I'm assuming the 154 and 42 and your heart rate. I am not sure your "silent killer" questions is regarding the heart rate or the frequent PVC's. I don't have any knowledge or experience with the right bundle block. How infrequent are your episodes? I went 8 years with no one suggesting a blood thinner until my first cardioversion. Perhaps someone else on the forum can shed some light on this. My biggest concern is your stroke risk -- I would have it calculated. I may also be looking at an ablation, so if you share what you learn you will help others too. Good luck -- keep us posted.
My episodes are infrequent and only recently had an EKG because if feel some mild chest pain. THe EKG showed a right bundle block. That lead to an echo, Holter and stress test. Holter showed a high of 154 and a low of 42 in 24 hours. Stress showed dysrhythmia and frequent PVCs. Is this the "silent killer" I hear about?
My experience was for AFib.
1) convert with meds, if that doesn't wook
2) electrocardioversion (shock) and if this works continue to treat with meds
3) when hear reverts to AFib, do again, when eclectrocardioversion no longer last for a year or more go to Ablation
4) If Ablation works may no longer need meds.
I have never had an Ablation, but I have undergone a mini-maze during heart surgery required to repair a valve. That didn't work, held for only a month.
Generalizations I believe are true.
1) clot mitigation is essential even for occasional AFib, an aspirin may be sufficient if there are no other risk factors....I'm not sure but age 60 may be counted as a risk factor.
2) conversion to normal sinus rhythm grows more difficult to reach when a heart is left in AFib - i.e., time makes AFib more resistant to change.
Having had Afib for 10 years and having had it progress, I would say you might want to have the chads2 score calculated and have your risk of clotting determined. You may be at risk for stroke. Also, afib that is not treated may lead to heart failure in the long run. I would certainly consult an EP and learn what your options are and what to expect if your afib is untreated. I think an ablation is premature -- sounds like you are doing well and your quality of life is good. You don't say how often you have episodes.
II don't think its premature if you have just Svt
don't have episodes that often maybe but.......a-fib
and a-flutter. Along with svt can ruin your day...
Its not that bad and you can only benefit from it. An ablation
now? There is a bunch of meds you can try