Based on what I hear from you, looks like you have responded some to the ablation. There are several factors that play a role here - how big was your left atrium, how much scar tissue was seen when they did the ablation? Is your sleep apnea under good control? are you still smoking? Most of these issues need to be addressed. Most common causes of recurrence are - Pulmonary veins reconnecting, new sources of electrical firing, developing new arrhythmic circuits around the areas of the scar that was created during your first ablation. A redo ablation can potentially address one or all of these factors and help you in improving your chances of having a successfull ablation. So please discuss with your doctor about getting a redo ablation. Seek some expert help that can do these procedures.
Eileen! Looks like you have intermittent paroxysmal AFib. If we have one or less risk factors below - age>75 yrs; hypertension; diabetes; congestive heart faiure and stroke/ministroke, you may just do fine with an aspirin a day. If you have two or more risk factors above you may have to consider warfarin therapy. Please consult your doctor for more details.
Your history is very interesting. Iam glad Magnesium supplements is keeping you out of AFib. Please make sure you are not having any silent AFib. I don't really see the need for digoxin at this point if you really don't have any AFib.
Stressful conditions, such as an infection, or dehydration, or
other physical/mental stresses can contribute to having an episode of
AF. In the same way, so too can excesses of caffeine or alcohol.
However, having AF with any of these things usually indicates that a
person is predisposed to AF and may develop it in the future. It is
not known what your risk of future AF is - you may go years without
another episode, or you may have one next month. No one has a crystal
ball. However, living a healthy and active lifestyle while limiting
caffeine and alcohol intake can help and perhaps delay the onset of
your next episode.
I am not very familiar with the herbal therapy palmetto and thus
do not know whether there is any effect on AF. You may want to
consult with your doctor and/or naturopath about this.
Multaq is known by the generic name of dronedarone. It can
prevent AF, in the same way as other antiarrhythmics, but it also
lowers and controls heart rate.
Rhythmol is known by the generic name of propafenone. It is an
effective antiarrhythmic against AF and can control AF in patients
with otherwise normal hearts. It is often prescribed with a
betablocker or calcium channel blocker to prevent the heart rate from
paradoxically speeding up. Side effects can include heart rate
slowing, gastric/bowel upset and fatigue. Rarely, the drug can cause
abnormal, serious arrhythmias if used in patients with coronary
blockages or heart failure. There have also been rare reports of
drug-induced lupus which is different from the disease lupus - it
usually causes some skin problems or laboratory abnormalities.
Low molecular weight heparins rarely cause allergic reactions.
The majority of patients tolerate it very well, aside from the
potential of bleeding. Your symptoms do not sound typical for an
allergic reaction, although this cannot be ruled out. If
anticoagulation has to be considered in the future, another brand of
low molecular weight heparin could be considered, or anticoagulation
with warfarin.
Because of the overlap in nerve inputs for both the atrium and the
esophagus, patients can develop temporary (rarely permanent)
esophageal problems post-ablation, such as reflux, belching or gas.
This usually resolves in 1-6 months. It is unlikely due to the
betapace.
Stressful conditions, such as an infection, or dehydration, or
other physical/mental stresses can contribute to having an episode of
AF. In the same way, so too can excesses of caffeine or alcohol.
However, having AF with any of these things usually indicates that a
person is predisposed to AF and may develop it in the future. It is
not known what your risk of future AF is - you may go years without
another episode, or you may have one next month. No one has a crystal
ball. However, living a healthy and active lifestyle while limiting
caffeine and alcohol intake can help and perhaps delay the onset of
your next episode.
Flecainide can cause side effects such as gastric/bowel upset,
headaches, and some mild visual disturbances. However, these are
usually short term and stop when the drug is stopped. The occurrence
of permanent side effects is very low with flecainide. It is very
effective for AF in patients with otherwise normal hearts and is
usually prescribed with a betablocker or calcium channel blocker.
However, this drug must be used carefully, since patients with heart
failure, coronary disease, or other significant heart disease may be
predisposed to developing very serious heart rhythm problems while on
this drug. The dose could be changed if side effects occur, but this
should be done with your doctor's advice.
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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