..this in not an adequate reaction. If your left ventricular pump function has went down to an ejection fraction of 20% and this is new information the patient needs a cardiac work up like tests detecting a coronary artery disease etc. Go back to your cardiologist, this aspect needs action!
He should explain you the exact reason for the pacemaker, significant pauses or bradycardia??
Did your Dad experience a syncope?
AF without significant bradycardia is normally not a pacemaker indication.
oral anticoagulation in a 77 yrs old male with persistente AF is of major importance. Is your Dad taking anticoagulation for stroke prophylaxis?
No, 1 hour of AF must be reported!
Please go back to your physician and ask him to check the time of the day you had your AF feeling. Still, it could be that frequent PVCs create a feeling of AF!
Restenosis might occur following stent implantation within 2-3 months; therefore in case of chest pain I recommend a low threshold to check the stent with a re-angiography
Most likely your symptoms are not a sign of impending heart attack; to be sure you might go for an echocardiography. Your symptoms are probably caused by muscle/nerves.
Yes, your overactive thyroid looks well controlled, the pulse going in AFib and out is a better situation than being in cont. AF; I think you can proceed
Personally I would recommend early ablation in case your current AF episodes are symptomatic. Guidelines recommend to test at least one antiarrhythmic drug before ablation.
Current clinical experience is, that patients get longer and longer episodes which triggers structural changes in the atria which make it more difficult to perform a successful ablation treatment.
To summarize; in case of recurrent symptomatic episodes (even when mainly vagal as in your case) I would go for early pulmonary vein disconnection
First if all, with 65 yrs and being in AFib patients in Europe would be put on oral anticoagulation to prevent stroke! In the US the perspective is slightly different, but comparing risks with the benefits I would recommed medical drug treatment with the newer drugs like rivaroxaban or dabigatran.
IN addition, with 65 yrs and a first time detected AF I would recommend cardioversion even with a low symptom burden. In case of recurrent Afib and no symptoms you might go with pure rate control.
In summary, please discuss the next steps with an electrophysiologist; topics: cardioversion and oral anticoagulation!
Normally low blood pressure without signs of heart failure is not a precursor of a heart attack. Low blood pressure and recurrent SVT´s are found in younger women, aside from the SVT treatment options, the low blood pressure is normally not dangerous.
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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