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This is an important question. If you have identified a specific and consistent trigger, then Yes, this is something that you should try to avoid. In general, there is no strong link between carbohydrate intake and AF, but people differ greatly in the triggers for their AF, so that what is not good for somebody else may have no impact on you, and vice versa.

Answer:

These are very good questions. In general, if your physician feels that you are a good candidate for ablation, then your age and other issues should not be a problem. It is important to note that there is no link to my knowledge between the ablation/anesthesia time and dementia, for any approach. The reason that only ~350 patients have had FIRM procedures thus far is that FIRM is still not generally (commercially) available, and has been tested only by a few sites on a limited case basis. However, that is likely to change with general release of the approach, since a large number of patients have requested this technique. Thanks very much for your questions.

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This is also a super question. The general answer I give my patients is \"most things in moderation\", since our goal as physicians is to treat you so that you can lead this moderation lifestyle without Afib. That said, some things definitely trigger Afib. First, any obvious precipitant of your personal AFib should be avoided. Second, too much alcohol. The data on moderate alcohol is less clear, but many of my patients have noticed that even a glass of wine can make things worse. Third, there is actually NOT much data that caffeine makes Afib worse, although again this should be taken in moderation since too much caffeine can cause many other issues. I hope that this helps.

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Thanks for your kind words. You definitely are eligible for ablation, although of course the timing of this decision is personal. It is reasonable to try a more effective medication (another choice is dofetilide). There are many reasonable ways to perform the ablation. FIRM only (without PVI) now has data to support it. I recently presented the 5-center PRECISE trial at the Heart Rhythm Society meeting, in which FIRM without PVI had a success rate of > 80%. Strengths were the very close followup for recurrence (more than most AF trials). Limitations were the relatively small patient size, and followup for only 9 months. Several centers in the U.S., and shortly in Canada, may be performing FIRM ablation.

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This is an interesting issue. One of the major reasons to have a surgical AF ablation is if you need heart surgery anyway, particularly given your mitral regurgitation. You did not mention other aspects of your history, which should be discussed with your physician including whether you have heart failure, and whether prior ablations have been tried. There have certainly been some interesting recent studies of hybrid ablation, in which a surgeon performs a through-the-chest limited procedure and an electrophysiologist also performs a procedure via your veins. However, the results of hybrid ablation have not been compared to those from traditional ablation, and the hybrid procedure requires more recovery time. There are also newer approaches to conventional percutaneous ablation that are very successful. In the end, a major factor is the comfort level you and your physician have with your local experts in each approach.

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This is an important question, for which we now have answers! There is a score known as the CHA2DS2VASc score (pronounced \"CHADSVASK\"). If you have 2 or more points, many doctors would recommend anticoagulation. The points are Congestive heart failure (1 point), High blood pressure (1 point), Age > 75 (2 points), Diabetes (1 point), prior Stroke or TIA (2 points), Vascular disease (such as angina or claudication in your legs; 1 point), Age > 65 (1 point) and Sex Category (being a woman; 1 point). This is worth discussing with your doctor. Thanks again.

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This is fascinating. The first point is that rotational movement of the neck (from side to side) and a few other movements are known to trigger heart rhythm disorders - but usually slow heart beats. The second, question is - are we sure that you are having Afib (that is, have you recorded it on a monitor such as a mobile phone app?). This is worth checking with your doctor to do a full workup, including checking the arteries in your neck and the reflexes triggered by neck movement. Thanks for sharing the very interesting story.

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This is difficult to explain, but I would like to reassure you since you feel fine with no other symptoms and normal testing. Make sure that you tell your doctor any symptoms you may have. Your pale appearance and other things could be due to very simple/non-serious things, particularly since your heart echo was normal. However, if you are still concerned, you should discuss this and the heart echo results with a cardiologist. I hope that this helps.

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I would definitely seek medical attention. If the pain is still there, call a doctor urgently or even go to the ER. Otherwise, ask to see your doctor and possibly cardiologist. Your palpitations must be worrying for you, but could be many things including several not-serious issues. Your doctor will be able to sort this out.