Where to go?

Posted by ricks2025 @ricks2025, Jul 22 9:56am

I am in my mid-60's and have persistent Afib and have had it for a while. I had a cardioversion, a few months back, it restored my natural rhythm. Unfortunately it only lasted about a day and a half. My doctor wanted to put me on a drug (don't recall the name but had some real nasty side effects) in order to do another cardioversion in order set up an ablation. I realize this is the standard progression for Afib: cardioversion, ablation, pacemaker... I have read a lot about these procedures and, given my age and that I do have persistent Afib, the chances of any of these procedures working are well under 50%. I take a blood thinner now and I read that people can live a relatively normal life with Afib and blood thinners. I am just not sure going through all these procedures with minimal chances for success is really worth it. I would like to get other folks thoughts on this.

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Profile picture for sjm46 @sjm46

I am glad that all those lifestyle changes have worked for you. As I said in my comments, I did all of that too; I lost weight, gave up all alcohol and switched to limited amounts of decaf coffee. I never drank any sugary sodas or ate super salty, heavy meals. I exercise every single day. But when we were grounded in France after my husband's injury, I drank regular coffee because that was all that was available, drank an occasional glass of wine because it was so stressful, ate chocolate in their sweet rolls because it was one of the decent things available to eat. I walked miles in hot weather, drank water like a camel because it was so dry and had many sleepless nights due to concerns over his condition and our situation--and I never missed a beat! I am convinced that there are "triggers" but that is not all there is to it; everyone is different and episodes are sometimes unexplainable! I admire your efforts and I am glad it works for you, but I would hate to have all those folks out there that think these changes will be the "cure" for their A-fib to be disappointed if they still have attacks of arrhythmia. My electrophysiologist calls it a crapshoot; all those changes may seem to work, but breakthroughs are often unexplained by any causal event/behavior. Good luck; I hope you stay well!

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I have done all these things but, to be clear, my Afib is still permanent. These lifestyle changes I know are necessary to hopefully help avoid future complications but I am under no false illusions that because of them my Afib will go away.

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Profile picture for sjm46 @sjm46

I am glad that all those lifestyle changes have worked for you. As I said in my comments, I did all of that too; I lost weight, gave up all alcohol and switched to limited amounts of decaf coffee. I never drank any sugary sodas or ate super salty, heavy meals. I exercise every single day. But when we were grounded in France after my husband's injury, I drank regular coffee because that was all that was available, drank an occasional glass of wine because it was so stressful, ate chocolate in their sweet rolls because it was one of the decent things available to eat. I walked miles in hot weather, drank water like a camel because it was so dry and had many sleepless nights due to concerns over his condition and our situation--and I never missed a beat! I am convinced that there are "triggers" but that is not all there is to it; everyone is different and episodes are sometimes unexplainable! I admire your efforts and I am glad it works for you, but I would hate to have all those folks out there that think these changes will be the "cure" for their A-fib to be disappointed if they still have attacks of arrhythmia. My electrophysiologist calls it a crapshoot; all those changes may seem to work, but breakthroughs are often unexplained by any causal event/behavior. Good luck; I hope you stay well!

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To sjm46: Amen. You’ve said something that needed to be said.

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Profile picture for sjm46 @sjm46

I am 79 and I have been diagnosed with A-fib since last October, about 9 months. I had a cardioversion on 12/4/2014. I was very anxious after this but it was successful until May, 2025 when I had 3 episodes about a week apart lasting a few hours before it resolved. I have made every "lifestyle" adjustment that I can make, short of changing my age! I was ready for an ablation after I took a vacation overseas. My husband had an accident abroad and we were not able to fly home for 20 days after our tour ended. During that time, I had every stress under the sun--and no decaf available, drank some wine, walked miles in the heat to grocery store, laundromat, hospital, pharmacy, hotel--worried about where to stay, how to get home, pay bills, keep husband positive--and I never had a single missed beat! Go figure! I thought I wanted an ablation before I left and now I am not sure. I don't think age has anything to do with this. I don't think statistics have anything to do with it--50% or 80%. It is a quality of life thing for me. I hate the feeling of the arrhythmia and I can't tolerate the way it limits what I want to do. My cardiologist also tells me that A-fib "won't kill me" but it also does not make the life I have left very pleasant. It is your decision but I would not rule out discussion with a good electrophysiologist (I was referred to one who is wonderful) and the latest procedures available to give you a more realistic picture of what your choices can be. Good luck!

