Long Term Afib

[rossi]

I am a 61 old male with a CHAD of 1 so I'm on 325 mg. aspirin daily for my afib. I am currently going into my 7th month of afib. My EP is not concerned because he said as long as my heart rate is below 100, I'm ok.

But I'm getting concerned. After being in afib for so long, is it possible I can spontaneously go back to regular rhythm on my own? I longer I'm in afib, isn't is bad for the heart somehow? Enlarged ventricle?

I've read where the options now would be either electrocardioversion or medication (flec). Which is preferable, if either? Can't we try medication first and then use electro... as a last resort?

Read where if going the electro... route, I would have to either have a TEE test done or go on bloodthinner for three weeks. Is that right and if yes, is there a preference?

Many thanks,

Getting more concerned by the day.

p.s. Just mistakenly posted in the heart disease community forum, my apologies.

[PapaOwl]

One of my favorite blogs for information on a-fib is  http://atrialfibrillationblog.com/ and sites is http://www.stopafib.org/what.cfm

Staying in a-fib will remodel your heart and it will think that is a normal rhythm making it harder to convert to NSR later and may cause fibrosis of the atrium.
Most EP's will want you to be in an INR range between 2-3 before a cardioversion to avoid throwing a clot.  The TEE will allow them to see any clots.
I have been battling a-fib for just short of three years and unfortunately do not convert back to normal sinus rhythm without a cardioversion.  I have tried 4 medications, had ten electrocardioversions and two ablations, second which also failed and the only thing currently keeping me in NSR is sotalol and whenever I wean off it to see if the ablations worked I go back into a-fib.  I did not want to be on medications the rest of my life but for now will stay on sotalol until it fails. At that point I will need to decide if another ablation is in order.  Good luck to you. Steve

[Jerry_NJ]

My experience over the past 15 years is atrial fibrillation is first treated with medications to see if that will convert to normal sinus rhythm (nsr).  If that fails the next step is to use electrocardioversion.  If that fails to go to ablation.

In my case electrocardioversion did convert me to nsr for up to 18 months at a run, but I always returned to AFib.  

My AFib symptoms are reasonably controlled with beta blockers and calcium channel blockers, and stroke risk is reduced with a blood thinner.  My doctors do not believe I have a good chance of success from an ablation, so I am just living with AFib.

To my knowledge AFib will not cause an enlargement of the either Ventricle.  The Ventricles are the strong muscle parts of the heart.  In my my case a leaky mitral valve allowed the high pressure of my left Ventricle to push into my left atrium, which was enlarged due to that pressure.  I have undergone mitral valve repair, but he damage is done, my left ventricle is enlarged, thus the low probability that an ablation will stop my AFib.

I think you should discuss with your doctor trying to get you back into nsr using drugs, and if needed, electrocardioversion.  Only you doctors can tell you if this can work for you.