Heart Disease Expert Forum
Treatment for A-fib
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Treatment for A-fib

I'm a 32 year old female with a pacemaker.  I posted a question previously, but I must not have been clear with my question.  I'll try better this time.  I think I was so amazed that I got on,I forgot what I wanted to ask.  Here goes.  I received a pacemaker for sick sinus syndrome caused by an ablation several months ago.  Now I am in a-fib more often than not.  My Dr. has me on tambocor, lopressor, verelan, coumadin (I also have a P.F.O.)and midodrine.  He wants to try meds. first and if they don't work have my AV node ablated.  He has already tried reprogramming my pacemaker,by turning off the rate response.  It didn't help with the rhythm, it only made it impossible for my rate to go above the set rate of the pacemaker.  I'm not doing real well so far on the meds.  I still have palps. all the time, however the ventricular rate seems slower, making them more tolerable.  My questions are:

        a)Since I already have a pacemaker why is it such a big deal to ablate the AV node?                                              
        b)How long should I try to stick it out with the  
antiarrythmic meds.?
        c)If the AV node is ablated will I remain in A fib, but
just not feel it; and if so will it weaken my heart over the years. (Dr. said I will probobaly be in A fib all the time)
        d)Is it an option to do nothing (i.e. no meds., no ablation)?
         Sorry one more
        e)My Dr. said my ekg showed wide complex tachycardia, he wasn't sure where it was coming from.  Could that be something else altogether?

Thank you so very much for your time. If you could answer even one of those questions, I would be happy.

Thanks again,

Chris
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a. As long as you have a pacemaker with leads in both the atrium and ventricle, the ablation of the AV node should not pose any excessive risk.
b. I would recommend sticking it out for at least a few months if you can.
c. Yes you would remain in afib (with its risk of stroke and the need for blood thinners). All the AV ablation will do is (hopefully) reduce your symptoms from the afib.
d. No ablation is certainly an option. You would need blood thinners to reduce the risk of stroke. Also, probably you need to be on medications to keep your heart rate form going too fast from the afib.
e. Yes. It could be afib, or it could be a ventricular arrhythmia. Only further evaluation could settle that.
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