Hello again, Resus. Team! Let's hope it turns out to be R(h)esus positive!
Naturally, I've been giving your kind posts and the problem in general a fair amount of thought, in the hope of trying to crystallise what I need to ask the consultant, not that it is likely to be the same one, it rarely is. Seeing the GP depends on having been walled in when the clinic was built. But I have a telephone appointment booked, so I look forward to helping him with his problems.
Thoughts as follow:-
AF is an electrical fault, for which there are two lines of treatment (according to mainstream medicine):-
1. Invasive methods, such as ablation, cardioversion and pacemakers. I don't know enough about ablation (although I have read your link, Chris, for which "thanks"!) but cardioversion may not be an option for me because I suspect my AF has not been sudden (would sudden AF cause a clot so quickly?). I think a pace maker would not initially be used in my case because they are for atrial fibrillation where the base heart-rate (pulse) is too high anyway. Beta blockers are used to bring the overall rate down and this often leads to the base rate being too low, so it is boosted by a pacemaker.
2. Medication. I have been prescribed Atorvastatin, though I'm not sure why (my cholesterol is only just over 5 and the proportions are good (less than 2)). I was told some time ago after a routine MOT that such a level was not considered a problem in someone with my healthy lifestyle. Incidentally, my parameters have been collated to give CHAD2S2VASC of 3 and HAS-BLED of 1. I only feature on the CHADS one by virtue of age and the fact that I have now had a TIA. The HAS-BLED one is age only, I think. These results posit a 3% chance of a further stroke.
(Chris, thank you for your mention of heart disease as a cause. There's certainly at least one poorly functioning part( LV), for which the numbers don't look good - and my mother died of heart failure. I've also read that strenuous exercise can be a factor and it may be instructive that although I've always been fit, I only took up Audax in my mid 60s, after which I did about 150 rides, including a 600 and several very hilly 400s. A significant factor may be that I did most of my riding on insufficient sleep, even the 200s, but I don't think I was ever "distressed"! Odd that strenuous exercise doesn't feature in the CHAD2S2VASC list - I thought AF was well known to be a possibility for endurance athletes.)
The other drug I have been prescribed is Edoxaban, which is an anti-coagulant. I'm a little surprised at this because when I was prescribed it, it was a month ago and I still haven't had the results of the MRI scan which is supposed to indicate whether or not I've had a bleed to the brain, or a clot. I know the latter is very much more likely, although, mercifully the echocardiogram couldn't find any obvious evidence of a thrombus in the heart. So I sort of understand the reasoning behind the anticoagulant, even ahead of the MRI results.
Both anticoagulants and statins have their downsides but the one I'm more concerned about is one I haven't been prescribed yet but might be when all the results are in. Of course, I'm talking about beta blockers. I have a basic heart-rate of about 55. That has always been the case and was again today when I took the average of four readings, taken at 3 or 4 minute intervals after a three mile walk this evening (no symptoms, as usual). These were on the BP monitor, by the way. It seems to me that beta-blockers would just bring my "natural" heart rate down to a level at which I'll need a pace-maker. I can still see a logic in that if it is actually the only way offered to me to get the AF reduced but I really don't want to go there!
So, in summary: it seems to me that in spite of the phraseology used in medical literature, drugs do not treat AF if you have an underlying low heart rate. What they do is try to ameliorate the possible effects of AF, without actually removing it. The likeliest way of "removing" AF is surgical intervention of some kind. Or can it spontaneously disappear? (Please only answer "yes" if you actually know!)
I'm aware that AF is unlikely to kill of itself, and that related stroke is a much likelier danger than a heart attack. But I also know that the heart is not intended to be pounded at AF levels and will probably weaken. It's a bit of a conundrum!
@ Chris again:- your suggestion to ask the consultant how they would treat a 40-year-old had already occurred to me. It was nice to have it emphasised by you!
@ mrcharly: A, thanks for your compliments! I'm really surprised by what's happened, too. I think it's the case that many, if not most, people who are diagnosed with A fib have no symptoms.
I think the likeliest reason for my condition is exercise-induced AF (and possible heart damage), with a little genetic disposition thrown in. Maybe Sleep Apnoea, too (I do occasionally wake up as though I've dropped down a lift shaft). I'm still awaiting the results of my brain MRI and the R-Test . The trick then will be to get the correct treatment for my case and/or learn to adjust to a different future, which I'm sure I can do - but I only want to do it if I have to!
Thank you all again. Be happy - don't worry!
I'll keep you p.....aaaaaaagh...................!