Options w A-Fib? Cox Maze?

I have an extensive history of Afib which has worsened over the years.  I have been on all kinds of antiarrythmic medications and have had two ablations in 2009.  My arrythmia continues to disrupt my life.  My EP highly recommended Amiodarone and another ablation but I have no faith in the meds nor the ablation.  In research that I have done online I located information on a mini maze and thought that might be a better option.  I found a surgeon who does the mini maze and went to him for a consultation.  In reviewing my records he decided the Cox Maze was the best procedure because I have had so many episodes of Afib and flutter.  In addition to the rhythm issues, he told me that I also have a hole in my heart that he can repair during the surgery.  He also said I have myocardial leakage which isnt bad now.  Is a Cox Maze too extreme for me?  I have read on other boards about how Cox Maze isnt usually performed just for Afib and was concerned.  Any info you might have is appreciated.  Thanks.

[cindy707]

I know this may be an odd quesion for you but would you mind posting your age?  There is a reason for this and why i am asking..................

[Jerry_NJ]

I understand you to be taking about a maze done via open heart surgery.. that being the case I agree that it isn't normally done just for AFib cure.

Again on the open heart surgery assumption, it sounds like you have other issues that in aggregate may better justify the risk.  

I have had open heart surgery for repair my mitral valve a couple of years ago.  And as I have AFib a (cox?) minm-maze procedure was done.  It did not cure my AFib.... but I had/have an enlarged left atrium, which make AFib harder to cure.

My experience with open heart surgery is with a good (great) surgeon and a great hospital intensive care staff the surgery was easy for me and the recovery was as predicted (takes some time to get back 100%).  My surgeon gave the maze a 60% chance of success, I think in a younger person with a normal size left atrium the odds are considerably higher, maybe 90%+, nothing is guaranteed.  

[ksig]

At the age of 42, I would hope you do some research on amiodarone before you start taking it.  It is pretty toxic.  Look at the costs and benefits.

I have had 4 ablations and the last one was to ablate the AV junction. Since I already had a pacer, that ablation was the easiest to recover from.  I have had many, many fewer episodes of AFib and the runs are drastically shorter.  I no longer get to the 200+ HR any more.  That in itself makes living with AFib more manageable.  I am on one arrhythmia drug: diltiazem where as before I was on a boatload of drugs.

In my opinion, get a second opinion from another EP and check out all your options and definitely ask about amiodarone.
Good luck to you.
ksig

[bethy67]

Hi Cindy,
I am only 42 and extremely nervous about all of this.

[bethy67]

I have researched quite a bit about amiodarone and its horrible side effects.  It bothers me that a physician would prescribe it to me knowing the side effects.  He says it would be 6 months to a year but I feel that it is too long.  I have asked about pacemakers but have been given different reasons as to why they wont give me one.  

[ksig]

Here's my pacer story: I had my pacer implanted 3 years ago because I my heart rate dropped to 28 bpm one day while I was at work.  I was carted off in the ambulance to the local hospital and found that my heart rate fluctuated between 28-30 bpm.  I was admitted and taken off all arrhythmia meds and went through all the tests again.  Two days later, while in the hospital, I had a huge AFib event with a skyrocketing HR of 250+.  SO the decision was to put in a pacer.  That way, the arrhythmia meds could still be administered and no one worried about a slow HR.  Not having a slow HR maybe the reason they have not traveled down that road.  However, if they ablate the AV node, you HAVE to get one.

As far as amiodarone, I was seeing a local EP at the time and he finally prescribed it for my AFib because other meds were not working.  I refused to take it so I sought out a new EP and wound up with a doctor 3 hours away from me at a huge medical center associated with a medical school.  I have been told that Amiodarone is probably the best med on the market for AFib but the side effects are too severe.  You are quite young so my advice is to get a second opinion.  You need you life back!
ksig

[bethy67]

Its ironic - I saw another EP for a second opinion for my second ablation and we discussed antiarrythmic meds and the EP said Amiodarone is the most effective but that the side effects were bad and that he can easily prescribe it to someone in their 80s but not to me since I am (in his words) a baby.  That EP is associated with a huge medical center and teaching college.  I returned to my EP and had the second ablation done and when that proved to be unsuccessful, he mentioned Amiodarone and I said that the other EP said no way.  He prescribed it anyway and I didnt take it.  I have had additional episodes and had to go see him and again it was Amiodarone that he prescribed.  He said I would be okay 6 months to a year and I asked what happens after a year?  His reply was that the medicine is too toxic long term - I then asked why would I take it???  I really like the EP that gave me the second opinion but he is pretty far from me.  I will probably go ahead with the cox maze and hopefully be rid of this.  I am hoping that it is the hole in my heart that is causing the A-Fib but who knows.  I would give almost anything to be free of these crazy heartbeats.