Sotalol effectiveness

Hello

Thereafter several presentations to ER I have been diagnosed with AFib and A Flutter, both very unpleasant and I feel extremely anxious. My meds have been changed several times from amiodrone (caused over active thyroid, which is now under control), minex, then to 160mg Sotalol daily, to 240mg Sotalol. The most recent held me for 3 months but today I again went into AFib although only lasted 3 hours and I was able to stay at home.
I am nervous this dosage will not continue to hold me, what next I have been told this dosage is as high as I can take. I have also been informed that ablation process is more risky and less effective with the two, AFib and A Flutter.
Any feedback appreciated

NMAC

[twinbee]

I also suffered from a-fib and a-flutter. Sotalol did help me for awhile, but my fib/flutter did break thru. Then I was put on sotalol (240) and Cadrizem (120) together and that helped me for about 2 years. In late 2007 my a-fib and a-flutter started breaking thru the combo. I started having episodes daily. In January 08 I had an ablation done for both a-fib and a-flutter. I have been in NSR ever since. I am no longer on any meds. I don't know  why your doctor told you that an ablation for both would be less effective. I personally know several people who have had successful ablations for their fib & flutter. I personally would get a second opinion. If you can, go to a top EP or a large heart or teaching hospital. If you decide to have an ablation, I firmly believe the better and more experienced the EP, the better the ablation outcome. Good luck! Wishing you well, and wishing you enough...

[Jerry_NJ]

You didn't mention electrocardioversion followed by a lower strength med like Propafenone, that work for me a couple of time, about 18 month each.  AFib always came back.

I've had a mini-maze procedure done while undergoing open heart surgery for a mitral valve repair.  The maze held for only 30 days, in fact it may have had not effect at all as my heart was stopped for the surgery... just like an electrocardioversion.

As I have an enlarged left atrium my prognosis for a successful ablation isn't good, i.e., the probability depends on a lot of factors, including what I mentioned and how long one has been in AFib.  

You are right left atrium ablation is the most risky of ablation procedures, that is more risky than right side ablation for other done for other rhythm problems.  Still the risk is low and if your symptoms are difficult then the risk/benefit may strongly recommend an ablation.  My cardiologist and the consulting EP said my symptoms are not serious enough for them to be willing to prescribe an abaltion.  So I am on HR control and anticoagulant only.  I suffer a bit from fatigue and shortness of breath, but no noticeable symptoms when just walking around or sitting down.  

I am in permanent AFib, the worst case for difficulty to convert, you seem to be in intermittent AFib, which makes you in a much better position than I for a cure.