Managing Atrial Fibrillation: Medication, Ablation, and Lifestyle Tips

Q: Managing Atrial Fibrillation: Medication, Ablation, and Lifestyle Tips

Hello： There are several specific types of arrhythmias that can be treated with catheter ablation, and the success rates and recurrence levels vary. <br>If the original arrhythmia persists post-procedure, it may be due to incomplete ablation or recurrence after some time. <br>Cat

Severe arrhythmia persists even after electrocautery?

Hello Doctor, I have arrhythmia.
Last year, during my first examination, my heart rate was 60,000 beats per day (without medication).
After the second examination, while on medication, it decreased to 10,000 beats (taking Dronedarone 150 mg, Sotalol 0.25 mg, and Concor 1.25 mg).
During the third examination, my heart rate was 20,000 beats, and after reducing the medication, it increased to 40,000 beats per day (taking Sotalol 1.25 mg).
Later, I underwent catheter ablation, and my heart rate is now 35,000 beats.
The doctor advised me to continue medication for three months and then return for another check-up.
Currently, I am taking Rhythmol 100 mg and Concor 1.25 mg.
I have noticed that my arrhythmia seems to stabilize when I lie down.

I would like to ask the doctor: 1.
In my current situation, is the medication only able to control the arrhythmia, or is there a possibility of a cure? I don't need it to be completely free of arrhythmia, but I would like to manage it so that my daily activities can be normal without significant spikes.
2.
If I undergo catheter ablation again, will it cause any harm to my heart? 3.
What can I do to minimize the occurrence of arrhythmia? Please help me with these questions! I am really worried! If my situation is serious, please tell me directly! Please keep it simple! Thank you, Doctor! Thank you!

Aga, 20~29 year old female. Ask Date: 2019/06/26

Dr. Huang Yinghe reply Cardiology

Hello: There are several specific types of arrhythmias that can be treated with catheter ablation, and the success rates and recurrence levels vary.
If the original arrhythmia persists post-procedure, it may be due to incomplete ablation or recurrence after some time.
Catheter ablation involves the physical destruction of specific myocardial cells to block abnormal electrical circuits, and there is a risk of collateral damage to nearby tissues.
If ablation is not successful, medication management or lifestyle modifications to reduce stress may help decrease the incidence of arrhythmias.
Since ablation is an invasive procedure, please discuss your treatment options in detail with your physician before making a decision.

Reply Date: 2019/06/26

More Info

Managing atrial fibrillation (AF) is a multifaceted approach that involves medication, potential procedures like ablation, and lifestyle modifications. Atrial fibrillation is characterized by an irregular and often rapid heart rate that can lead to various complications, including stroke and heart failure. Your experience with fluctuating heart rates and medication adjustments is common among patients with AF.

Medication Management
From your description, it seems you have been prescribed several medications, including Rivaroxaban (脈律循), Amiodarone (贊安鍩), and Dronedarone (康肯). These medications serve different purposes:
1. Anticoagulants (like Rivaroxaban): These are crucial in preventing blood clots, which are a significant risk in AF patients. They help reduce the risk of stroke.

2. Antiarrhythmics (like Amiodarone and Dronedarone): These medications help control the heart rate and rhythm. They can be effective in managing AF but often require careful monitoring due to potential side effects.

Your current regimen appears to be aimed at controlling your heart rate and rhythm. It’s essential to understand that while medications can significantly manage AF, they may not completely eliminate the arrhythmia. The goal is often to control symptoms and reduce the frequency of episodes.

Ablation Therapy
You mentioned undergoing catheter ablation, a procedure that aims to destroy the areas of heart tissue causing the irregular signals. This can be an effective treatment for many patients, especially if medications are insufficient. However, it’s important to note that while ablation can lead to significant improvement or even a cure for some, it does not guarantee complete elimination of AF.
Regarding your concerns about potential harm to the heart from the ablation procedure, it is generally considered safe, but like any medical procedure, it carries risks. These can include bleeding, infection, and in rare cases, damage to the heart or surrounding structures. Discussing these risks with your cardiologist can help you weigh the benefits against potential complications.

Lifestyle Modifications
In addition to medication and possible procedures, lifestyle changes can play a crucial role in managing AF. Here are some tips:
1. Diet: A heart-healthy diet rich in fruits, vegetables, whole grains, and lean proteins can help manage weight and reduce cardiovascular risk factors.

2. Exercise: Regular physical activity can improve heart health. However, it’s essential to consult with your healthcare provider to determine the appropriate level of activity for your condition.

3. Stress Management: Stress can trigger AF episodes. Techniques such as mindfulness, yoga, or meditation may help reduce stress levels.

4. Avoiding Stimulants: Caffeine, alcohol, and certain medications can exacerbate AF. Monitoring your intake of these substances may help in managing your symptoms.

5. Sleep Hygiene: Ensuring adequate sleep is vital, as sleep apnea and other sleep disorders can worsen AF. If you suspect you have sleep apnea, discussing this with your doctor is crucial.

Conclusion
In summary, managing atrial fibrillation involves a combination of medication, possible procedures like ablation, and significant lifestyle changes. While medications can control AF, they may not completely eliminate it. Ablation can be a beneficial option, but it’s essential to discuss the risks and benefits with your healthcare provider. Additionally, adopting a heart-healthy lifestyle can significantly impact your overall well-being and help manage your condition more effectively. Always keep an open line of communication with your healthcare team, as they can provide personalized advice and support tailored to your specific situation.

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