heart damage by adriamycin

I was in perfect health prior to my breast cancer and treatment with Adriamycin from Nov. 2003 through Jan. 2004.  In Dec. 2006 during an extremely stressful situation, I developed congestive heart failure and atrial fibrillation, which continued until Feb. 2007 when, after some treatment with Amiodarone as well as many other meds, I had a spontaneous conversion.  

Two and one half years later, after another stressful situation, the a-fib returned and has persisted now for almost 5 months.  One electrocardioversion was successful but for only one week.  Since then, the a-fib has persisted.  I am now taking only Warfarin.  My questions are: 1) Is it possible to find out precisely what damage was done to my heart by the chemo?  2) What measures other than drugs and/or surgical procedures can help me to recover and maintain sinus rhythm?  I have always exercised regularly and continue to do so.  I am a 74 year old woman, have always been very active, am not overweight, have low blood pressure, have never smoked, have no diabetes and have a high HDL.

I have been unable thus far to have any treatment or help of any kind which does not assume that my history is not that of a typical heart patient.  Any and all information you can provide that will help me to help myself with the very mimimum of medical or surgical intervention will be most appreciated.  

[Cleveland Clinic]

Dear Carolsuzanne:  Adriamycin is known to potentially cause damage to the muscle of the heart resulting in problems with the pumping action, which could lead to congestive heart failure.  This is why the pumping action of the heart is checked prior to chemotherapy and if any issues arise during therapy as well.  These problems could be immediate or delayed.  Adriamycin is not known to cause dysrhythmias (such as A-fib).  The difficulty is that as we age, our hearts also age and while it is entirely possible that the Adriamycin could have caused some heart damage, it is unlikely to be responsible for the A-fib.  Regardless of cause, with the current body of knowledge, there would be no difference in how treatment would be approached.  The cardiologists are the best qualified to determine the best treatment for your situation.  It may not be possible to determine how much damage is related to the chemotherapy because we have no way of knowing what might have been the situation had you not had chemotherapy.