You should definitely see an electrophysiologist to get an opinion. There are many options, depending on how long your AF has been \"persistent.\" Probably starting with a cardioversion and anti-arrhythmic drug such as dofetilide makes sense, to see how much better you feel in normal rhythm. If you feel better then ablation is an option. Standard catheter ablation may be fine, depending on how long you have had AF and how enlarged your atrium is. Near Maryland I can suggest the following: Timm Dickfield at Univ of Maryland, Hugh Calkins or Ron Berger at Johns Hopkins, Frank Marchlinski, Matt Hutchinson or Sanjay Dixit at Penn. Good luck. Let me know if I can be of further help.
Star AF2 was just recently published in NEJM and confirmed several smaller studies. I know of no follow-up planned yet. In all honesty the ablation approach for persistent AF depends on the center and electrophysiologist. I do believe the STAR AF2 results and mainly focus on wide astral PVI, ablation of any induced macro reentrant flutters, and ablation of nonPV triggers for persistent AF. I don\'t believe empiric linear or CFAE ablation has a role any more (or ever did), but others may feel differently. Flecainide is an anti arrhythmic medication used to treat AF - it can be used in many situations if you have no coronary artery disease.
Yes you have many other options. There are many other medication options - flecainide, propafenone, dofetilide to name a few. Ablation is also an option. I can\'t comment on which is best for you. You should discuss this with your cardiologist or seek an opinion from an electrophysiologist.
This is a common complaint. Alcohol is a common AF trigger, and many patients develop AF at night or when lying on the left side. I would avoid alcohol and see a cardiologist.
There are several medications that can slow down the heart rate in a fib, beta-blockers, calcium channels or digoxin. If the AF persists then cardioversion or anti arrhythmic medications can be used. Good luck.
This is too involved a question to answer without more records on your sister. She should discuss these questions with her cardiologists at Univ Washington.
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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