Answer:

The mini maze approach still requires minimally invasive thoracotomy or thoracoscopic approach which may still be more invasive then a catheter ablation, and therefore recovery time may be longer. The mini maze does not have as good visualization of the regions that give rise to AF because of it’s minimally invasive nature and therefore may be associated with higher recurrence rates. In general the success rates with mini-maze are not as well determined as with the catheter-based percutaneous approach, and the percutaneous approach is probably safer over all. For all these reasons the mini-maze approach is not usually considered 1st line therapy. However even in people who have undergone mini-maze, it certainly is possible to undergo catheter ablation afterwards.

Answer:

Frequent APCs preceding a dose simply suggests that the previous dose may be wearing off. Your doctor will have to determine if you can tolerate a higher dose. The success rates of AF ablations are best correlated with the duration of AF (< 1 year better than > 1 year) and the type of AF – paroxysmal (reverting back to sinus rhythm within 7 days without antiarrhythmics of cardioversion) or persistent (lasting more than 7 days, or requiring cardioversion of antiarrhythmics for return of sinus rhythm). Within the 1st year of paroxysmal AF the chance of successfully eliminating AF is the highest. It is a general rule that in people with symptomatic AF that is not responding to medicines, to effectively treat AF 2 ablations are required. While some people do not require more than 1 procedure, many do. Early after AF ablation, particularly within the 1st 4 weeks but even as long as 3 months, the irritation and injury caused to the heart muscle from the ablation procedure may provoke atrial arrhythmias of all sorts. Generally arrhythmias within the 1st 2 to 3 months are not considered a recurrence of clinical AF and are actually anticipated. They usually subside by 3 months after an ablation. If atrial arrhythmias continue beyond this time, then it suggests that there may areas – possibly new, that were not evident or active before – that are giving rise to continued arrhythmias, or some of the previously ablated areas have regained activity and/or conduction.

Answer:

In many ablations may be truly curative, but sometimes the same rhythm may recur, and at other times a similar heart rhythm – not necessarily the original rhythm that was ablated – may develop over time. PVCs can arise from many different areas of the heart, and an ablation to target PVCs from one area of the heart does not guarantee that PVCs from another area will not manifest. Frequent PVCs are not dangerous themselves but it may reflect an irritability of the cardiac electrical system due to blockages in the arteries of the heart (coronary artery disease), weakening of the heart muscle (cardiomyopathy), or just excessive sensitivity of a specific location to produce extra beats (i.e. PVCs) particularly in response to stress or anxiety or any source of excess adrenaline release. Depending on the underlying condition, ventricular tachycardia can develop.

Answer:

Oral betaxolol does have an effect to slow heart rate. However the effect is not reported to be dose-related, so the effect may not necessarily achieved by simply increasing the dose of betaxolol, though the package insert does seem to contradict by communicating that a increased reduction in heart rate should be anticipated with escalating doses. If the IV medication seemed to work, then perhaps the oral form will be effective in you as well.

Answer:

Atrial enlargement itself is not usually a primary abnormality or disease, but rather develops in response to another medical condition, such as atrial fibrillation (AF), high blood pressure, valvular heart disease, and in people who’s heart is weaker than normal. Atrial enlargement does not have any mainstream treatments per se because it would ineffectual without treating the underlying condition, so addressing the underlying medical problem is where treatment strategies are focused and if effective, may allow the atria to shrink in size, sometimes back to normal. The most significant concern related to enlarged atria is the development of atrial fibrillation (AF), and the impact AF and its treatment has on you.

Answer:

Fluid and electrolyte balance is mediated by ADH and other neurohormones, and in animals regulation is effected by the LAA, however in humans it seems that this is more mediated by the right atrial appendage (RAA), so removal of the LAA should not much of an impact on fluid balance and regulation, and the relevant endocrine glands such as the adrenals, hypothalamus, and pituitary should continue to function normally. Many people retain fluid during their hospitalization and once they are mobilizing better, that fluid which was distributed in the tissues gets recirculated into the blood stream and people have increased urination, essentially to rid the body of the excess fluid.

Answer:

In some people AF seems to develop from specific triggers such as at night rather than daytime, related to caffeine and other stimulant intake as well other medical conditions such as thyroid dysfunction. Removing the triggers through lifestyle modification, and treating underlying medical conditions can sometimes prevent AF from returning. Supplements often contain non disclosed components because their overall percentage in the product is so small that it is not required to be mentioned, yet these components can include stimulants, so the use of only very specific multivitamins is recommended and other supplements should generally be avoided because their content is often not entirely known. In the medical community we rarely say AF is “cured” because there are so many common factors that increase tendency towards AF, such as simply getting older, high blood pressure, diabetes, heart disease, and other common medical problems – so if someone has AF and lifestyle modifications help prevent a recurrence for a period of time, and then AF returns for some other reason, then from the patient’s perspective it wasn’t “cured”, because their expectation is that it will never return. Sometimes a “trigger” of AF is an extra beat or another heart rhythm that then gives rise to AF – having an invasive procedure to “ablate” or burn away the areas from which the precipitating extra beats or rhythm originates, may be reasonable to prevent further AF occurrences, if medications and lifestyle modifications have not worked. What we know is that once someone develops AF, for whatever reason, even if it is suppressed that person has a higher likelihood of developing it again in the future because there is something about that patient that allowed him or her to develop AF in the first place.

Answer:

No you do not necessarily need to avoid pregnancy but you must discuss with your primary doctor, cardiologist, and or obstetrician about the medical requirements of AF and the impact of certain medicines on pregnancy and the fetus.

Answer:

There is no age limit age limit for ablation in patients with atrial fibrillation. A patient who is active, limited by atrial fibrillation, and failed medical treatment may be a candidate for this procedure.