Dabigatran works in a different way than Warfarin. As a result serial blood tests
are not needed to detect if it is working properly. The recommended dose was
determined as a result of clinical and pre-clinical studies that investigated the
efficacy of this medication.
It is not clear if this episode of AF is related to vagal tone or alcohol. Reducing
or stopping alcohol may help. If you like to exercise one possible approach is to
continue to do so and see if AF recurs. If it does an antiarrhythmic medication may
be considered.
You husband likely has “vagal” AF. The increased frequency is not unusual and is
consistent with the natural history of AF. He seems to have failed treatment with
Flecainide. You may want to discuss with his doctor other treatment options which
include catheter ablation or trying another medication. Some medications, such as
Disopyramide can be helpful in “vagal” AF.
It is not common to have AF at age of 21. I suggest you stop alcohol. I also suggest
performing tests for the thyroid gland. It may also be useful to get ambulatory
non-invasive ecg monitoring to make sure you do not have a supra-ventricular
tachycardia that results in AF.
Your doctor is correct in saying that AF at any age can increase the risk of stroke.
However this risk is minimal in young people with no other risk factors such as
hypertension, congestive heart failure, and diabetes. I suggest you continue the
healthy life style. If you do so, it is possible that the episodes may not recur.
The amount of alcohol that can cause AF varies from one person to another. Because
your episode seems to be related to alcohol, I suggest you keep the amount of
alcohol consumption to a minimum.
Atrial fibrillation and flutter are related in some patients. More than 50% of the
patients with atrial flutter also have AF. Treating the atrial flutter does not always fix
the atrial fibrillation.
You can continue your current treatment program. However if the recurrent arrhythmia is bothersome despite these medications, you can consider catheter ablation or an alternative medical treatment plan.
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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