There is no limit. However, there is not much point in doing it repeatedly if the patient continues to go back into fibrillation especially if on medicine to maintain normal rhythm. Patients can do quite well even if in fibrillation as long as the heart rate is controlled with medication.
No limit. There is no limit. However, if atrial fibrillation keeps recurring, it would make more sense to explore other options (medications, ablation) rather than to keep undergoing cardioversions - which are not risk free.
How many times can cardioversion be performed on an individual to revert atrial fib to normal sinus rhythm?
There is. No specific number or limit, however, if multiple cardioversions are needed it might be time to consider ablation or a change in medical therapy.
I am on Flecainide and Warfarin for Atrial Fibrillation and I am now in sinus rhythm. Do I also need Bisoperal Fumerate?
Maybe. Flecainide is a specific medication to prevent recurrence of atrial fib. Bisoprolol is a beta blocker and can prevent rapid heart rate if you go back to atrial fib although it is not the drug commonly use. You may have another reason that your doctor preferred this such as hypertension. Check with your prescribing doctor. It is always best to ask when given a prescription.
Yes. Flecainide should always be combined with a beta-blocker or calcium channel blocker.
For an Atrial Fibrillation patient, how critical is it to have sinus rhythm restored within a short time, assuming the patient takes NOAC full time?
Afib begets Afib. The longer you are in Afib the less likely you are to be able to be converted and maintained in NSR. It is not "critical" but certainly desirable to be restored to NSR as soon as possible. If you are fully compliant with your NOAC you could go for cardioversion at any time. No waiting required.
What is the loading oral dose cordarone (amiodarone) In old patient with atrial fibrillation returned to sinus rhythm and how to reduce its side effect?
Amiodarone. There are a number of schemes to load but to obtain levels one uses 800 mg for 5 day, 600 mg for 5 days, and 400 mg maintenance for 3-6 months and then attempt to lower dose to 200 mg daily. Side effects are followed by monitoring thyroid, chest X-ray and liver function as well as sun screen.
Do you think Atrial Fibrillation would improve with an ablation? Only remedy so far is cardioversion
Yes. RF ablation for atrial fibrillation and/or atrial flutter in good hands ought to be curative. Factors that determine success: electrophysiologists experience and record of success, duration of AF; size and function of Left atrium. Good luck!
Yes. Cardioversion is used in some patients with atrial fibrillation in an attempt to return to sinus rhythm (the normal rhythm). This is usually done in newly confirmed diagnoses of afib. Before elective cardioversion, the doctor also needs to be sure there is no clot already present in the heart. If converted to sinus, long-term Coumadin (warfarin) may not be necessary. It is needed for a short period however.
I do. We perform cardioversions as an absolutely routine part of our practice in cardiac electrophysiology. It is a safe and well-tolerated procedure which can restore normal rhythm for many patients.
Cardioversion. The shorter the duration of atrial fibrillation the more effective cardioversion is at converting the rhythm. When underlying cardiac pathology like mitral insufficiency or stenosis is present, keeping the patient out of atrial fibrillation or converting the rhythm is quite problematic. The procedure is low risk for most people if they have been anticoagulated for several weeks beforehand as needed.
If you do... Make sure that your provider is either keeping you on good anticoagulation for the 3 weeks before or performs a "tee" procedure at the time of cardioversion to minimize the stroke risk. The advantages of doing the cardioversion are that you'll know whether you feel better in sinus rhythm than you do with fib, and you'll know how easily you can hold normal (sinus) rhythm.