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.

Interested in more discussions like this? Go to the Heart & Blood Health Support Group.

@bettycll

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.

Jump to this post

Just remember though that associations do not prove causation. The sample population in this study had an adjusted odds ratio of 1.11, 95% CI 1.06-1.15 P < 0.001). While those are significant odds they aren’t off-the-charts by any means. It just means those people sampled with CLL have a 1.11 times greater likelihood of having AFIB.

REPLY
@fortunateoldguy

Just remember though that associations do not prove causation. The sample population in this study had an adjusted odds ratio of 1.11, 95% CI 1.06-1.15 P < 0.001). While those are significant odds they aren’t off-the-charts by any means. It just means those people sampled with CLL have a 1.11 times greater likelihood of having AFIB.

Jump to this post

I appreciate the clarification. Basically, it is like the association between AFIB and stoke - an individual with AFIB has a greater likelihood of having a stoke - but will not necessarily get a stroke. My having CLL does not cause my AFIB; it just increases the likelihood of my having AFIB. Apparently, that is true of other malignancies. A relative with lung cancer was put on anticoagulants because of the greater likelihood of her getting AFIB. Thanks again!

REPLY
@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.

Jump to this post

Hello @djeanc and welcome to Mayo Connect. I really appreciate your post about your many successful cardiac procedures. Posts, like yours, are encouraging to others who are facing similar health issues.

How long have you had Afib? Did you try other remedies before the ablation and Watchman?

REPLY

I had four ablation procedures. One lasted a years. The second one do work. The third one lasted 7 yrs. I had my fourth ablation, April 16th. It’s a new procedure called Pulsed Field Ablation. S three month recovery. The other thing you should consider is; what do you have to lose giving ablation a chance. Believe me, you do not want to live with Afib if you can help it. I was on Sotalol for 15 years. adversely affected my breathing. I should be off all heart meds the last of July. Google the ablation procedure for more details.

REPLY

Some comments from me:

Generally, AF begets AF. The longer you are in AF, the more intractable it is and the more resistant to treatments of ALL kinds. This means drugs won't work, and neither will interventions such as ablation. About the only thing left for some is a pacemaker...which fortunately works very well in all but one serious case I know of.

As a result of my first observation, the sooner you get your AF treated and under control, the less likely it is that you'll progress to the more difficult forms such as 'persistent' and 'permanent'.

For most AF sufferers, the best results will come from catheter ablation where the pulmonary vein ostia is isolated by scarring the circumference with cold, heat, or the newer pulsed field varieties. Also sometimes needing ablation are the coronary sinus, the septum, and the left atrial appendage. In more rare cases, the Vein of Marshall is going to need treatment, usually with cryotherapy.

Cardioversion: it often works on early cases where the AF is truly paroxysmal. I had it done to me four times, and it failed to convert me for all but a few hours. Some people I know of have had literally scores of cardioversions, none of which lasted more than a few days or weeks. Let's face it, the heart is now electrically disordered, and while it might be shocked back into NSR, it is still disordered and is likely to revert in time. The longer this goes on, the more evolution time the heart has to continue on its path to permanent AF and possibly heart failure (really just heart insufficiency, meaning a weakened heart that won't let you run any more).

Once you have a formal diagnosis, but especially if you have weekly or daily events, you should avail yourself of the services of a highly skilled electrophysiologist. Get on a waiting list, keep your schedule as clear as you can for a few months, and have your catheter ablation to scarify the endothelium around the pulmonary veins, or around any other area where there is a re-entrant focus for the interfering signal(s).

Last sober reality for those reading if it's news: ablations only have a 75% success rate for the 'index', or first ablation. Subsequent ablations run in the 80-90% range, which is good news and means if you need that touch-up second ablation that it will likely succeed in putting you into permanent NSR. In some cases, after a few years, you'll need another touch-up ablation if/when you begin to get some palpitations. The reason is that AF is a progressive disorder. It can be put into a temporary abeyance if ablated, even if drugs work by themselves, but the heart keeps looking for other foci to bring the other signals to beat into its atrium. Once it finds one, your palpitations will commence anew. Get on the waiting list again, ideally with the same EP, and in no time you should be back in NSR.

Is some ways this is not a very encouraging post, and I'm sorry to sound somewhat negative. However, after much reading, including of the experiences of many scores of other sufferers of AF around the www, and with my own, I paint a realistic view of the current state of the problems and the art and technology associated with treating AF.

REPLY
Please sign in or register to post a reply.