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Maybe it’s the fact that there were fewer food additives and preservatives in the food you were eating.
It seems like my vagus nerve and gut control my Afib. I make food and Eat at home no Afib. I eat restaurant food and most of the time I get a huge chest bubble followed by Afib in a few hours.
I need a Doctor that treats this.

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Profile picture for moski @moski

Maybe it’s the fact that there were fewer food additives and preservatives in the food you were eating.
It seems like my vagus nerve and gut control my Afib. I make food and Eat at home no Afib. I eat restaurant food and most of the time I get a huge chest bubble followed by Afib in a few hours.
I need a Doctor that treats this.

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I think that for you, this may definitely be a factor. Everyone is so individual with this. On the issue of food additives in France, let me tell you that may be possible since the food for the average citizen there us pretty unexciting. I don't care if I ever see another baguette! LOL Their selection of vegetables and meats were limited since meat is very expensive. We did eat a lot less processed food and heavy oils like mayonnaise. I never did find any peanutbutter! The first thing we did when we got back to the states was go out for a good hamburger! I wish you good health; it is cheaper to eat at home anyway!

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Profile picture for ricks2025 @ricks2025

I have, for the most part, done what you have stated above. I have made a concerted effort to cut sugar out of my diet and I haven't drank pop in years. I don't eat fast food and I rarely eat red meat or pork. I haven't given up on my coffee but I only drink one cup a day and that is probably the only caffeine I have all day. I try to drink at least 48 ounces of water a day. I still like to have a couple of beers on the weekend but rarely more than 4 at any given time. I walk for 20 minutes every morning and do a weight workout 3X a week. I honestly don't notice my Afib probably because it is constant and I have just gotten used to it. I am open to looking into other options, as long as they don't involve prescription medication. I take a blood thinner but I am not going to go on pill regimen. I watched my parents go through that and I swore I would not go down the same path.

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I hear you; while I have the A-fib in control, I do take a lot of meds--some prescribed and some OTC. Unlike you, I can't stand the feeling of being out of atrial rhythm; it just makes me so uncomfortable and annoyed. I have been told that many folks really don't feel bothered by the arrhythmia, so if it is constant, there really isn't much you can do to change that. I am holding out for an ablation at this point since the small dose of anti-arrhythmia drug I am trying has been working so far, but if it fails then I am in for plan B. The other thing that makes my situation tolerable is that my insurance company pays for most of my meds; some folks are just paying a lot for Eliquis alone. These med costs can be a real drag on someone's budget. Take good care!

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Profile picture for sjm46 @sjm46

I hear you; while I have the A-fib in control, I do take a lot of meds--some prescribed and some OTC. Unlike you, I can't stand the feeling of being out of atrial rhythm; it just makes me so uncomfortable and annoyed. I have been told that many folks really don't feel bothered by the arrhythmia, so if it is constant, there really isn't much you can do to change that. I am holding out for an ablation at this point since the small dose of anti-arrhythmia drug I am trying has been working so far, but if it fails then I am in for plan B. The other thing that makes my situation tolerable is that my insurance company pays for most of my meds; some folks are just paying a lot for Eliquis alone. These med costs can be a real drag on someone's budget. Take good care!

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One thing to consider is that, the longer you put off an ablation, the more difficult it is for the electrophysiologist to successfully block all the spurious signals. The reason is that the heart is now electrically disordered, but it continues to evolve in this process, always 'improving' itself in how to ensure it gets more and more incorrect signaling. That is to say, it continues to develop new foci or reentrants for the signals, and you'll need more and more drugs to beat it back. By the time your EP can get to you, you're very advanced and may even find that drugs no longer work at all. So, for two reasons, you should get an ablation as early, and as soon, as possible. They are: a. that your case becomes more difficult the longer you put off the procedure, and b. the heart continually remodels itself when in AF, and that means atrial enlargement, ventricular enlargement if the AF compromises the mitral valve, and eventual heart failure if it goes on for years.
So, you apparently are still in the paroxysmal stage of the disorder. That's great! It means that a simple PVI (pulmonary vein isolation) should suffice for you. But the longer you go, the more complicated and difficult it becomes, and by then you'll have twice the medication in you that you have now.
So, my message is mainly that, while things are good now, and you may have solid reasons for not wanting an ablation just yet, mind letting your heart advance itself to the point where you have more breakthrough episodes of ectopy, need more or new drugs, and you get more and more remodeling going on due to the heart's insistence that it wants to beat irregularly. Early is better when it comes to the electrically disordered heart. Ablation is now the 'gold standard' of treatment for AF.

