Questions posted in the Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.

Question Title: WHAT ELSE CAN I DO?

Forum: The Heart Forum
Topic: Arrhythmia


i AM 57, HAVE HAD AFIB EVENTS FOR 17 YEARS. eARLY ON THEY ONLY OCCURED WHILE PLAYING TENNIS AND WHEN I BECOME
EMOTIONALLY INVOLVED WITH THE GAME, EG, I REALLY WANTED TO WIN. nO OTHR
TYPE OF EXERTION BROUGHT ON THE CONDITION. IN RECENT YEARS THE FREQUENCY
HAS INCREASED DRAMATICALLY AND THE EMOTIONAL INVOLVEMENT FACTOR HAS DECREASED.
i HAVE HAD NUMEROUS EKGS, STRESS TESTS AND LATELY OTHER HEART DIAGNOSTIC TESTS.
NO HEART CONDITIONS HAVE BEEN FOUND. I HAVE BEEN ON BETA BLOCKERS, CALCIUM BLOCKERS
AND NOW LANOXIN. I WAS ON COUMADIN AND NOW ONLY ASPIRIN. THE EPISODES STILL
COME. MY DOCTOR SEEMS TO HAVE GIVEN UP.I HAVE NOT!! ARE THERE OTHER COURSES OF TREATMENT I CAN TRY?
THANK YOU, SKIPPER

Dear Skipper, thank you for your question. Atrial fibrillation (Afib) can be a difficult problem to treat because this condition tends to recur despite our best medical therapies. There are two strategies to treat chronic afib. First, the heart rate can be controlled with lanoxin, beta blockers, or calcium channel blockers and the blood can be thinned with coumadin or aspirin (the choice is up to the physician, but if no contraindication exists, coumadin should be used since it is a more powerful blood thinner than aspirin). The blood needs to be thinned since clots can form in the atrium with afib. Second, afib can be treated with medications that are designed to convert afib to normal sinus rhythm. Often, electrical cardioversion is needed to initially convert the rhythm to sinus. However, these medications have many side effects and only work in the long-term in 50% of patients. You sound like you might have paroxysmal afib (occurs intermittently) which is more difficult to treat. If you are most bothered by the rapid heart beat, than higher doses of calcium channel blockers, beta blockers, or lanoxin may help. If the irregular heartbeat of afib, and not the rapid pulse rate, is what bothers you the most, then your physician may consider trying a medication like cordarone (amiodarone) which works best to maintain sinus rhythm. However, there are many long-term side effects with this drug so it's not right for everyone. Thus, I hope you find this information useful.

Information provided in the heart forum is for general purposes only. Only your physician can provide specific diagnoses and therapies. Please feel free to write back if you have more questions.

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