Atrial fibrillation and cardiomyopathy

Posted By  CCF CARDIO MD-APS on December 31, 1997 at 16:29:31:

In Reply to: Atrial fibrillation and cardiomyopathy posted by Marty on December 28, 1997 at 20:35:13:

: I am a 37 YOA male diagnosed with cardiomyopathy and atrial fibrillation in September 1997.   A cardioversion attempt (4 shocks) in November failed to convert me to a sinus rythem.   My question is two-fold: first, what more can be done about the atrial fibrillation to attempt to convert it and second, if I cannot convert the rythem how might this effect my bout with congestive heart failure? Thanks for the help!

[CCF CARDIO MD APS]

_
Dear Marty,
    When cardioversion fails the next step is usually to start an antiarrythmic drug, followed in the appropriate time period by reattempts at cardioversion.
The drug is given in an attempt to make cardioversion to sinus rhythm more likely as well the drug tends to keep a person in sinus rhythm once there.  There
are many drug options as well as timing of reattempts to consider especially given that the risk of stroke while in atrial fibrillation is significant.  Of note
one can reduce the risk of stroke by being on the anticoagulant drug warfarin.  
    In terms of your heart failure, sinus rhytm is the preferred rhythm since it
provides more power (about 10-20%), the equivalent of another piston in engine terms, but if the antiarrythmic drugs and cardioversion fail and you remain in heart
failure on medications for the same one might consider you a candidate for an electrophysiologic aprroach to treat the atrial fibrillation, the evaluation and
treatment are done by a cardiologist that specializes in heart rhythm disturbances.
    Only if all of the above fails to convert and or control your atrial fibrillation should you resolve to live with it so to speak.  I hope that this general
information on atrial fibrillation treatments has been helpful.
Information provided in the Heart Forum is intended for general medical informational purposes only.  Actual diagnosis and treatment of a particular medical illness
can only be made by your physician(s).