Answer:

It is difficult to answer your question without having significantly more information about the nature of your atrial fibrillation.

Answer:

Atrial flutter ablation has a very high efficacy because every patient undergoes the same ablation. Although there is not just “one point”, there is just “one area” that need to be targeted. This is located in the floor of the right atrium, the upper right chamber of the heart. Atrial fibrillation ablation generally involves ablation within the left atrium (upper left chamber of the heart). During the ablation, typically all patients undergo ablation around the pulmonary veins. However, unlike atrial flutter, patients then often need additional ablations within the left atrium (and sometimes even in the right atrium) based on the particular circumstances of their AF.

Answer:

You describe a condition known as paroxysmal atrial fibrillation (AF). You may be a good candidate for antiarrhythmic drug therapy and/or catheter ablation for long-term management of your AF given the frequency of your episodes. Dabigatran is currently not available in the United States. It should be noted, however, that currently available scientific data do not support the use of anticoagulant medications like dabigatran in an "on/off" mode that you are using. Rather, the data are limited to using the medications on a daily ongoing basis.

Answer:

Both catheter and surgical based approaches to atrial fibrillation (AF) ablation aim to create transmural lesions. Recurrences of AF occur because neither system can accomplish this goal with 100% efficacy. There are many reasons for this, including the need to limit energy delivery to prevent collateral damage and the difficulty in maintaining good contact with the tissue being targeted for ablation at all times. Nonetheless, both types of ablations can be associated with similar types of complications.

Answer:

From your question, it sounds like you were treated with a short course of oral steroids. Assuming that this is correct, I do not believe that this treatment should materially affect the likelihood of you developing atrial fibrillation.

Answer:

The left atrial appendage is the site where blood clots typically accumulate in patients with atrial fibrillation. It is now considered good practice to either ligate (tie off to close its opening) or remove the appendage in patients undergoing open heart surgery. In theory, this reduces the likelihood of blood clots forming within the heart and thus a reduced risk of stroke. I say "in theory" because there have not been prospective studies to confirm this hypothesis. There is no known downside to having the appendage ligated or removed in patients like yourself.

Answer:

From your question, it is not clear whether you mean a blood clot in the heart (such as left atrial appendage) or a part of a clot that has broken off and lodged elsewhere in the body (embolus). Blood clots in the heart are initially treated by anticoagulation with coumadin, and if present despite good therapeutic levels (INR around 3) the addition of aspirin. Rarely, clots present despite medical therapy, and depending on their particular characteristics, may need to be removed surgically. The treatment of an embolus to another part of the body than the brain also requires anticoagulation (and potentially other measures), but how this is done depends on how recently the embolus occurred, and what damage it has caused.

Answer:

Many healthy people have slow heart rates. The number alone is not as important as how an individual feels. Slow heart rates may cause fatigue, poor exercise tolerance, dizziness or even fainting. However if none of these symptoms is present, and exercise capacity (the ability to do daily activities etc) is normal, there is little reason for concern, and the exact pulse rate not important. If you have symptoms related to a slow pulse you need to discuss with your doctor the best way to deal with this (may involve stopping heart rate slowing drugs, or possibly a pacemaker)

Answer:

While levels of electrolytes such as magnesium and potassium have received a lot of press as a potential factor that influences the likelihood of having AF, most otherwise healthy people have very good internal processes for maintaining body electrolytes at optimal levels. Certain types of medical illness (diarrhea, some types of kidney disease) or drugs (water pills most commonly) can disrupt the normal body processes for maintaining electrolytes, Supplementation and monitoring may be needed. In my own experience, electrolyte levels have a minor impact on AF for most patients.