A-FIB & A-FLUTTER

In 2004 I was diagnoised with a-fib and a-flutter. I have been on several different meds (cardizem, rhythmol,atenolol,sotalol}. My a-fib keeps "breaking thru" my meds. In February and December 2007 I was hospitalized with at first was thought to be v-tach. Now I am being told it wasn't v-tach, however it was a-fib and a-flutter together {I think they called it 1to1 or something like that}. Can you tell me more about this condition. I've been on a cardio net monitor and my H/R on several occasions has been 290 - 310.
The doctors think that sotalol may be causing this "rapid a-fib". Have you ever heard of this.
My cardiologist now wants me to see a EP doctor at the University Of Penn to have an RF ablation.
Is this a good place for me to go?
Is it common for a-fib to progress to this 1 to 1 rhythm?
Thanks for any information you may be able to give me.

[Michael J. McWilliams, M.D.]

Hello,
Typically when you have atrial fibrillation and/or atrial flutter, most signals from the upper chamber do not make it to the lower chamber to stimulate a beat.  In atrial flutter, 2:1 conduction is common, where every other upper chamber beat is conducted to the lower chamber chamber (example atrial or upper chamber rate of 300: lower chamber or ventricular rate 150 ---- 2 beats atrial for every one ventricular).

For some people, the conduction between the upper chamber an lower chamber can be very quick and allow 1:1 conduction, either on it's own (through normal conduction or through an extra pathway in the heart) or because the medication slowed the atrial flutter rate enough to allow 1:1 conduction.  This is a somewhat complicated concept but it does happen.

U of Penn is a great place to go for a second opinion and possible ablation.  They have lots of experience and do a lot of cases.

If you have significantly symptomatic atrial fibrillation or atrial flutter that cannot be controlled with medications, as you have, ablation is a very reasonable option.

I hope this helps, thanks for posting.

[twinbee]

Thank you for the information on the 1:1 conduction. My doctor faxed my file to an EP doctor at Univ of Penn. They called me today and told me that I need an ablation immediately. They have scheduled the procedure for next week!  I meet with the doctors on thursday.
However, on the phone they explained the procedure and told me it will take 9 hours. Does this sound right? Why will it take 9 hours?
They did tell me that they were going to try to stop both the a-fib and a-flutter. Can you tell me what the success rate is for this procedure.

Thanks for all your help

[Rick069]

A related discussion, Atrial fib was started.