afib question

[redeye001]

hi, I have had afib for the last 5 years. I was taking toprol xl , cardizem, warfarin, and pacerone for the first 2 years with just moderate success in controlling the afib. 2 years ago I had the catheter ablation proceedure but still was taking 200mg of pacerone daily. It didn't cure the problem 100% but there was a noticeable improvement in duration of the episodes. when I did have an epdisode it only last a few minutes. now 2 years later the afib is back worse than before. the episodes are lasting up to 3 days and are very fatigueing. One of the symptoms I'm experiencing is pausing of the heartbeat which I didn't have before the ablation surgery.  I have never tried rhythmol or flecainide and was wondering if anyone has gotton good results using them. I spoke to my cardiologist about trying rhythmol but he didn't recommend it because I had a stent implantation about a year ago. I'm seeing my EP in 2 days to discuss what options I have left. I'm presently just taking metoprolol and warfarin. there must be some other medication I can try for this problem.

[Jerry_NJ]

Wow, you've really gone the extra mile for get the best.

I had mitral (open heart) surgery last November, and I had it done in the closest small hospital that offered that type of surgery.  I did look into the experience of the surgeon, but I suppose they all look good, board certified...  I did like the surgeon, and my mitral vial has been repaired.  I consider ablation a much simpler, lower risk, process than open heart surgery, so if I should go for that to address my ongoing AFib, I suppose I can get it done at the same hospital as my surgery.  

I had an EKG yesterday, and while I though I had drifted back into AFib, I am in fact in AFlutter.  I can tell the difference, my heart beat is very regular, just too fast, 100 when at rest, and not much more when walking around.

[twinbee]

Where did you have your first ablation done? If you can, go to one of the top hospitals or EP to consult about a second ablation. It took me 2 years and traveling to many different states to talk to the top EP's before I finally became comfortable and confident in the procedure. I went to Cleveland CLinic, Mass. General, St. Lukes in New York, John Hopkins and Univ of Penn. Some people I know thought I was crazy, but I wanted one of the best "burning" my heart.

[redeye001]

thanks for the input. a repeat ablation proceedure seems my only hope now but I just can't seem to have faith in it.. I did try sotalol but it had no effect stopping the afib episodes. I seem to have the same problem as twinbee with the meds. As I tried new meds they worked for a while but once the afib broke through they became ineffective. I also tried high doses of magnesium. for the first 2 weeks I was in sinus rhythm and then the afib broke through and the magnesium was no longer effective. I keep hoping medical science will find a cure but it looks to be way off in the future an I'm 60 now and probably looking at imminent heart failure.

[twinbee]

I was on rythmol for about 2 months for my a-fib and a-flutter. When I was first put on the drug it worked wonderful. However, within 2 months I had a bad reaction to it and I had to be taken off the med. I do know alot of people on a different forum who are taking rythmol and  they have no side effects and it does help control their a-fib. After I was taken off the rythmol I was put on sotalol and cardizem, and that seemed to help for a couple of years. Eventually, my a-fib broke thru those meds, and I decided to have an ablation done. Maybe you need to go and have another ablation to do a "touchup". It is very common to have to go in and have a second ablation.

[Jerry_NJ]

I have been on a high dose of Rythmol SR, 425 mg twice a day, and Toprol XL 50 mg twice a day.  I think the Toprol helps slow down my too high heart rate, but the AFig continues on.  I was on Propafenone prior to Rythmol.  I have also had repeated Electrocardioversions with mixed success, 2 weeks being the shortest period of steady sinus rhythm, the longest 18 months.  I have no way of knowing how the heart drugs helped, but I can say none of them alone has given me even a short term cardioversion.

Ablation and/or a pacemaker seems to be the "next" step for me.  I will discuss that with my EP appointment.  Your experience with ablation isn't encouraging me to go that way.  I may just live with AFib as I am mostly asymptomatic,  other than the need to take a anticoagulant and a reduced capacity for physical exertion.