Atrial fibrillation

[Gunter]

Although drug therapy may eventually work for my chronic atrial fibrillation, catheter ablation has been suggested as a possible cure. This brings to mind the following questions:



1.)Are there any non-invasive tests, such as special EKG's, that might be useful to determine if catheter ablation might be successful.



2.)When drug therapy fails I have to be on Coumadine. If I should have to come off Coumadine for the dentist or surgery, is Plavix a viable substitute for a limited period of time, and why is Heparin quoted a a substitute in the Coumadine literature - is it related to the Heparin half-life compared to that of Coumadin?



3.) Is there a known correlation between the occurence of atrial fibrillation and early childhood scarlet fever?



Thanks for your time!

[CCF CARDIO MD JMF]

Dear Gunter ,



In response to your questions:



Are there any non-invasive tests, such as special EKG's, that might be useful to determine if catheter ablation might be successful.

the ECG may be helpful, but an electrophysiology study is required to truly characterize the afib circuit.



     2.)When drug therapy fails I have to be on Coumadine. If I should have to come off Coumadine for the dentist or  surgery, is Plavix a viable substitute for a limited period of time, and why is Heparin quoted a a substitute in the Coumadine literature - is it related to the Heparin half-life compared to that of Coumadin?

Heparin is a better choice around procedures because it is short acting and does not increase bleeding risk around surgery.

     3.) Is there a known correlation between the occurence of atrial fibrillation and early childhood scarlet fever?



Valvular changes caused by rheumatic/scarlet fever may be a prime cause for the developement of AFib