ATRIAL FIBRILLATION

My father has atrial fib and has had for at least 8 years now.  It has been easily controlled by medication(lanoxin, topral, or sotolol).  Just recently he went in to atrial fib. and stayed in it,( his heart rate is normal between 60-80bpm. but he has pauses in the rhythm).  His doctor put him on coumadin which has not been any problem so far and is being regulated easily.  Is is true that some people live in atrial fib all the time? My father is 63 and is extremely active walking a mile every day and spends a great amount of time outdoors. His doctor suggested that if he is concerned about it he should try pacearone and my dad did for a couple of days and it converted him.  Because of the side effects and we have a big 3 wk. trip planned to disney and the beaches in Florida in June he got off the pacearone because of fear of the side effects and when he did he went back into atrial fib.  My father is looking into one of the new procedures offered but doesnt have an apt. with the doctor(the one that specializes in the electrical conductivity of the heart) until May 21st.  We are having a hard time deciding if he should stay on the pacearone and take a chance on the side effects or if he should just stay in the atrial fib. until his apt. with this other dr. on the 21st.  His current cardiologist is basically leaving the decision to him but we want to do what is best. We are losing sleep over this decision please help us ???? He is still on coumadin and takes an aspirin a day and really has no other major cardiac problems.  His heart rate runs between 60-8-bpm while in atrial

[CCF-M.D.-RCJ]

Lanastamp,

Thanks for the post.

The good news is that there is no "wrong" decision.  The AFFIRM trial was recently completed and reported in the New England Journal of Medicine.  This trial looked at older patients, many of whom had histories of heart disease, and found no difference in mortality or serious adverse events among the set of patients who did not aggressively pursue normal rhythm versus the set of patients who did.  The bottom line is that if the afib does not give your father serious symptoms, then deciding to not take the pacerone is a fine option.  It should be remembered that the coumadin needs to be taken appropriately, whichever decision is made.  The current cardiologist's opinion of "leaving it up to you", is fine.

Hope that helps.