Regarding your response to the poster below about his/her 50 day long atrial fib episode - our father is going through something similar. He has a CHADS score of one (only because they suspect a partially clogged artery but it’s one of those arteries in the back of the heart so they are not positive if it’s the artery or something in the diaphragm that’s showing up on the nuclear stress test – you’re right, we are confused also with this).
Here’s the question we are facing now, even though he has no bad symptoms (pulse about 80’ish), he’s approaching his 90th day of being in afib. What do you think of cardioversion or using something like flec to try to get him back to sinus rhythm? The cardiologist said it’s our decision and that he would have no problem with having him stay in afib. Doing nothing doesn’t sound right to us (other than a daily aspirin with metoprolol and a statin). Our father would rather do nothing more. Your opinion?
Converting someone back to sinus rhythm can be done either electrically (DC cardioversion) or by medications (pharmacological). Regardless of the CHADS score, a clot in the left atrium/left atrial appendage needs to be ruled out by TEE or with empiric treatment of anticoagulation for at least 4-weeks +/- confirmation by TEE.
Medications usually used for cardioversion include Class III antiarrhythmics such as amiodarone, sotalol, or dofetilide. Class Ic medications include flecainide or propafenone -- but are contraindicated in those patients who have a history of coronary artery disease of any kind. These medications need to be administered by a licensed physician.
Its your dad's life and thus his decision to make. If he has decided he wants to do nothing more and his cardiologist has discussed his options to him, then I would suggest that you honor your father's decision.
Copyright 1994-2017MedHelp International.All rights reserved. MedHelp is a division of Aptus Health.
The Content on this Site is presented in a summary fashion, and is intended to be used for educational and entertainment purposes only. It is not intended to be and should not be interpreted as medical advice or a diagnosis of any health or fitness problem, condition or disease; or a recommendation for a specific test, doctor, care provider, procedure, treatment plan, product, or course of action. Med Help International, Inc. is not a medical or healthcare provider and your use of this Site does not create a doctor / patient relationship. We disclaim all responsibility for the professional qualifications and licensing of, and services provided by, any physician or other health providers posting on or otherwise referred to on this Site and/or any Third Party Site. Never disregard the medical advice of your physician or health professional, or delay in seeking such advice, because of something you read on this Site. We offer this Site AS IS and without any warranties. By using this Site you agree to the following Terms and Conditions. If you think you may have a medical emergency, call your physician or 911 immediately.