, and it may take months until they see, or admit, that a bipap machine simply isn't up to the job. They also figure whatever the patient can afford, or whatever their insurer will support, is probably better than nothing. Often, they're amazingly right, but just as often they're plain wrong. Without proper sleep and rest...and recovery...you can count on continued, and almost certainly progressive, atrial fibrillation if sleep apnea was the progenitor.