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With these factors, I recommend you have a full evaluation by a cardiologist who can advise you on specifics related to your particular condition. It seems that you have stopped using tobacco and excessive alcohol - that is excellent. Thanks.

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That is a nice theory! Some of what you are saying is part of our mainstream of science - that the vagal nerve can trigger AF. However, other portions are less clear - that PVI essentially works primarily by eliminating this trigger. At this time, while the nervous component of AF is likely important, we don\'t have final answers to what ablation does in any one patient. In our work, for instance, ablation worked primarily by eliminating rotor areas. Upcoming work will try to address these excellent questions.

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These are excellent and well-informed questions. Yes, in the first 3 months after an AF ablation the heart heals and may give rise to AF or even \"flutters\" that often go away. For arrhythmia recurrence at this stage, more than 6 months after the procedure, ablating the flutter(s) was very appropriate and I\'m glad that it went well. It may be that you don\'t actually need drug therapy if the flutter ablation was successful. Drug management at this time is very person-to-person specific, and depends upon your heart health and overall state of health. While propafenone can sometimes make flutter worse, it can also be very useful in other patients. Your treating physician is the best person to make this decision with you. Best wishes

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This is an excellent question. In fact, several studies have shown that the process of PV isolation itself actually tends to isolate some special nerve endings in the heart called ganglionated plexi (or plexuses). Thus, after PVI, these GP are often already modulated. Some groups do additional modification of the GP, but they are difficult to identify based on traditional methods. The approach in my laboratory is somewhat different, and involves ablating the regions driving AF called \"rotors\" in a procedure called FIRM. These rotors are located throughout the heart, typically 2-3 per patient. Thanks again for your question.

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This is a very topical question - thanks. Your family history of high cholesterol, and calcium in your heart artery are both important pieces of information. .The iron levels you quote are interesting, but not directly related to blockages of the heart arteries. However, you should see a cardiologist about this. Even more important than what you have written are whether you feel symptoms of chest pain, chest pressure, arm pain, shortness of breath or other symptoms when you exercise. If so, or if have any untoward symptoms, you may need additional work-up including stress tests, heart scans or other tests. You are definitely going about this the right way, and a visit to a physician who can "put all the information together" will be helpful.

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Thanks. You have done the right thing to get a series of tests and relevant medical opinion. Your worry about "heart failure" is something that you should ask your cardiologist about immediately. Based on your symptoms, your physical exam and your echocardiogram, he/she should be able to tell you Yes/No with some certainty. After that, therapy may change. Your hospital admission is also a time when, typically, other investigations could be performed to save time. Please mention this to your medical team at the hospital, and have them contact your cardiologist (and other doctors) to get all the information on you.

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Thanks for your question. If you are getting "a weak feeling and disoriented", then this is not normal. However, it is not clear from your account what is causing this. It could be your heart "Palpitations", but it could also be several other things related or even unrelated to your heart. This is a time when going to see your doctor, and your cardiologist will be very useful. He/she can then do some monitoring, including an ECG that you wear hopefully during times of "palpitations" to see what they are. Based on this, and other tests, they can decide what the right therapy is for you.

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This is becoming quite a common question. In my opinion, if the original reasons to place the defibrillator were sound, then the defibrillator should not be removed and should be replaced when its battery is low. This is based, among other things, by data that (a) the first (lifesaving) defibrillator therapy can be years after implant and (b) the risk for life-threatening arrhythmias does not necessarily go away even if your heart function improves over time. Thanks for this interesting question.

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This is a super question. We are working on this now. What we do know, however, is that rotors are not always at sites that are traditionally targeted, such as sites of fractionated electrograms or low voltage, and may lie widely within the atria. Watch this space for more updates!