Aa
Son's afib
I have a 15 year old son who plays high school football but had to discontinue football due to 2 seperate afib events. However he just had an ablation that only corrected atrail flutter something he was never diagnosed with; the doctor could not get my son to go into afib; she spent the first 3.5 hours of the 6 hour procedure trying to get my son to go into afib; which never happened. Is this a good thing?
She said that he went into atrial flutter instead; 95% of the time she repeated this so she suggested we ablate the flutter because she suspected that it may be causing his afib so we told her to proceed with the procedure. After the procedure she said it was a success but i have some concerns.
My concerns are that I wonder if my son needed this procedure in the firs place; he only had two seperate events. The first afib converted on it's own within 8 hours. He had continued to practice football with no problems. the second event happened 3 weeks after the first event; he converted the next day but this time he was put on 50mg of med to be safe. His first cardiologist did perform all test; ekg and ultrasound no structual deffects at all. We had a gottent a second opinion from emory; the second cardiologist recommended the abalation because she felt two afib events were too much and he should get off meds.
Here are my questions; since my son was abalated for atrial flutter is he now fixed from atrial fib? I've read they are somewhat connected but can also be completely independent. If so, then why would the doctor assume my son is no longer at risk for afib? She said he is fine to continue to play football and stop taking the meds; what makes her feel it is now safe? She only fixed atrail flutter so this has me a little concerned. I would feel better if she came out of the procedure and said she fixed afib. It's been 3 weeks since the procedure; been playing basketball and everything with no problems; just have not let him play football yet.
She said that he went into atrial flutter instead; 95% of the time she repeated this so she suggested we ablate the flutter because she suspected that it may be causing his afib so we told her to proceed with the procedure. After the procedure she said it was a success but i have some concerns.
My concerns are that I wonder if my son needed this procedure in the firs place; he only had two seperate events. The first afib converted on it's own within 8 hours. He had continued to practice football with no problems. the second event happened 3 weeks after the first event; he converted the next day but this time he was put on 50mg of med to be safe. His first cardiologist did perform all test; ekg and ultrasound no structual deffects at all. We had a gottent a second opinion from emory; the second cardiologist recommended the abalation because she felt two afib events were too much and he should get off meds.
Here are my questions; since my son was abalated for atrial flutter is he now fixed from atrial fib? I've read they are somewhat connected but can also be completely independent. If so, then why would the doctor assume my son is no longer at risk for afib? She said he is fine to continue to play football and stop taking the meds; what makes her feel it is now safe? She only fixed atrail flutter so this has me a little concerned. I would feel better if she came out of the procedure and said she fixed afib. It's been 3 weeks since the procedure; been playing basketball and everything with no problems; just have not let him play football yet.
MEDICAL PROFESSIONAL
Dear Storm,
It’s going to be difficult for me to help you, as I don’t have very much information here. Based on what you are saying, I would believe that your son was diagnosed with atrial fibrillation (a-fib) from either an ECG or a Holter monitor. The reason that I say this is because even though it was not found in the electrophysiology (EP) laboratory, your cardiologist felt that it still exists. Unfortunately, what is found in the EP lab is not always what can be seen under awake conditions. The electrical conduction properties of the heart can be changed by anesthesia that is given to put him to sleep. Therefore, the a-fib may have been suppressed, which is why it wasn’t found. Your son apparently also had the ability to go into atrial flutter (a-flutter), although it was never demonstrated outside of the EP lab.
A-fib typically is associated with structural cardiac disease; in the absence of that, it is most frequently seen in adolescent males. I’m not sure which medication he was started on, based on your history, so I don’t know if it was enough medicine or if he had room to improve. Nor do I know what side effects were associated with the medication, which may have potentially been minimal enough to allow him to continue to play football. At our institution, we do not treat this with medications unless he has had more than two episodes of a-fib in a year. I disagree with the other posted response.
