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

Subject: Re: A-fibs, bradycardia, and pacemaker
Forum: The Heart Forum
Topic Area: Electrophy
Posted by CCF CARDIO MD - DLB on February 12, 1999 at 17:59:45:
In Reply to: A-fibs, bradycardia, and pacemaker posted by James M. on February 12, 1999 at 13:38:17:


I am a 56-yr.-old male who has had paroxysmal atrial fibrillation (PAF) for 25 or more years. The episodes of PAF have gradually become more frequent and of longer duration, recently up to 20 hours at a time notwithstanding my routines of physical exercise, meditation, taurine, and higher doses of magnesium. At the same time, my normal heart rate has slowed (bradycardia) into the 30's at night and high 40's throughout much of the day. I am now taking Coumadin. An electrophysiological study in December found no identifiable extra sources of electricity in the left atrium. Generally agreeing that my bradycardia is contributory to my PAF, three cardiologists have recommended drug therapies (which would tend to reduce the heart rate further) and a pacemaker (to avoid dangerously slow heart rates). My daughter at Harvard Medical School heard the other day that it has been clinically observed, though not yet clinically proven, that pacemakers set at about 85 b.p.m. in bradycardiac, PAF patients can prevent the recurrence of PAF. Does this latter observation make sense? Is the link between bradycardia and PAF understood? It is possible that I could avoid drugs by going directly to a pacemaker?


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Dear James

In certain patients, bradycardia can trigger episodes of atrial fibrillation. Increasing the heart rate with a pacemaker can decrease the chances of atrial fibrillation in such patients. However, even those patients usually end up on medication to help keep the heart rate and rhythm regular.

I hope this has been useful. I wish you the best of luck. Feel free to write back.

Information provided here is for general purposes only. Specific questions should be addressed to your own doctor. 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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