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