I'm a 48 y/o Caucasian male at 5'6" & 200 lbs, Dx'd w/ Paroxysmal A-Fib back in 12/06. No other medical issues except pre-hypertension (135/85) & high BMI. My PCP & cardiologist initially Rx'd weight loss, stimulant avoidance, Aspirin 325mg & Atenolol 25mg/day. All labs values were normal. 24-Hr. Holter showed NSR except for 1 palpitation x 2-3 minutes. Baseline echo results after meds started: Normal left ventricular function, Mild mitral regurgitation (advised SBE prophylaxis), Peak TR regurgitation velocity of 1.46 m/s & Peak RV systolic pressure 8.5 mmHg greater than RA pressure. This last reading - peak RV systolic pressure 8.5 mmHg > RA pressure - apparently is below the normal range of 20-30 mmHg. Can you tell me what could be the causes/implications of this low reading? My cardiologist said he would be more concerned if the readings were above the normal range. To date/14 months later, my A-F/palpitation episode freqency has increased. My cardiologist increased my Atenolol dosage to 25mg, 2x/day & felt another echo is not necessary at this time. If the AF frequency/duration increase further, then rhythm control meds could be considered. What are your thoughts on this plan? Thank you very much.
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