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Heart Forum have been answered by doctors from The Cleveland Clinic Foundation.
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Subject: Re: Atrial Fib I am a 41 yo male and have been troubled with AF for about six years. I am presently on a daily dose of 200 mg Cordorone, 2.5 mg Coumadin and 10 mg Prinniville. It took me about two of the six years to get the condition diagnosed. For the past four years I have been seeing a cardiologist. I understand that I have mitral valve regurgitation and an enlarged atrium. I have been cardioverted six times. Four times I converted to sinus rythmm, but then shortly reverted to AF, anywhere from 2 days to two weeks. The fifth time I remained in a sinus rythmm for two years. I recently (December) reverted back to AF and was cardioverted a sixth time, converted to sinus, but then reverted to AF in a couple of days. I find AF to be a tremendous inconvenience. In sinus rythmm I can exercise anywhere from 30 to 45 minutes without stopping. I must stop for breath about every 8 to 10 minutes in AF, and my stamina is greatly diminished. I am guessing that I have gone about as far as I can with medication, and that unless I want to be hardwired to a defibrillator, that this treatment also has its limits. I am keen on pursuing ablation and valve repair as therapy. Do these treatments have potential? My cardiologist has not been enthusiastic. Am I giving up on medication too soon? My cardiologist tells me that Cordorone is a pretty heavy duty drug, are there other options. I am not ready to consider remaining in AF as an option; it is too limiting. I would appreciate your opinions and thoughts. Thanks in advance for your help. Sincerely: John -------------------------------------------------------------------------------------------------------------------- Thank you for your question. You are correct that the valvular problems are probably causing the atrial fibrillation and it may be necessary for you to have the valve fixed. There are currently no good ablation procedures for afib but you may be thinking of a surgical option called the Maze procedure. This can be done in conjunction with valve surgery. Dr. Pat McCarthy is the surgeon here who does this procedure if you are interested in coming to Cleveland. Here is some general information concerning afib. Atrial fibrillation Causes, incidence, and risk factors: The impulses may be transmitted to the ventricles in an irregular fashion, or only some of the impulses may be transmitted. This causes the ventricles to beat more rapidly than normal, resulting in a rapid or irregular pulse. The ventricles may fail to pump enough blood to meet the needs of the body. Causes of atrial fibrillation and flutter include dysfunction of the sinus node (the "natural pacemaker" of the heart) and a number of heart and lung disorders including coronary artery disease, rheumatic heart disease, mitral valve disorders, pericarditis, and others. Hyperthyroidism, hypertension, and other diseases can cause arrhythmias, as can recent heavy alcohol use (binge drinking). Some cases have no identifiable cause. Atrial flutter is most often associated with a heart attack (myocardial infarction) or surgery on the heart. Atrial fibrillation or flutter affects about 5 out of 1000 people. It can affect either sex. Atrial fibrillation is very common in the elderly, but it can occur in persons of any age. Prevention: Symptoms: sensation of feeling heart beat (palpitations) Note: Symptoms may begin and/or stop suddenly. Signs and tests: An ECG shows atrial fibrillation or atrial flutter. Continuous ambulatory cardiac monitoring--Holter monitor (24 hour test)-- may be necessary because the condition is often sporadic (sudden beginning and ending of episodes of the arrhythmia). Tests to determine the cause may include: an echocardiogram
Electrical cardioversion may be required to convert the arrhythmia to normal (sinus) rhythm. Expectations (prognosis): Complications: incomplete emptying of the atria which can reduce the amount of blood the heart can pump
The links below are good sources of information about atrial fibrillation. http://www.med-edu.com/patient/arrhythmia/atrial-fib.html 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 with additional questions. If you would like to make an appointment at the Cleveland Clinic Heart Center, please call 1-800-CCF-CARE or inquire online by using the Heart Center website at www.ccf.org/heartcenter. The Heart Center website contains a directory of the cardiology staff that can be used to select the physician best suited to address your cardiac problem.
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