Answer:

I am concerned about your chest pain. Please see your doctor immediately. If you cannot contact your doctor, then you should go to the Emergency room. From what you are writing, it is unclear if this pain is from the heart, chest wall muscles or some other reason, but there is no reason to take any chances. Let your physician or the ER make the decision if this is a 'simple' problem or not.

Answer:

Thanks. If you are having difficulty breathing when you try to lie down, then you should go to the ER. If things are not that severe, they you should still contact your doctor straight away to discuss this. There are many possibilities, and only your care giver who knows your full history can go through these possibilities with for.

Answer:

Thanks for your question. However, this is a very, very difficult one. In general, it is very difficult to "predict" how long any particular condition can go on for. Instead, it would be more useful for you and your father to have a long discussion with his doctor(s) to address all of these concerns. It is possible that altered medications for his heart failure may improve his health.

Answer:

It is quite common to get a "racing heart beat", and often this is a normal rhythm - sinus tachycardia - and not atrial fibrillation or another arrhythmia. It would be nice to know what the ECG showed when you had your symptoms in the ER. If this is not clear, then if the symptoms are recurrent a "wearable ECG" (event monitor or Holter) would be useful. Your doctor can then decide what course of action (if any) to take. Thanks.

Answer:

Thanks for your question. The distinction between atrial flutter and fibrillation is important, as you say, and is something that your cardiologist can probably resolve by looking at all tracings. If there is any doubt, then getting another ECG or Holter monitor (it sounds like you are in the arrhythmia frequently) would be a good idea. Once that is done, then if you cannot tolerate this (or another) medication, you would be a good candidate for ablation. Many practitioners would ablate both AF and \"atrial flutter\" (if that is indeed what it is), but what you actually have needs to be resolved with your doctors first. Thanks.

Answer:

Many thanks for this question. First, I fully agree with your decision to persevere with CPAP for sleep apnea, since many studies have shown that this treatment can improve many facets of your health, including stamina and energy levels as well as possibly helping with AF in some patients. Any form of AF ablation could certainly be considered in your case, depending on whether your symptoms are related to AF, and not sleep apnea (or something else). FIRM is certainly an option, and several centers will be able to evaluate your suitability for this. Finally, Yes, some centers have actually combined FIRM with cryoablation for pulmonary vein isolation. I hope that this answers your questions.

Answer:

This is an excellent question. Whether to continue or discontinue blood thinners, in this case Xarelto, is based upon more than whether you are in sinus rhythm at the current time. Firstly, you have recently had an ablation and so I would generally recommend to continue Xarelto for at least 8 weeks. Secondly, after that time, the decision is heavily based upon other factors in your past medical history, including prior stroke or \"mini-stroke\", diabetes, or other factors. You should discuss this, and the \"open\" left atrial appendage, with your physician to make the final decision.

Answer:

You should do an event monitor to correlate your symptoms with your heart rhythm. This can be arranged by your doctor or he can refer you to a cardiologist for it.

Answer:

I agree with doing sleep apnea study for your symptoms. You will need a heart monitor to assess for abnormal rhythm and blackout spells. The duration of monitor depends on the frequency of symptoms ( Holter monitor for daily episodes and event monitor for episodes that are less frequent). This can be arranged by your GP. You need to see your cardiologist for the blackout spells and ECG analysis.