This was not my first AFIB episode or cardioversion.

I feel it!

Many people have asked me how I know if my heart is out of rhythm. In my case, I feel it. In many of my previous episodes, I even know the precise moment it goes out.

In nearly all the cases I hope and pray that it’s Ectopic beats(I have written about them previously) but this year I’ve had 4 AFIB “attacks”. I call them attacks others call it an episode. Well, they attack me. My life changes immediately after I feel that beat go out.

I start thinking about my work, cycling, time in the hospital, “farm” work, church meetings, my wife, my life, children, and mother.

It changes everything I have planned for the next few days. Previously it was “sort of easy” because it was an easy in and out of the emergency room. But no! corona is here and now every man, child, dog, cat, chicken, and whatever must be tested.

What now?

In total, I’ve had about 12 cardioversion during my lifetime.

This year alone I’ve had 4 cardioversions. But I’ve also done the Cape Town Cycle Race of 67 miles (109 km) in March this year. That was about 2 months after my first cardioversion for AFIB this year.

The first one was done in the ER room because it was pre-corona. Can you remember those good old days? Receiving a cardioversion only a few hours after arriving at the ER. Aaah those were the days.

The Corona affect

My second AFIB attack was in May. How naive was I to think things would be the same. Corona only arrived in late March at our shores. In May we were only at the beginning of our corona wave.

Nurses tried to explain that I first had to be tested, while I was thinking of the braai(barbeque) later that night. My head was already made up and I tried to explain to them that this was a simple procedure and that they only had to patch me up and press the button.

I waited, in my ER bed for a while and then asked to speak to the cardiologist. Unfortunately, it was not my doctor on duty but I thought I would explain myself and be out of there in a shockingly fast time.

It was Saturday morning. I had things to do and places to go. Why was the cardiologist explaining to me about how I would have to wait? Wait for WHAT?

Corona of course! I was admitted and spent Saturday and Sunday night in the hospital. My COVID test results only arrived late Sunday afternoon and I was cardioverted Monday morning late.

The procedure

With my second cardioversion for the year, which was my longest hospital stay (for this year) because of corona, I was put on an antiarrhythmic and an anticoagulant.

I was put on Tambocor (Flecainide) an antiarrhythmic to try and get my rhythm back. Heparin an anticoagulant was also administered through an IV line.

Unfortunately, the antiarrhythmic did not work@#$%&*$#.

Joules was my next option. I think they usually cardiovert between 100–200 Joules. My first few cardioversions were with those metal paddles but in the last few years, they used electrode patches on me.

With my 1st and 4th cardioversions, no transesophageal echocardiogram (TEE) was done because the possibility for a clot was nearly zero. The reason for this was because I went to the doctor immediately and for the 4th time because I was immediately put on an anticoagulant ( Xarelto -Rivaroxaban).

According to UpToDate website, aTEE is done by putting an ultrasound probe down the throat and into the esophagus while the patient is under sedation. The probe uses sound waves to create images of the heart.

With cardioversion nr 2 and 3 I had to have the TEE done. Fortunately, I was put to sleep with all 4 my cardioversions and it actually did not make any difference to my cardioversion experience.

Recovery

The recovery after cardioversion is actually just waking up and going home. The only thing is that in all my cases I was advised that I should not drive home. After the cardioversions, I was sent home the same day.

With one of my earlier cardioversions, I did experience serious acid reflux but after receiving medication from a pharmacy it quickly went away.

So apart from that acid reflux episode, my recovery after cardioversion has been very easy and fast.

Your experience with cardioversion or similar medical intervention?

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