Atrial Fibrillation persists

[Cheryl8352]

My 57yr. old husband, in excellent shape with no heart disease, was cardioverted the 1st time in Feb. for A fib. He stayed in sinus rhythm for 6 mos., then was cardioverted again and only remained in rhythm for two weeks. At that point, he was scheduled for an Ablation. This was done, along with cardioversion #3, 3 weeks ago. Since that time, he has been in constant A Fib with extremely high heart rate (150-240), until one week ago, when they changed his meds from Betapace to Cardizem and Amiodarone. They are planning to do cardioversion #4 on the 12th of Nov. if A Fib persists. He is feeling unsure of what to do now since he is worse off now than ever before. Is this the normal course of events for someone with the type of A Fib with many different areas of electrical misfiring but no underllying heart disease? His calcium score was 0 and his EF was 58. Is there something else that he can do or does he need to seek a second opinion? We are both very worried and don't know where to turn. Thanks!!

[Jerry_NJ]

I see your post slipping down without a response.  I think that is because of the complexity of the difficult situation you both face.

I am a long time AFib suffer and have had period of time (up to 18 months)  of NSR following electrocardioversions, I have had four.  The first lasted about 6 weeks, and the next two lasted about 18 months each.  The last one lasted about 5 days, and I have not had another since, August of 2008.  I have had a mini-maze procedure done when I had open heart surgery for a leaky mitral valve in November 2007.  That put me in NSR for about 30 days, than back to AFib.  In my case it may have been the leaky mitral valve that caused the AFib due to a stretching (enlargement) of my left atium.

As my symptoms are mild both my Cardiologist and EP recommend against (or more correctly refuse to do) an ablation, which I was willing to try.  They said the risks are too high given my almost normal life with AFib.  I take beta blocker to lower my HR and coumadin to reduce clot formation.  

Your case seems to highlight the risk I was warned about.  I know this doesn't help you but I put it down to let you know someone has read your post, someone who is also dealing with permanent AFib.  

The powerful drugs may lead to some help and another attempt to convert with electric shock is a low risk procedure.  I always converted, albeit I recall the doctor saying that didn't happen on the first lowest energy "hit".  But then I always converted back some time later.  I took Propafenon to hold me in NSR, and I suppose the Amiod.. will work to do the same thing.  

I think you have to wait and see what happens in the next few days, including the 4th electrocardioversion if done.  If nothing works a second ablation may be best hope.

Wishing you some luck, it is about time you got some.