I had a cardioversion in 2013- lasted 7 months. I just had another cardioversion on 3/17/15 and started on sotalol...back in Afib in less than a week. Getting another cardioversion will probably be a waste of time for me, so I'm going for a more aggressive approach and getting an ablation on 4/29/15.

Burn. Not even close.

So when you say "burn..not even close" that Ablation is the way to go?

I believe there is no right answer to this question. It really depends on each AF patient's total clinical picture.

Cardioversion seldom KEEPS people in sinus rhythm for years (unless a freak event or if a 1 time event and/or the cardioversion is sustained with rhythm drugs and/or you don't mind getting cardioverted multiple times ). So if you want to buy time and/or are okay with rhythm drugs and repeat cardioversions, cardioversion is fine. You might luck out. Ablation is a more long time solution (not cure). It also reduces symptoms and often rhythm drugs that didn't work prior to ablation start working after ablation.

petey

What type of afib has the best outcome with ablation?

paroxysmal

shorter history of afib

younger

patient who takes care of health, weight, and causative medical conditions

It depends on how bad your afib is. I was on solalol for about 6 months. It didnt work too well. After being on it for a week i ended up back in er. It takes like a month for the mess to get in system and start working. I had a cardioversion attempt. I was shock 4 times. 2 of those four were at 360 joules which ended up causing burn marks that lasted about a month. Remember after ur ablation u might still have afib. It takes 3 to 5 months for u to feel full effect. Don't be surprised if they have to put you back on med to help u maintain NSR. Good luck with everything.

Cardioversion can be a temporary fix for some and not work for others and it did not work for me but we are all different, as far as ablation, a lot depends on your EP and what they are more experienced with in using for ablations, some do RF, some do cyro and some do both depending on each persons case. Just be sure to find an experienced EP. Good luck!

Thanks all....as a commercial airline pilot I am grounded pending resolution of my AFib. I never even knew I had AFib till my last EKG physical in April. Last year...no AFib.

Cardiversion will get me back in the air in 4-6 weeks. Ablation in 3-4 months....

So I want to go the EZ route first

All of us want to be "fixed" and rid of our afib symptoms and complications. We each try what we believe to be best. There are no guarantees.

Knowing this, I would urge you to update techniques for reducing stress. It does seem that a lot of us have a tendency to be type A. All the other healthy choices vary with each of us....just see if there are things you can do or not do that might keep you out of afib longer.

There have been folks on DS that have had good results with cardioversions. If this is what you choose, I am cheering for you to be one of them.

I talked to man today who had a cardioversion. A year later, his wife died , he went back into afib He . self converted, went into afib again and was cardioverted for the 2nd time.
He has now been in NSR for over 10 years. He takes Flecainide. He said he lives a normal life and is very happy.

Cardioversion gets you into NSR. Dr. Calkins, when I saw him at Johns Hopkins, said cardioversion works 100% of the time, if only for 1 second. Flecainide's job is to KEEP you in NSR. Without it, maintenance of NSR is not likely UNLESS the afib was a fluke. Cardioversion changes nothing in the heart. It just resets it. If the cause remains (or you don't get an ablation or take a drug that alters the electrical properties), afib is likely to return. If it is a dilated atrium, scar tissue, thyroid issues, sleep apnea, high blood pressure, valve issues... the afib is likely to return. You could get another cardioversion, and many do, but it isn't always the solution. It is important to know that. It buys you time.

petey

Adding a bit to Pete's response,

paroxsymal AF is typically triggered by ectopic foci (abnormal electrical activity) in the 4 pulmonary veins (PVs) near where they join into the left atrium. Ablation involves burning the threshold area between the PVs and the left atrium thus electrically isolating the left atrium from the abnormal electrical activity in the PVs.

If all of the abnormal electrical activity is in the PVs and they can zap the threshold, it makes it a greater chance of success for ablation. If the abnormal electrical activity is elsewhere in the atria (left or right), it makes it harder to track them all down and zap them.

To flaflyer;

Couple of questions:

1) how did you manage to be unaware the you had afib (AF)? The 3 times I had AF episodes, I certainly was aware of the irregular banging my heart was making - in fact it woke me up at night at its onset and kept me up for its duration. If I were in continuous AF, I would get zero sleep time.

2) if they cardioverted you and put you on a rhythm drug like Flecainide, and if the drug managed to keep you in NSR for the prerequisite duration of time, would they let you fly again? Just curious.