best options for afib

I am currently on rhythmol 425mg bid.  It was controlling my afib for about 9 months and then I started having episodes from weekly to now every day for about 2 hours.  I am concerned about going on sotalol and was considering an AV sequential pacemaker.  Is this an appropriate approach?

[Michael J. McWilliams, M.D.]

Rhythmol is definitely note working.
Depending on age and other factors, it might be worth thinking about an atrial fibrillation ablation. The procedure is indicated for people that fail an anti arrhythmic medication.  Sotalol, tikosyn, and amiodarone are other medical options.  In general, unless you are very old or have poor health, AV sequential pacing with an AV node ablation is considered a last resort by many.  Some physicians that were not trained it atrial fibrillation ablations are reluctant to recommend them.  If that is case, consider a second opinion from a center with experience with afib ablations.

I hope this helps.