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Thank you for your question. If i understand you correctly, you have high blood pressure that is controlled. In view of your age, you have a CHADsVaSC score of 3. Your sotalol regimen is once a day. Sotalol as needed is helpful in ending an episode of AF. I would make the following suggestions: 1. Sotalol is a twice daily drug and can even be given three times a day. Perhaps a full regimen of twice daily will reduce your current AF event rate. 2. Anticoagulation to reduce risk is not directly related to the amount of AF you have but to the underlying disease and demoraphic status as well. As such, you should be anticoagulated regardless of AF control. This is the best method for stroke prevention. Even if AF was fully controlled, this would be necessary. 3. A repeat ablation with mapping as we perform or Dr. Narayan does, is probably likely to be more effective than an empiric one and should be considered before you are much older. This would particulary be the case if the drug therapy is ineffective.

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In first, to confirm the relation between your symptom and heart rate is important. More precise medication adjustment to release your symptom is needed. Of course, Redo ablation including epicardial ablation can help you. However epicardial ablation is not only one answer. Conversion and syncope related with bradycardia. Medication change and modification also can help you.

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Although reduced LVEF 35%, CAD, CHF, wall thining and dyskinesis, medical approach should be the initial treatment. According to the guideline, the patient is needed for ICD. Considering for refractory medical treatment in the future, you should resgist for heart transplantation. We can recommand the stepwise treatment from medication to ICD device. However, the clinical conditions of patient will be worse rapidly, we consider directly heart transplantation.

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Thank you for your question. I think that bloody mucus may be related bloody tinged sputum. Under general anesthesia, high pressure of endotracheal tube cuffing can make the endotracheal or larynx mucosa damaged. In most case, endotracheal damage is healed spontaneously, however pain killer will relieve her symptom. Sometimes, even though endotracheal tube cuffing, aspiration pneumonia can occur. However, because she did not complaint of infection related symptom, the possibility of pneumonia is less likely. Esophageal fistula or pulmonary vein stenosis can be related with the bloody mucus or sore throat. However those complication occurs at least 3 weeks after procedure.

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At first, it¡¯s important to decide the objective of imaging study. Cardiac MRI is more specific for the wall thinning and scar of ventricular muscle. So it is more useful for evaluating patients with wall motion abnormality or evaluating the relationship of coronary artery disease with muscle abnormality. On the other hand, cardiac CT is useful for finding out the artery stenosis. Therefore, we recommend cardiac CT for this patient, because we want to know the stenosis. As stated above, cardiac CT is good for confirming the severity of artery stenosis. Cardiac calcium score is known to be related with the long term prognosis. Life expectancy or clinical outcome can be more related with calcium score than severity evaluated by cardiac CT.

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The cause of edema is various. Diligent activity is definitely helpful to your health. However it is not enough to treat heart failure completely. A few medication, for example diuretics may help you. Your effort make your heart healthier. But cause of heart failure correction and medical therapy also upgrade your status

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LIPScience cholesterol report is a particle concentration and size report, insulin resistance score. It is an index to measure lipid profile and insulin resistance. Prediabetes is diagnosed by demonstrating any one of the following: a. 100 mg/dL ¡Â fasting serum glucose level ¡Â 125 mg/dL b. fasting serum glucose level < 126 mg/dL and 140 mg/dL ¡Â 2hr OGTT (oral glucose tolerance test) ¡Â 199 mg/dL c. 5.7 % ¡Â HbA1c level ¡Â 6.4% Therefore, a diagnosis as prediabetes depends on whether your glucose level is from serum or from the result of OGTT test. Because your total cholesterol and LDL cholesterol level are elevated than normal range, management with medication such as statin or life style modification seem to be needed. Also, your HDL cholesterol level is lower than normal range, so you¡¯d better exercise or modify your diet to improve your lipid profiles.

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I would need more detail about this test. Can you be more specific? His cardiologist should answer this question.

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I would not recommend the use of marijuana