cause of A. Fib.

I've had A. fib. for 20 yrs.
normally in excellent health
normal BP 110/70
normal RHR 60
55 yrs old
ex-athlete  
non-drinker
non-smoker
eat healthy
5' 8" 180 lbs
Lately i've been in extreme pain especially at the end of the day.
Losing sleep.
with a RHR @ 175 - 225
tried all medication known they worked for a few months but then the a fib would come back with more pain.
2 stress echo's finding heart is healthy as a 25 yr. old heart
2 cardiac ablations
5 cardioversions
3 months of  acupuncture
3 months of Chinese erbologist
currently taking coumadin 7.5 mg daily, cardizm 120 mg 2 X per day, magnesium, potassium.


Can a third ablation get me back to normal sinus rhythm permanently?
what's the success rate of third ablation?
or
should I have the mini-maze procedure? what the success rate of mini-maze?

Pacemaker is out of the question.
With a pacemaker I would still be in afib, on medication, on coumadin for possible stroke  and limited ability to exercise.

Why can't the cause be treated not the symptoms???
Obviously something is telling my atrium to beat this way and it hurts!!!

[stutterheart]

What about minimaze?

[Jerry_NJ]

You didn't say anything about how frequent (once in a while, or all the time) you AFib is active, or what the size of the left atrium is.  Those all play a important input role in predicting the success for ablation, or maze for that mater.  I have permanent AFib and an enlarged left atrium... I also had a mini-maze done when I had open heart surgery in 11/2007, I still have AFib.  I have never tried an ablation, and as I am absent any of the pain you mention, as well as have a reasonable rest HR with Metoprolol (200 mg a day) my doctors do not recommend an ablation for me.  

[drbiles]

Thanks Jerry for your comments.

I've tried all the meds. they worked for a short time but the a. fib came back even stronger.
currently taking 120mg diltiazem 2 X day Although I'm still in A. Fib. it does slow it down to a tolerable rate)
7.5 mg coumadin
I'm constantly in A. Fib.
Heart size is normal for an ex-athlete.

[Jerry_NJ]

Ablation may work for you, and worth the risk if you left atrium is not enlarged (over 5cm diameter) and you symptoms are troublesome, really lower you quality of life.  My doctor says my permanent AFib symptoms are at such a low level I should just live with them.  My live expectancy isn't improved with regaining NSR.  I even get along fairly well with Coumadin, some people don't.  I take 5 mg a day.

[hcurrie]

have you tried the medications again? you said they worked for a few months...i would start over in the order you tried them before, there may not be a way to get rid of the afib permanentely but a few months break may help ya some