Answer:

There are many causes of heart palpitations, and this can only be diagnosed by a heart monitor recording at the time of the palpitations. You will need to see your doctor who my order a Holter monitor (24-48 hours), Event monitor (1-2 weeks) or implantable monitor (up to 1 year).

Answer:

Your father has been treated very appropriately with Coumadin, and it is good that his INR is so very well controlled. There are many causes of swollen ankles in a man of this age, and he should be seen by a physician to assess. Often this responds to a small dose of a diuretic(water pill) such as Lasix 20 mg daily for a period of time, but only a physician seeing your father could decide this.

Answer:

Atrial fibrillation is performed safely without stopping Coumadin in most centers around the country. This avoids need for so-called bridging with heparin, and the coumadin effect can be quickly reversed if needed. People with atrial fibrillation that comes and goes(paroxysmal) are usually the best candidates for ablation, but the decision to proceed is one that only you and your cardiac EP physician can make together.

Answer:

Recommend you see a physician, either internist or cardiologist for evaluation. You a taking a common heart medicine also known as metropolol. There are many causes of \'heaviness\' in chest or abdomen, and your doctor will want to consider doing an ECG and possibly stress test.

Answer:

This is definitely not normal 4 days after an ablation procedure. If your mother cannot immediately see the doctor who performed the ablation, she should go to the hospital Emergency Room where the procedure was done.

Answer:

Having a normal angiogram test (normal coronary arteries) does not exclude electrical problems of the heart. There are many different abnormal heart rhythms that can cause palpitations, and your doctor will consider doing an ECG and other monitoring such as Holter (24-48 hours), event monitor or Zio patch monitor (up to 2 weeks) or using a small implantable hear monitor (up to 1 year). This should provide information on the exact cause of your palpitations, and allow your doctor to choose best treatment option.

Answer:

Yes - you should certainly see a physician probably starting with your Family physician or Internist. A detailed medical history and examination, together with ECG,chest x-ray and blood tests will likely help the doctor make a diagnosis, or at least exclude a serious problem. If your symptoms worsen, you should go to your nearest Emergency Room .

Answer:

It is very appropriate the gentleman is taking warfarin with a history of stroke and atrial fibrillation. There are many causes of swollen ankles in a man of this age - your doctor will be able to look for causes with a physical exam and some blood tests. Often a \'water pill\' such as Lasix 20 mg daily will help reduce the swelling.

Answer:

There are several other anti arrhythmic drugs that could be tried including propafenone, dronedarone, dofetlilide or amiodarone. Expect a 50% response from any drug (100% if it works for you!) and about 70% from Amiodarone. While all the drugs have potential side effects, particularly amoiodarone (less at low dose), there is no way to know if a specific drug will work for you without trying it. Sometimes we use Amiodaron for 3-6 months to stabilize the rhythm, and then try to discontinue. Only you and your cardiac EP specialist can decide if a second ablation is right for you - the radiation dose can be minimized using mapping systems. The overall success rate of 50% that I previously quoted is based on population studies (again if it works for you it is 100%!). Nevertheless, we want all patients considering procedures to be fully aware of success rates and risks - physicians understand how disappointing it is if a procedure is unsuccessful. Finally a heart rate in the 50s is not necessarily a sign of \'high\' vagal tone normal heart rates run 50-90 rather than the textbook range of 60-100.