Cardiofront Logo
Jafib Logo
St. Jude Medical

August 27th, 2014
Submit Manuscript
Meet the Expert
Enter your question
Browse Questions Answered by Our Experts
OR
Search
[1] 2 3 4 5 ...    
What is the recommended cholesterol level to maintain with AFB?

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your question. There is no recommendation related to Afib. You should follow the usual guidelines for cholesterol management as in all other patients.

I have had 2 failed ablations. Before my first ablation, I sensed NO heart anomalies except during an AFib attack. Attacks usually lasted a few hours and returned to NSM spontaneously. After each ablation, I collected a new set of rhythm symptoms. My AFib attacks did not improve in duration, frequency or intensity. Before both ablations, my doctor said I was an ideal candidate--excellent physical condition with no other physical ailments. After each ablation the doctor said everything went perfectly-- he was able to induce AFib in the OR and was able to quiet it completely with ablation. My question is: wouldn't the ablation be more likely to work if I entered the OR while in a naturally occurring AFib? Then he ought to be able to see who the real problem cells are, rather than the chemically induced ones. I can put my self into AFib by running a block and then suddenly stopping.

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your insightful question. There is no better way to localize AF that if it occurs naturally and mapping is done from its beginning. We like to map and localize it before an ablation procedure to know where to ablate. I would suggest you consider a mapping guided approach as the empiric anatomic methods have not been successful.

What are the major advantages and disadvantages of phased duty-cycled RF vs cryoballoon ablation for AF? When is each approach indicated? Thanks k

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your question. These are options in catheter ablation of atrial fibrillation.The use of either can be effective and there is very little data on any preferential approach. Cryoablation has some unique risks such as phrenic nerve palsy and the other method has all the risks of radiofrequency methods. The long term outcomes of both methods are still coming in. No definite evidence based recommendation can be made at present but in failures of one technique the other may be an option.

I have congestive heart failure and working diligently to improve my health. During the day I have pre-hypertensive and just got my labs back confirming .My BP is normal and my cholesterol is down to 223.My lung function is improved and I have headway with my pervasive inflammation. I am not making any noticeable progress with my edema? Please suggest me

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your question. I would suggest that you consider evaluating the medical therapy for your heart failure with a specialist and may also consider other forms of therapy if applicable. This would be best done by a cardiologist or an electrophysiologist.

Hello Doctor, after climbing two floors by stairs, I feel very tired for next 20-25 minutes. Suddenly my heart beat increases and I had a breathe very fast with omitting feelings. I have experienced these symptoms from last 1-2 months. Please suggest is this problem is related to heart or lungs

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your question. It would seem you are having sudden changes in your heart beat that should be evaluated by a specialist. This can be due to electrical disease in the heart or other heart conditions. I would suggest that you see a cardiologist or an electrophysiologist at your earliest opportunity.

I am 50 yrs old female. In last 20 years,i have had food poisoning for two times and experienced with vomiting for both times. frequent occurance of vomiting at that time causes irregular heart rate and my heart rate has shot up to 230 beats per minute. Heart Rhythm is irregular ie;skipping and pace (230).I have been converted with adenosine. My doubt is that Is this form of AFIBand please suggest me how can i stop this from happening?

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your questions. You may have one of a variety of heart rhythm disorders encompassed by the overall category of supraventricular arrhythmias. Please consult an electrophysiologist for expert management of this condition.

Hi, I am in my early 30's, a healthy person who does not smoke or drink much alcohol or caffeine. I've asthma problems since moving to the south, and was on allergy shots and a number of inhalers, including albuterol, advair, and pulmicort. I was having exercise intolerance which I thought was my asthma, but turned out to be constant, mild a-fib with a resting heart rate of 80-100. I was put on Multaq and after an ER visit, diltiazem, which was was later taken off of becuase it was unneccesary and really made me feel horrible. I was cardioverted last week and am still on Multaq, waiting to see an electrophysiologist about ablation. My asthma symptoms are still around and giving me trouble breathing, especially at night, but I am afraid to use the inhalers now. Could using advair and then exercising put me back into a-fib or could it have some other interaction with the multaq? Also, I know it would be rare, but could the multaq be causing any of the breathing problems?

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your questions. It seems that your afib and breathing problems could be related. This should be explored with a pulmonologist and electrophysiologist. Advair should be safte and so should steroids. Multaq is unlikely to cause these effects of bronchospasm.

I have been in A/F for about 8 months and am going to have a caradioversion.while I wait for an ablation which might take 12 months as I am in the public system in Australia. My EP perscribed amiodarone to be taken prior the cardioversion and then until the ablation. I am concerned aboud harmful side effects and wonder if they are likely to develop in this time period. Is there a safer drug option? My pulse is 50-70 bpm and my ventricular ejection fracyion is 40% Thank you. Kate

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your question, Kate. Antiarrhythmic drug pretreatment makes the longer term success of a cardioversion more likely. Amiodarone is effective but quite toxic and sideeffects can easily develop within one year. We prefer to use other agents first such as sotalol, dronedarone or propafenonse. We would need to know why your ejection fraction is depressed to decide the best drug choice. Some of these drugs are contraindicated with heart failure. You may wish to dicuss this with your cardiologist.

I am a 75 year old female with AFib. Do I have to give up all caffeine or can I go back to my routine of one cup of coffee per day? I have tried decaf but it doesn't get me started. I do avoid sodas with caffeine (Coke). Will one cup of coffee with caffeine in the morning be allowed?

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your question. Caffeine in modest amounts should not be an issue so one cup of regular coffee should be fine.

long standing paroxysmal AF (since 1990's) with marked increase in frequency and ass. sx's. tach/brady episodes many times with conversion (spontaneous) and bradycardic/pause episodes randomly. tried all meds with no affect at this point. may have 2-3 episodes daily. echo ok. talking about epicardial ablation. what is the likelihood this will help me. the AF is affecting my ADL.

2014-08-06 Answered By : Dr. Sanjeev Saksena,MD, FACC, FESC, FAHA, FHRS

Answer:Thank you for your question. In view of the long history of AF, and tachy/ brady syndrome, I would prefer to do a dual site atrial pacemaker to prevent it in combination with limited ablation of the right atrium or pulmonary veins. This is done on a backgournd of antiarrhythmic drug therapy. This approach was pioneered by our group and is very effective in this situation. This is our preferred approach in the elderly, if a pacemaker is needed etc.

[1] 2 3 4 5 ...    
No.of Questions Asked in All Sessions: 899
No.of Questions Answered in All Sessions: 881

Disclaimer

1. JAFIB and the invited expert reserve the right to decline any question. The question declined will not appear in the list of questions asked.
2. The questions or advice from the expert can not be considered as alternatives to your clinician's advice. This discussion is only for educational/informational use. Your EP doctor is THE person to advice you on treatment and management of your condition.

Feedback : Your suggestion on this new initiative are much appreciated. Please write to the managing editor(editor@jafib.com) about your feedback on "Meet the Expert".
Jafib
Powered by - Jafib Team   Privacy Policy | Site Map
hits counter