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Forum Name: Miscellaneous Cardiology Topics

Question: Is Abrasion effective in reversing permanent AF


 Johnny Pong - Sun Nov 01, 2009 12:25 am

Dear Doctor,

I am 56 years old and was diagnosed with sinus AF 8 years ago by my cardiologist and have been taking amiodarone for the whole time until recently when my my endocrinologist stopped the amiodarone due to hypothyroidism. When my hypothyroidism was reverted to normal, my cardiologist told me that the amiodarone is no longer effective with me and my AF had became permanent. With that, he prescribed warfarin for me to prevent stroke.

My question is... what is the chances of having abrasion to revert my permanent AF to sinus level.

Hope to hear from you.

Best regards,
Johnny
 John Kenyon, CNA - Fri Nov 13, 2009 12:39 am

User avatar Hi Johnny -- Radio frequency (AF) ablation is sometimes effective in permanently correcting atrial fibrilation (A-fib), although not as good a cure rate as with many other arrhythmias. It is the ideal when it is workable, however. Quite often there are too many irritable foci causing the A-fib and then medication, electrical cardioversion (a very minor and easy procedure) or sometimes even ablation of the atrioventricular (AV) node may be employed (this last requires a permanent pacemaker placement as well. The others do not). A-fib is often a chronic, constant or recurrent problem, and the primary risk is that it may lead to secondary stroke owing to clot formation in the quivering atria going to the brain,which is why Coumadin is often employed. Coumadin is an anticoagulant which slows the tendency of the blood to clot, so clot formation in the more slowly moving blood from the atria doesn't have time to form those clots.

It is very difficult to calculate the chances of a successful ablation at a distance, since many factors are involved, but it is definitely worth looking into, and an electrophysiological (EP) study with attempted ablation can usually be tried without much additional risk. If it is successful it may be a permanent cure. Sometimes the A-fib will eventually return anyway, unlike most other arrhythmias, which is one reason many doctors don't go to the trouble and expense of trying the EP study, but I do believe it's worth a try if the patient has decent health insurance.

I hope this is helpful. Good luck to you. Please follow up with us here as needed.

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