The medications you are on are intended only to control the heart rate once it goes in AF and not to prevent AF from happening.
You should talk to your doctor and ask if your case is suitable for an Antiarrhythmic Drug (could be Sotalol, Flecainide, Amiodarone).
Usually AF that mostly happens during sleep is due to a strong influence of the Vagus nerve. I am not aware of any proved benefits (or of a potential harm) of Melatonin or of any other influences on the sleeping pattern.
Defitely the best time to have the ablation done is when you are still in paroxysmal AF, even more so if left atrium not enlarged.
So, this may be the window of opportunity to have the procedure done.
There are several referral centers in the US. At the heart rhythm society\'s webpage you can find information on experts in AF ablation. Can\'t give you one name, but there are several good options.
I believe that 70% after 3 procedures is not a great result for a patient with paroxysmal AF.
Anyway, you should discuss that with your doctor and you both agree look for a second expert opinion.
If you had a heart attack before you should probably on several medications and maybe those also have some side effects (dizziness may be one of these).
You should talk to your doctor to figure out the best medication regimen that you can tolerate.
Pain in the right shoulder and arm are not commonly due to neither heart problems nor esophageal reflux.
However, smoking definitely increases significantly the risk of heart problems as well as the risk of pulmonary diseases.
He should see a doctor and have those issues adequately investigated.
If you have a damaged kidney and atrial fibrillation, the Warfarin is definitely a correct anticoagulation medicine to take.
You do need those medications to control blood pressure and the heart rate. Otherwise you can seen your kidney function get worse as well as the risk of cardiovascular complications such as stroke and heart attack.
You should talk to your doctor and find an adequate medication regimen that you can tolerate.
It seems like in your case catheter ablation surely is an accepted indication, according to several different guidelines from several different international societies.
There are long term studies showing that many patients (I would say most patients) do well over the long term with catheter ablation.
The important message is that the best results are obtained before you go into persistent AF and before your left atrium becomes dilated. So, there is an ideal time frame to do it, so if you consider that don\'t miss this \"window of opportunity\". The results with persistent AF are not as good.
There is still controversy weather ablation reduces the risk of stroke. But there are some initial studies in that direction. We are currently awaiting the results of a clinical trial addressing that issue.
AF can in the future become a major problem with its consequent thromboembolic risk.
So, I would definitely consider ablation. But also, I would do it in centers that have expertise in performing lots of those procedures. In high volume centers, not only are the results better but also the complications are less commonly seen.
Depending on the severity and the location of the blockage, an interventional procedure (Angioplasty with stenting or even open heart surgery for bypass) can be indicated. In cases where the blockages are not so severe, medical therapy with medications can be indicated.
Dr. Andrea Natale
Dr. Andrea Natale is a board certified electrophysiology expert and practices at executive medical director of the Texas Cardiac Arrhythmia Institute at St. David's Medical Center in Austin, Texas. Dr. Natale also is the Senior Medical Director at Pacific Atrial Fib and Arrhythmia Center in San Francisco. He visits MetroHealth in Cleveland, and Akron General, Ohio. He has pioneered a new circumferential ultrasound vein-ablation system to correct atrial fibrillation and performed the procedure on the world's first five patients. For further details Please visit :Link
Dr. Dhanunjaya Lakkireddy
Dr. Dhanunjaya Lakkireddy, MD, F.A.C.C, FHRS. is a board certified electrophysiology expert and practices at Mid-America Cardiology and The University of Kansas Hospital Clinics in Kansas City, KS, USA. He has several distinctions in clinical and research career to his credit and serves as an associate editor for Journal of Atrial Fibrillation.For further details Please visit :Link
Dr. Dhanunjay Lakkireddy, MD, F.A.C.C, FHRS, The Kansas City Heart Rhythm Institute (KCHRI), KS, USA.
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