Atrial fibrillation is a cardiac arrhythmia associated with a number of underlying diseases. Identification and quantification of the disease is a mandatory part of the diagnostic process and influences the efficacy of any treatment. If your doctors don’t have a clue about your atrial fibrillation, I would recommend you to refer to other doctors until your clinical picture is fully allucidated. This, in turn, would influence the subsequent therapeutic strategy and possibly give you some relief and substancial benefit.
Relapses of atrial fibrillation are not uncommon. It would be important to undergo a full cardiovascular investigation. This would allow recognition of the possible causes and therapy which may, in turn, reduce the risk of AF relapses. Finally, appropriate therapy against atrial fibrillation, whether pharmacological or interventional (catheter ablation) may ultimately fix your problem and prevent risks of relapses.
Are you affected by atrial fibrillation? If not, aspirin is not indicated except if you’re suffering of a chronic ischemic heart disease. If yes, the current guidelines suggest the use of aspirin alone in a very selective population of afib patients. Please have your clinical picture be investigated by a specialist. He/she will be able to recognize the most appropiate antithrombotic protection in your case.
Nodal blocking agents are usually prescribed together with pure antiarrhythmic drugs to possibly control mean ventricular rate during atrial fibrillation relapses in case the antiarrhythmic drug is not sufficient to prevent atrial fibrillation recurrence at any time during follow up. Having a low rate control provides higher probability of relief or reduction from symptoms makes atrial fibrillation recurrences more acceptable particularly when they’re asymptomatic.
Your AF may or may not be associated with your Ischemic heart disease. If any relationship was found after comprehensive investigation of your cardiovascular system then a progression of heart disease to congestive heart failure may be identified. However, this possibility is extremely unlikely.
Yes, your thyroid should be rechecked to possibly counterbalance “slow-thinking” and lethargy, if possible. Once the thyroid function is confirmed to be optimally handled, other conditions potentially responsible for similar symptoms could be investigated by your doctor. Finally, Af recurrences may not be associated with thyroid dysfunction. In these regards, the throughoutfully investigation of your cardiovascular system is recommended. At the end of this process, a potential cause for atrial fibrillation might be identified and appropriate therapy be administered in order to prevent or cure AF recurrence.
Yes, it indicates food as a trigger. However many people have meals on a regular basis and few develop AF episodes in response to this. This condition indicates that your cardiovascular system as well as your gastro-intestinal system are required to be throughoutfully investigated. At the end of the process your cardiologist may indicate you what the best therapy option is in order to limit the relapse of AF episodes in response to food.
Reflex vagal palsy affecting the upper gastrointestinal track is an unusual side effect occurring after AF ablation (less then 1% of cases). In addition, it is not certain that your current discomfort is related to such condition (for example this may last a few days, such as following infection or intoxication). I would therefore wait a couple of days more and get further investigation if symptoms do not disappear.
Your case is certainly very articulated. It appears to me that Catheter Ablation has generated a new arrhythmia, to which we generally refer to as Atypical Atrial Flutter, which can be more symptomatic than the original atrial fibrillation. This “complication” is not infrequent and requires special care. In fact, it may occur a couple of times before it expires definitively leaving the patients with free of symptoms thereafter it may continue to recur, in which case Catheter Ablation is required. Ablation is certainly preferred to any AV-Node cut and CRT/ICD therapy as suggested to you. This latter therapy option is in fact an a last resort in case curative treatment with Ablation of the new induced arrhythmia cannot be affectively removed.
The amount of information contained in your question is limited to provide a comprehensive answer. We would need to know which type of arterial tachycardia are you suffering from. Do you have any EKG to submit at the time of atrial tachycardia? I would certainly suggest that Catheter Ablation may be considered in your case, once the characteristics of the underlying arrhythmias have been throughoutfully elucidated with an EKG. How often are you suffering from arrhythmia relapses? How much are there impacting your quality of life? How did Multaq interfere with the symptoms that you had before drug administration?
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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