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What are options for A-Fib
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What are options for A-Fib

I am a 32 year old female with a pacemaker, that was placed about a year ago after a sinus node ablation.  Now I am in A-Fib on/off all day.  I now take coumadin, verapamil, metoprolol and tambocor.  The meds. have never worked.  My E.P. Dr. said he doesn't think meds. will work and says I need to choose between a new catheter ablation procedure, or an av node ablation.  I am very symptomatic as well. I can't lay down at night without several pillows (can't catch my breath, and I feel like my head will pop there's so much pressure, and I have trouble exerting etc.)  A recent echo. showed mild tricuspid regurg., and mild mitral regurg., also mild pulmonary hypertension, I can't remember what else).  I also had a recent V.Q. scan (my internist ordered)because I get very sharp pains at times when I breath in.  The result was low-probability.  No follow-up after that.  I also have a patent foramen ovale.

My questions are as follows:
A)Do you you have any ideas what would cause chronic a fib after a sinus node ablation?

B)Do you have an opinion as to which procedure is best to teat A-Fib?  My Dr. seems very confused about what to do.

C)Also I'm wondering about what mild pulmonary hypertension may indicate, and should it be followed up?

D) Does a low-probobility v.q. scan correlate to pulmonary hypertension?

E)Should I tell my E.P. DR. the results of the V.Q. scan the internist did?

I'm sure the  rsesults are probobaly insignificant but none of it was explained to me so I'm a little curious.  I have alot of faith in my Drs.  I truly appreciate any help or insights you have.  It all has been so much to deal with lately.  
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A)Do you you have any ideas what would cause chronic a fib after a sinus node ablation?
A: It is possible that your previous high heart rate (I assume you had the sinus node modification for inappropriate sinus tachycardia) suppressed the atrial fibrillation.  Now that the heart rate is lower the afib is manifesting.

     B)Do you have an opinion as to which procedure is best to teat A-Fib? My Dr. seems very confused about what to do.
A: I would personally go with the afib ablation.  Understand that this procedure is still very new but it has at least a 50% cure rate.  The other option would still leave you with afib and all the risks of stroke, etc.

     C)Also I'm wondering about what mild pulmonary hypertension may indicate, and should it be followed up?
A: Hard to say why you are having that.  It is something that bears keeping an eye on.

     D) Does a low-probobility v.q. scan correlate to pulmonary hypertension?
A: No, these are two separate things.  If you had a high prob scan it would be possible to have a connection but not with a low prob. scan.

     E)Should I tell my E.P. DR. the results of the V.Q. scan the internist did?
A: Yes. I would make sure he has copies.
5 Comments
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Avatar_n_tn
micaso es muy interesante: primero soy doctor en medicina ,cirujano;desde los 29 a
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Avatar_n_tn
Hello Christine,

My wife Laura is having the same symptons as you.  But it is her AV node that has been ablated.  She also has a pacemaker and continues to have the same problems.  She would like to keep in contact with you to see how you are doing and if you have any progress in treatment.  You can email her at ***@****.

Good Luck
Ray
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Avatar_n_tn
Hello Christine,

My wife Laura is having the same symptons as you.  But it is her AV node that has been ablated.  She also has a pacemaker and continues to have the same problems.  She would like to keep in contact with you to see how you are doing and if you have any progress in treatment.  You can email her at ***@****.

Good Luck
Ray
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Avatar_n_tn
I've had Arrythmias of some sort since age 19 (I'm now 44). I've been hospitalized 3 times in the last 2 months with A-Fib. Typical drugs like Quinidine, Tambicor, etc cause Torsades & V-Tac so they are out. Atenolol & Lanoxin keep my rate down when I go into A-Fib but don't prevent it anymore. I'm considering an Ablation, although I'm told it's less successful for A-Fib than other forms of SVT. Has anyone out there been "healed" of A-Fib by ablation? I've been told it can take 6-8 hours to perform - is it a nasty procedure?
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