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Profile picture for gloaming @gloaming

One thing to consider is that, the longer you put off an ablation, the more difficult it is for the electrophysiologist to successfully block all the spurious signals. The reason is that the heart is now electrically disordered, but it continues to evolve in this process, always 'improving' itself in how to ensure it gets more and more incorrect signaling. That is to say, it continues to develop new foci or reentrants for the signals, and you'll need more and more drugs to beat it back. By the time your EP can get to you, you're very advanced and may even find that drugs no longer work at all. So, for two reasons, you should get an ablation as early, and as soon, as possible. They are: a. that your case becomes more difficult the longer you put off the procedure, and b. the heart continually remodels itself when in AF, and that means atrial enlargement, ventricular enlargement if the AF compromises the mitral valve, and eventual heart failure if it goes on for years.
So, you apparently are still in the paroxysmal stage of the disorder. That's great! It means that a simple PVI (pulmonary vein isolation) should suffice for you. But the longer you go, the more complicated and difficult it becomes, and by then you'll have twice the medication in you that you have now.
So, my message is mainly that, while things are good now, and you may have solid reasons for not wanting an ablation just yet, mind letting your heart advance itself to the point where you have more breakthrough episodes of ectopy, need more or new drugs, and you get more and more remodeling going on due to the heart's insistence that it wants to beat irregularly. Early is better when it comes to the electrically disordered heart. Ablation is now the 'gold standard' of treatment for AF.

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Dear gloaming
While your message is certainly well-meaning, it communicates a level of knowledgeability and authority that goes beyond simply parroting widely available information. Many folks on this site are hurting and desperate for answers. In all fairness to them, I think it would be appropriate to preface your comments by stating the source(s) of your information, as well as reminding them that you are not a medical professional and finally urging them to seek qualified medical attention. To me, this site is most valuable when used for sharing personal experiences, not for dispensing medical advice. Just saying, thanks.

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Profile picture for nevets @nevets

Dear gloaming
While your message is certainly well-meaning, it communicates a level of knowledgeability and authority that goes beyond simply parroting widely available information. Many folks on this site are hurting and desperate for answers. In all fairness to them, I think it would be appropriate to preface your comments by stating the source(s) of your information, as well as reminding them that you are not a medical professional and finally urging them to seek qualified medical attention. To me, this site is most valuable when used for sharing personal experiences, not for dispensing medical advice. Just saying, thanks.

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I do that repeatedly. Almost every time I post. I don't post medical advice. I post what I have learned, and nothing more. If you know differently, kindly follow your own counsel.
In the spirit of good will, see this: https://www.heartrhythmjournal.com/article/S1547-5271(24)00124-3/abstract

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I appreciate any and all feedback. Thank you all for your input.

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Profile picture for sjm46 @sjm46

I am 79 and I have been diagnosed with A-fib since last October, about 9 months. I had a cardioversion on 12/4/2014. I was very anxious after this but it was successful until May, 2025 when I had 3 episodes about a week apart lasting a few hours before it resolved. I have made every "lifestyle" adjustment that I can make, short of changing my age! I was ready for an ablation after I took a vacation overseas. My husband had an accident abroad and we were not able to fly home for 20 days after our tour ended. During that time, I had every stress under the sun--and no decaf available, drank some wine, walked miles in the heat to grocery store, laundromat, hospital, pharmacy, hotel--worried about where to stay, how to get home, pay bills, keep husband positive--and I never had a single missed beat! Go figure! I thought I wanted an ablation before I left and now I am not sure. I don't think age has anything to do with this. I don't think statistics have anything to do with it--50% or 80%. It is a quality of life thing for me. I hate the feeling of the arrhythmia and I can't tolerate the way it limits what I want to do. My cardiologist also tells me that A-fib "won't kill me" but it also does not make the life I have left very pleasant. It is your decision but I would not rule out discussion with a good electrophysiologist (I was referred to one who is wonderful) and the latest procedures available to give you a more realistic picture of what your choices can be. Good luck!

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Can you please share with me what an episode is like. I’m currently here at Mayo to figure out what is going on. Have holster monitor on as I type. Have been held over to next week for test with cardio and consult. I know I am tired of my episodes and trips to the ER

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