Non-symptomatic afib treatment

[patsy butch]

I'm 70 and have been in afib since last May/June.  Before that, as of 2000, I was diagnosed with paroxysmal afib and placed on Atenolol.  I have seen a cardiologist and a rhythm specialist who are urging me to decide between two option treatments:  continue my warfarin and take amiodarone or have the ablation procedure.  I do not have symptoms and have had all the tests that show a "normal" heart plus cardio version and flecainide, which did not help.  I am in afib all the time; the only way I discovered this was by checking my heart rate at the gym while cycling:  the monitor was showing my heart rate going all over the place instead a being steady as it was before May, 2006.  

Question:  The doctors in this forum and others suggest basically, "If it ain't broke, don't fix it."  How viable is this third option, especially given that my 5 older siblings and mother had the same condition and that the brother next in age to me is having open heart surgery this week- blockage and valves.  I was told that afib is not life threatening but after a while, wouldn't it affectt the heart?

[PikaPika88]

Cardio keeps saying that I didn't have tachy or fib for more than one year.  I do feel vibration and tightness in my chest always.  Comparing the echo in 2005 and 2007.  My mitral valve went from trivial to mild regurgitation.  Tricuspid valve went from trivial to moderate regurgitation.  I hope it is all the echo "artefact" or mis interpreting!

[dquenzer]

If you are not symptomatic that is good.  I had an ablation for paroxymal afib 3 years ago, but meds didn't work to keep me in and I felt tired while in afib.  Felt like my "light" had dimmed.  The ablation worked.  But the doctor was really certain that a pulmonary vein isolation would work because of my symptoms.

Afib can be hard to ablate so if you go that direction go to a REALLY good clinic.

My brother just had an ablation for flutter that he was in all the time.  He's 64.  It appears to have worked.  He wasn't symptomatic either but he likes to ski.  Skiing and blood thinners just don't mix.

If your heart is in generally good shape and you want to be active an ablation is a real viable option but a bit more risky.  One has to weigh lifestyle issues.  If it were me I would want the ablation because I don't like the idea of my blood being thinned.

Cost benefit analysis is about the only way to make the decision.  Good luck.

[Forum-M.D.-bkj]

patsy,

thanks for the post,

It's a difficult decision and there is no right answer. There are a lot of factors that change between patients such as the duration of the afib, whether its chronic or not, the presence of other stuructural disease or symtpoms, the desire to avoid long term anticoagulation and a patients desire to avoid procedures. There is no right answer.

I would discuss the options with your physician and come to a decision together. Seek a second opinion if you need to.

good luck