Answer:

Pradaxa is certainly the most effective drug that you can be administered in order to reduce the risk of stroke associated with your condition. Although your is substantially asymptomatic, I would suggest that the best therapy to consider in your case is represented by Catheter Ablation of the arrhythmic substrate. Please consult your doctor and evaluate the potential benefits and potential disadvantages of considering this therapy. If you consider this therapy, please also investigate the selection of an appropriate center with significant experience in this field. Restoration of sinus rhythm following catheter ablation of atrial fibrillation may have additional advantage in the absence of symptoms associated with your arrhythmia.

Answer:

Your condition is normally referred to as Paroxysmal atrial fibrillation. You should have your cardiovascular system being carefully checked up. In this regard, a normal EKG, a stressed test EKG, an ultrasound echocardiogram, and a 24hour holter monitoring are advisable. In addition your blood pressure should be checked and if found abnormal should be treated to restore normal blood pressure values. The outcome of the cardiovascular investigation is crucial to select the most appropriate therapies to possibly prevent future events of atrial fibrillation and restore those conditions that may have precipitated it.

Answer:

In order to accurately answer your question, it would be necessary to know a couple of additional information. For example how old are you? Do you have any underlying heart disease? If yes, which form? Do you have any left ventricular dysfunction of a large left atrial or valvular heart disease? Identification of the underlying condition, as well as evaluation of its extent are crucial to define the probability of success of subsequent atrial fibrillation ablation procedure. Did you have any improvement of your atrial fibrillation symptoms duration and discomfort following the two procedures as compared to the baseline situation? In principle, a third procedure can be proposed provided that clinical condition is suggestive of a potential benefit from an additional approach inside your heart.

Answer:

Indeed, a cardiovascular check up is not only appropriate in your case, but it is advisable. In particular, you should have your heart be investigated by means of regular EKG, a stress test EKG, an ultrasound echocardiogram and a 24 hour holter monitoring. Through this examinations, your cardiologist should be in the position to provide you with a comprehensive picture of your cardiovascular system. This would in turn give you an answer to the possible causes (hypertrophic cardiomyopathy, hypertension, and other conditions) that may be indirectly responsible for your atrial fibrillation. You should also carefully check your blood pressure, for example by systematically investigating values by three samplings per day (morning, midtime and evening) for about fifteen consecutive days. These values should be written and forwarded to your cardiologist for a throughoutful evaluation. If your blood pressure was beyond the upper limits, a specific anti-hypertensive therapy should be started. Finally, it is possible that, given the early age of first presentation and your essentially normal physical condition, atrial fibrillation does not have any apparent cause. This condition is referred to as idiopathic atrial fibrillation. In this latter case, regular annual cardiovascular screening is recommended, and treatment of single episodes, when so distant from each other, with long intermissions, would be recommended to limit the duration and the discomfort associated with atrial fibrillation relapses. Anti arrhythmic drugs usually administered in such conditions include flecainide, propathenon, sotalol, and, exceptionally, ammuterol.

Answer:

Pradaxa is certainly the most effective drug that you can be administered in order to reduce the risk of stroke associated with your condition. Although your is substantially asymptomatic, I would suggest that the best therapy to consider in your case is represented by Catheter Ablation of the arrhythmic substrate. Please consult your doctor and evaluate the potential benefits and potential disadvantages of considering this therapy. If you consider this therapy, please also investigate the selection of an appropriate center with significant experience in this field. Restoration of sinus rhythm following catheter ablation of atrial fibrillation may have additional advantage in the absence of symptoms associated with your arrhythmia.

Answer:

You’re certainly a candidate for catheter ablation of atrial fibrillation. This therapy should be performed with the aim of preventing you from future relapses of atrial fibrillation. As a consequence, less fibrillation or no fibrillation means less or no risk of stroke recurrence, respectively. The probability of success in a situation like yours ranges between 70 and 90% for the one or two subsequent catheter procedures. Today, there’s no evidence that stereotaxis ablation is associated with a better outcome as compared to the conventional catheter ablation. Whatever strategy is proposed to you, you should make sure that the centre where you’re referred has a high volume experience. Similar to what observed with any interventional or surgical procedure, high experience is associated with a high success and low complication risk

Answer:

You should be very happy with your 98% restoration of baseline neurological condition. Afib ablation represents a curative treatment for risk of afib relapses, which in your case are associated with a higher exposure to stroke recurrence. You should be aware that cure of atrial fibrillation, with stable restoration of normal sinus rhythm, does not preclude you from chronic anticoagulation treatment. This therapy should accompany you for the rest of your life with the major aim to protect you from future stroke recurrence.

Answer:

PV stenosis is an infrequent complication of catheter ablation of atrial fibrillation. It generally originates as a late response of scar tissue to the inflammatory reaction which is generated through the thermocoagulative necrosis produced by acute radiofrequency lesion deployment in the heart in the contest of the procedure. A scar may ultimately produce retracting scar that limit the lumen of the pulmonary veins the wall of which was a target of catheter ablation a few weeks before scar development. Treatment of PV stenosis is guided by symptoms. If you’ve no symptoms PV stenosis may represent an incidental finding not affecting your physiology during your entire future life. If symptoms develop, such as shortness of breath at rest or during effort or cough or hemoptysis (blood in your sputum), then pulmonary vein dilatation is recommended as a therapeutic strategy. This therapy is applied by means of balloon catheter dilatation using a catheterization strategy. PV dilatation is usually successful and may relieve you from symptoms.

Answer:

Catheter-mediated pulmonary isolation is usually the gold standard of any interventional procedure performed with the aim of curing patients with atrial fibrillation. During the procedure, the cardiologist identifies the PV anatomy and delivers radiofrequency lesions in order to electrically isolate tissue inside the pulmonary veins from the remaining left atrium, where atrial fibrillation usually propagates. Isolation of pulmonary veins prevents activation of atrial fibrillation in the left atrium whenever the arrhythmia originates from the pulmonary vein. Ablating PV provides, as you correctly speculate in your question, prevention of about 80% of all atrial fibrillations occurring in the heart. Recurrence of atrial fibrillation after ablation may either be related to reconduction across the isolation lines, not an infrequent condition, or origin from a site other than the pulmonary veins. These sites are hardly identifiable during a single catheter ablation procedure and may sometimes not be identifiable at all which make catheter ablation a nonperfect procedure with about 100% success rate in the usual patients.