Atrial Fib/flutter and Pacemaker

I posted this question in June of this year.  I have had problems with atrial fibrillation since 1996.  I had my first cardiac ablation in Oct. 2002 with most of the work being done on the right atrium. I had my next ablation done in April of 2005 and I had a problem with my heart getting a hole in it so the procedure was stopped.  In August the cardiac ablation was finished.  I did fairly well until
late last year.  I had another cardiac ablation done in May.  I still am getting atrial fibrillation at times even with high
doses of amiodarone and metoprolol.  Over the years no other medications have worked.  My doctor is saying
a pacemaker would be the next step if this ablation does not work.  

I would like to know your thoughts and if you would recommend anything else.

You answered as follows:    that is a lot of procedures.  If the medications are not working to control your heart rates and you have slow heart rates with escalating doses of medicatoins, a pacemaker is the next step.  Sometimes we just can't get the afib to stop.  Depending on  your age, there are other medications.  I assume because you are on amiodarone, the others haven't worked either (flecainide, propafenone, sotalol, tikosyn).

The only other options is to consider a trip to Austin Texas to have Dr. Natale decide if he thinks he has something to offer the ablation.  Other large centers can help too, but Natale is very good and I trained under him.  That is where I would send afib ablations that weren't working for a second opinion.

I had a pacemaker put in early October.    I am in continous AF/flutter and many of the symptoms that I had before.   I am trying to work, but it is getting more difficult to do so.   Is it possible for me to email Dr. Natale about my situation before I travel to see him?

Thank you for your assistance.

[Michael J. McWilliams, M.D.]

I didn't see a link to contact him on his websites.  If you want his advise, it is probably best to schedule a consultation with him.  

http://andreanatale.com/

This website mentions the various sites he works from.  It sounds like you have had a lot of unsuccessful procedures.  Not everyone can be cured of atrial fib.

Good luck and thanks for posting.

[scouser costa rica]

I also have a pacemaker but this does not stop A-Fib,despite the claims of the manufacturer, and only corrects the Bradicardia caused by rate controled medication. At least when my LAF starts the HR is lower and normally around 100 which does not affect my life style. Mild exercise normally will stop my A-Fib,but check with your doctor before trying it,and also use a pulse meter.
                                          Good luck
                                                        Ian.

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