I am scheduled for a TEE and Cardioversion

Posted by bettycll @bettycll, Jun 10 9:38pm

I have had 3 episodes of Afib. Of course, I have been on Xarelto since this began. The first Afib episode lasted several months, and I was on amiodarone, which turned out to be toxic to my lungs (but did stop the Afib). Over a year later, and after a pacemaker, I went back into Afib. I was then on Sotalol, and it did bring my heart back into rhythm. Now a year later I have been back in Afib for 3 months. I am on Flecainide. However, the electrophysiologist wants me to have a TEE and a cardioversion. I am not sure I want to do this. I know many people who had cardioversions MANY times, so that does not seem like a good solution. I would love to hear other people's experiences. Through all of this, I have been on metoprolol without any problems. Please let me know your experiences with Afib and cardioversion. Thanks.

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I have afib and a leaking valve. Had replacement and abrasion procedure and a bypass. Received a link and the battery died and now I have a watchman which seems to be working for the clots but still have afib. So, we will see what happens I am 74. If you need do it.

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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.

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@djeanc

I have afib and a leaking valve. Had replacement and abrasion procedure and a bypass. Received a link and the battery died and now I have a watchman which seems to be working for the clots but still have afib. So, we will see what happens I am 74. If you need do it.

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Thank you! I appreciate your response.

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@fortunateoldguy

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.

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Thank you for your information, Fortunateoldguy! I very much appreciate your information. It is similar to mine, as I believe I am now in persistent AFIB, having had it non-stop for over 3 months. Everything happened at once, as I had to have (unrelated surgery) and was diagnosed with CLL at the same time I went into AFIB. I am scheduled for a cardioversion in a few days. I certainly hope my experience is like yours - and will put me back into sinus rhythm immediately. I had an appointment this morning with my electrophysiologist who wants me on a higher dosage of Flecainide after the cardioversion. He feels this is my best chance of not going back into AFIB, since it appears that I will have longterm AFIB without medication. You are making me feel better about having the cardioversion. I hope this 3rd episode is my last. Just call me Fortunateoldgal!

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@bettycll

Thank you for your information, Fortunateoldguy! I very much appreciate your information. It is similar to mine, as I believe I am now in persistent AFIB, having had it non-stop for over 3 months. Everything happened at once, as I had to have (unrelated surgery) and was diagnosed with CLL at the same time I went into AFIB. I am scheduled for a cardioversion in a few days. I certainly hope my experience is like yours - and will put me back into sinus rhythm immediately. I had an appointment this morning with my electrophysiologist who wants me on a higher dosage of Flecainide after the cardioversion. He feels this is my best chance of not going back into AFIB, since it appears that I will have longterm AFIB without medication. You are making me feel better about having the cardioversion. I hope this 3rd episode is my last. Just call me Fortunateoldgal!

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What a coincidence, like you, I have CLL/SLL too. Your doctor definitely sounds like he’s giving you good advice. Good luck!

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@fortunateoldguy

What a coincidence, like you, I have CLL/SLL too. Your doctor definitely sounds like he’s giving you good advice. Good luck!

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bettycll:

You may find this of interest. There is a significant association between having CLL and AFIB. Here is the evidence based research. Mayo Connect still won’t allow me to post weblinks, but you can Google the tile of this study to read it in full.

Article:

“Incidence, predictors and outcomes of cardiovascular events in patients with chronic lymphocytic leukemia”

“Conclusions: CLL patients are at increased risk of developing atrial fibrillation, pericardial effusion, pericardial tamponade and all-cause in hospital mortality compared to their non-CLL counterparts, even after accounting for variables such as age, gender etc. Moreover, CLL patients have higher inpatient mortality associated with certain factors such as age progression, AKI, black race, alcohol abuse and malnutrition. Patients should be referred to cardiologist early and cardiovascular status should be optimized especially before initiating targeted therapy.”

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@fortunateoldguy

bettycll:

You may find this of interest. There is a significant association between having CLL and AFIB. Here is the evidence based research. Mayo Connect still won’t allow me to post weblinks, but you can Google the tile of this study to read it in full.

Article:

“Incidence, predictors and outcomes of cardiovascular events in patients with chronic lymphocytic leukemia”

“Conclusions: CLL patients are at increased risk of developing atrial fibrillation, pericardial effusion, pericardial tamponade and all-cause in hospital mortality compared to their non-CLL counterparts, even after accounting for variables such as age, gender etc. Moreover, CLL patients have higher inpatient mortality associated with certain factors such as age progression, AKI, black race, alcohol abuse and malnutrition. Patients should be referred to cardiologist early and cardiovascular status should be optimized especially before initiating targeted therapy.”

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Hello @fortunateoldguy, I see you were trying to post a research article as a new member. There is a temporary hold on new members to prevent spammers. Let me help you with that:

"Incidence, predictors and outcomes of cardiovascular events in patients with chronic lymphocytic leukemia." - https://ascopubs.org/doi/10.1200/JCO.2022.40.16_suppl.e19524#

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@fortunateoldguy

bettycll:

You may find this of interest. There is a significant association between having CLL and AFIB. Here is the evidence based research. Mayo Connect still won’t allow me to post weblinks, but you can Google the tile of this study to read it in full.

Article:

“Incidence, predictors and outcomes of cardiovascular events in patients with chronic lymphocytic leukemia”

“Conclusions: CLL patients are at increased risk of developing atrial fibrillation, pericardial effusion, pericardial tamponade and all-cause in hospital mortality compared to their non-CLL counterparts, even after accounting for variables such as age, gender etc. Moreover, CLL patients have higher inpatient mortality associated with certain factors such as age progression, AKI, black race, alcohol abuse and malnutrition. Patients should be referred to cardiologist early and cardiovascular status should be optimized especially before initiating targeted therapy.”

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Wow! Thank you for this information! Although I am seeing an oncologist, cardiologist, electrophysiologist, etc - NO ONE has indicated the association between CLL and cardiovascular events! Two different physicians suggested the AFIB resulted from stress after being diagnosed with CLL and needing the unrelated surgery! My oncologist already said that Flecainide conflicts with a therapy she uses, but she did not indicate any association. I will definitely read the article. Thanks again.

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@JustinMcClanahan

Hello @fortunateoldguy, I see you were trying to post a research article as a new member. There is a temporary hold on new members to prevent spammers. Let me help you with that:

"Incidence, predictors and outcomes of cardiovascular events in patients with chronic lymphocytic leukemia." - https://ascopubs.org/doi/10.1200/JCO.2022.40.16_suppl.e19524#

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Justin - I very much appreciate your posting this. I am newly diagnosed and a sponge for information. In addition, I have had everything thrown at me at once! Thank you!

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