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AF Association
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Questions about AF

I have just been diagnosed with AF after breathlessness and pain in my neck and shoulder. I was in hospital twice with a very fast heart rate and was put onto medication (Bisoprolol, Apixaban and Digoxen). I am to have a cardioversion on Thursday and am very nervous!

I no longer have any pain and not much breathlessness, so obviously the drugs are controlling my AF. Will the cardioversion improve things even further?

I was surprised that the cardioversion is done by a nurse and that the clinic which follows later is also nurse-led. Is it usual not to have the opportunity to discuss the situation with a cardiologist? Would it be worth making a private appointment?

We are planning to go on holiday next week, a few days after the cardioversion takes place. We will be on a long-haul flight to the USA. Is there anything I should be careful of?

13 Replies

Welcome here (to a place you'd rather not be!!!) and sorry to hear that.

Firstly check with your insurance company and update them with the diagnosis and also when you are having the cardioversion. Failure to do so could render your policy invalid and you certainly don't want that to happen in the USA!!!!

Bisoprolol and digoxin do not control the AF itself. All they do is control the rate. Medicines like Flecainide control rhythm. However at this point they have decided not relevant (and many people in persistent AF are on rate control and not rhythm control),

Have you looked at the booklets on the main AFA website, which are all very good? There are three or four on there that are particularly relevant at this point.

Good luck and let us know how you get on.

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In answer to your question DCCV should return you to normal sinus rhythm (NSR) and yes you should feel much better.

Many such clinics are nurse based and trust me when I say most are better qualified than many doctors. As far as DCCV is concerned the clinic may be nurse based but there will be doctors present as they need an anaesthetist to send you to sleep while they do it. The machine is pretty much automated anyway once it is set up. Enjoy.


I'd like to reiterate what has been said by PeterWh . Please make sure your insurance company is fully aware of what is going on with your AF and treatment. Particularly important with going to US and a long flight .


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You really should ask the medical team about travelling to the States and not wanting to be a killjoy having just got back myself.....please do be sure your travel insurance is valid!!! A couple of days after the cardioversion you should feel fine...if you do fly, keep well hydrated and off any alcohol and lots of walkabouts.....well you will anyway if you drink the right amount of water!!! Good luck. John


Like BobD said, if you go back into NSR you will feel better from the instant you come round.

My EP freely admits that the rhythm nurses know as much or more than some cardiologist about AF.

And the cardioversion is pretty much done by the machine, the timing of the shock is down to milliseconds, no human could be that accurate.

I hope you are in NSR soon

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I was diagnosed with AF whilst on holiday in the USA? A trip to the Emergency by ambulance and 4 hours there where the treatment was very good, I had actually gone back into sinus rhythm before arriving in hospital. But it was recorded in the ambulance.I was flying back the next day, The bill came to over $5000 but I was insured. So do make sure you are insured. I told my insurance company before travelling again and it increased my premium by £80.00 Enjoy your holiday.

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Thank you for all the helpful replies. The insurance company have said that if the cardioversion is successful on Thursday, they will cover me. If it isn't, and I'm fit enough to go, should I ask the hospital for a letter confirming this or look for insurance elsewhere?


You need to ask the insurance company what they mean by successful. In nearly all cases the person is returned to NSR. The question is how long does the person stay in NSR. That can range from minutes to years!!!!

Unfortunately the person you get through to ion the phone is unlikely to have the knowledge or the power to decide.

You need to ask them if you are in AF are you covered or will they pay the cancellation charges.

Trying to get a letter out of the hospital is difficult at the best of times let alone in the timescale that you are working to. May be an idea to see if GP will give one.


Peter raises a good point, a friend of mine was due to go long haul after a serious heart attack and his insurance were prepared to take the risk rather than pay out cancellation cost which were significant, but they did say they would not renew his cover. Do try to get the doctor you see at your CV to confirm that you are fit to travel and note his name just in case as it is unlikely he will confirm in writing....good luck John



It is really imperative that you get it in writing from one of them before you go because neither medics at hospital nor GP will write it in your notes and if unfortunately something does happen they can write back dated caveats that could be misinterpreted. In any event in some weeks time your recollection will be much better than theirs (for you it's 1of 1 but for them you are one of hundreds) but however their word will be regarded in higher esteem and more accurate.

Be careful about one from the arrhythmia nurse because the insurance may not accept it. Check with insurance tomorrow.


Thank you for your further advice. I'm having a preliminary blood test tomorrow so I'll see what the nurse can tell me about the situation.


Today I had a successful cardioversion and my husband subsequently phoned the insurance company to ask if our policy was still valid for our trip to the USA next week. They have decided that they will refund our fares and hotel accommodation rather than cover me, as the procedure took place too close to our departure. Are there any travel companies who might cover us?


No recent experience of names so I'll leave that to others.

If you have a longstanding policy with an insurance company for pension (including if paid by your work but an individual plan)house insurance or for car insurance or medical insurance it's worth giving them a ring to see since quite often they will accept new policies for existing customers more favourably than brand new customers.

I know my stakeholder pension plan provider does.


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