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Pulmonary Vein

I have Mitral Valve Prolapse, Paroxymal Atrial Fibrillation, and the last year or so many many PAC/PVC's <thousands a day> I've been evaluated by an EP doctor, who switched my meds to verapamil and corgard. I still continue to have these skipped beats although I don't feel them as much as I used to. He tells me the problem originates in my pulmonary vein and ablation won't help. He said the kind of surgery I'd need would be open heart and is still very new and experimental at this stage. He says they wouldn't consider doing it for "simple PAC's and PVC's and paroxymal atrial fib" now my question to you is do you know what he's talking about? And do you feel ablation would help me in this instance? Have you heard of this operation he's speaking of? It's very confusing as I've seen many who post on this forum that had ablations for the same type of problems, some with and without success. Also, any different meds you would try that might help more than these? I was on tenormin, didn't help anymore than the corgard. Thanks for your time!
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Avatar universal
Debra,
According to the EP, and also the other cardio I saw, I have very mild regurgitation. I'm sorry to hear of your stroke, yes, I too worry about that. So far <keeping fingers crossed> the combo of verapamil and corgard has kept the A-Fib at bay. Here's hoping it stays that way. But these skipped beats are just terrible. Going to the Dr. again this week to see if there's anything new he can try. I can't be on a blood thinner, as I am a bleeder already. I bleed a lot even with small cuts, and my menstrual cycle is already bad enough, I'd hemmorhage. It's been almost a year since I've had an episode of A-Fib, so here's hoping. Good luck to you!
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Avatar universal
Laurie,
I am not a doctor but only some one who had mitral valve prolapse and had a repair as well as Afib.The AFib usually goes hand in hand with mitral valve prolapse.What is the status of the regurgitation?Are they considering repair at some point?
I was the unfortunate victim of cavalier medical care by a cardiologist.He didn't treat my A-fib either because it only happened on occassion.Well the occassion occurred that I had a massive stroke from the "somtimes atrial fib." Anyone with atrial fib and structural changes in the heart ,this includes mitral valve prolapse should be on coumadin, if not coumadin a healthy dose of asprin to prevent clot formation.There is an abundance of literature on this topic in research articles out of Medscape.com Become informed.I said after the stroke I would rather of taken the risk of a GI bleed from coumadin  than to have had  the stroke.
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Avatar universal
Debra,
No, I don't take coumadin. My A-fib is paroxymal, I think I wasn't clear enough with the doctor when posting my question. My biggest problem is the thousands of PAC's and PVC's I get every day, some doctors have called it PSVT, the EP guy says they are benign, but they are terribly bothersome. I've only had a-fib maybe ten times in the last three years, it isn't a huge problem, but these skipped beats are. Even with the verapamil and corgard I still feel them strong sometimes, and they are always present, I feel them in my pulse if I take it with or without a jump in my chest. I want relief from them desperately. They've done an echo, holter, thalium stress test, event monitor and came back with the problem being in the pulmonary vein. He doesn't want to try me on antiarrhythmics saying sometimes they are worse than the original problem, they can be dangerous, and he said they wouldn't do the kind of operation I need unless I was to go into a-fib full time and not restore as the operation is risky. It wasn't the mapping, something else. I'm printing out what the Heart Dr. told me and bringing it to his office this week in hopes he knows what that is all about. There is also a Cleveland Clinic in Naples FL and I live nearby so hoping maybe they could do something.
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Avatar universal
I had the ablation done after valve repair because my Atrial Fib continued.I would like to ask a question?Are you on coumadin in addition to the corgard and verapimil? Your atrial fib may be from the valve as well .Have you had a echo and TEE to monitor when repair of the valve becomes necessary? Back to the coumadin, the greatest concern about atrial fib is the risk of stroke(I had one at age 46 from a fib.)Have you all discussed this? Just some food for thought.
By the way the ablation seems to be holding my afib in check.I now only take Toporol LX once a day. No episodes of heart rate in the 300 range since the ablatation.
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Avatar universal
Dear Laurie,
There are several different approaches to the treatment of afib.  The most common approach is medications.  There are many different types but unfortunately the success rate in treating afib with meds is only about 50%.  Another approach that has been around for about 10 years is a surgical approach called the "maze procedure".  This requires open heart surgery and the atrium are cut into many pieces and then sewn back together.  This can be done by itself but we prefer to do this when other open heart surgery is required such as a valve surgery.  The last option is a minimally invasive approach called a "focal afib ablation".  This procedure electrically isolates the pulmonary veins and has a cure rate of >80%.  If you would like to be considered for any of these options at the Cleveland Clinic you can make an appointment with Dr. Natale in the section of electrophysiology by calling the number below.
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