Finally, without any information from the electrophysiologist where the ablation was performed, I cannot say whether the elimination of his a-flutter has reduced his risk for return of a-fib, nor can I say what makes her say why she feels that he is safe. Usually, a-fib is typically tolerated reasonably well; I don’t know how your son responded to it, though, meaning I don’t know if he passed out, or just felt palpitations, chest pain, dizziness, etc. The location of the a-flutter may have also been that of the a-fib initiation, or it may not have been and they were unrelated. The adult data that suggests that there may be a weak relation between a-fib and a-flutter has not been demonstrated in children. Since he was not able to have a-fib induced in the EP lab, we won’t know unless he either undergoes another EP study or he has another a-fib event. In the end, you need to address these concerns with the electrophysiologist and make sure that she answers your questions and ensure that you understand exactly what the situation is with your son. She won’t be able to tell you everything, though, because the a-fib was non-inducible.
It’s going to be difficult for me to help you, as I don’t have very much information here. Based on what you are saying, I would believe that your son was diagnosed with atrial fibrillation (a-fib) from either an ECG or a Holter monitor. The reason that I say this is because even though it was not found in the electrophysiology (EP) laboratory, your cardiologist felt that it still exists. Unfortunately, what is found in the EP lab is not always what can be seen under awake conditions. The electrical conduction properties of the heart can be changed by anesthesia that is given to put him to sleep. Therefore, the a-fib may have been suppressed, which is why it wasn’t found. Your son apparently also had the ability to go into atrial flutter (a-flutter), although it was never demonstrated outside of the EP lab.
A-fib typically is associated with structural cardiac disease; in the absence of that, it is most frequently seen in adolescent males. I’m not sure which medication he was started on, based on your history, so I don’t know if it was enough medicine or if he had room to improve. Nor do I know what side effects were associated with the medication, which may have potentially been minimal enough to allow him to continue to play football. At our institution, we do not treat this with medications unless he has had more than two episodes of a-fib in a year. I disagree with the other posted response.
Finally, without any information from the electrophysiologist where the ablation was performed, I cannot say whether the elimination of his a-flutter has reduced his risk for return of a-fib, nor can I say what makes her say why she feels that he is safe. Usually, a-fib is typically tolerated reasonably well; I don’t know how your son responded to it, though, meaning I don’t know if he passed out, or just felt palpitations, chest pain, dizziness, etc. The location of the a-flutter may have also been that of the a-fib initiation, or it may not have been and they were unrelated. The adult data that suggests that there may be a weak relation between a-fib and a-flutter has not been demonstrated in children. Since he was not able to have a-fib induced in the EP lab, we won’t know unless he either undergoes another EP study or he has another a-fib event. In the end, you need to address these concerns with the electrophysiologist and make sure that she answers your questions and ensure that you understand exactly what the situation is with your son. She won’t be able to tell you everything, though, because the a-fib was non-inducible.
I am not a doctor.
I think your cardiologist is on the right path. Two events of a-fib is too much for a 15 year old. From what I understand about ablations and electrophysiology, which is admittedly limited, as you said the aflutter can sometimes cause the a-fib. So if you elimnate that pathway that is causing the a flutter, it has the potential to limit the pathway that triggers the a fib.
From what I've seen, taking a wait and see approach about the a fib is what I would do. It is possible that he may need another ablation, I 've had family that had somewhat of the same problem. I think that the need for another ablation is small, like less than 10%. I would say let him play football if he is playing basketball with no problems.
Take care and good luck.
I think your cardiologist is on the right path. Two events of a-fib is too much for a 15 year old. From what I understand about ablations and electrophysiology, which is admittedly limited, as you said the aflutter can sometimes cause the a-fib. So if you elimnate that pathway that is causing the a flutter, it has the potential to limit the pathway that triggers the a fib.
From what I've seen, taking a wait and see approach about the a fib is what I would do. It is possible that he may need another ablation, I 've had family that had somewhat of the same problem. I think that the need for another ablation is small, like less than 10%. I would say let him play football if he is playing basketball with no problems.
Take care and good luck.
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