Coumadin, Aspirin, Afib and Ablation

[uplbet]

I have paroxysmal afib, and a dual-chamber pacemaker that was
inplanted mid last year against a very slow heartbeat and AV block
1st degree and God knows of what else.
Yesterday, as a result of my PM control (third check), my cardio's
response was the following:

1. (good news) my PM device works fine
2. (good news) drop Coumadin [after eight years, yahoo!], since my
afib episodes, though quite frequent, never lasted more than 3-4 hours
over the last 18 months
3. (so-and-so news) start Aspirin
4.( bad news): double the present dosage of my antiarrhythmic drugs,
Flecainide and Sotalol; get re-checked in a couple of months and,
should my afib situation stay as today (or worse), seriously consider
ablation.

For the moment, I have just a few questions, please:
- why should I now get on aspirin, in your opinion?
- what are the success statistics of ablation against afib?
- after an eventual ablation surgery, would my heart pump (i.e. my
life) become totally dependent on my pacemaker?

Thanks in advance
--
uplbet
(in email reply delete 01234 from the address)

[florald@bigfoot.com]

On Fri, 05 Dec 2003 16:54:43 +0100, uplbet <uplbet01234@tin.it> wrote:

>I have paroxysmal afib, and a dual-chamber pacemaker that was
>inplanted mid last year against a very slow heartbeat and AV block
>1st degree and God knows of what else.
>Yesterday, as a result of my PM control (third check), my cardio's
>response was the following:
>
>1. (good news) my PM device works fine
>2. (good news) drop Coumadin [after eight years, yahoo!], since my
>afib episodes, though quite frequent, never lasted more than 3-4 hours
>over the last 18 months
>3. (so-and-so news) start Aspirin
>4.( bad news): double the present dosage of my antiarrhythmic drugs,
>Flecainide and Sotalol; get re-checked in a couple of months and,
>should my afib situation stay as today (or worse), seriously consider
>ablation.
>
>For the moment, I have just a few questions, please:
>- why should I now get on aspirin, in your opinion?
>- what are the success statistics of ablation against afib?
>- after an eventual ablation surgery, would my heart pump (i.e. my
>life) become totally dependent on my pacemaker?
>
>Thanks in advance
>--
>uplbet
>(in email reply delete 01234 from the address)


Helo Umberto

Your cardiologist must believe that aspirin will be sufficient to keep
your blood thin. It may also protect you against heart attacks.
Warfarin keeps a lot of people safe from having a stroke but it does
have its downside. I wish I could take Aspirin. It is good for other
things like helping to protect the colon from cancer. I don't know
the success rate for ablation done via the groin but I do know this
method is used frequently at my local heart centre. My ablation
(radio frequency) was a very new technique done at only one London
hospital as far as I know. It was done after surgery for replacement
MV. It did not work for me. and. I was in permanent AF but after the
surgery now have, like you, paroxysmal AF and flutter and 2:1 heart
block. And a PM.
Your last question should have been directed at the cardiologist. You
would be totally PM dependent if they ablated the AV node. They were
talking about this in my case but, fortunately, I seem to be doing OK.
Don't like the idea of being entirely dependent on the PM.
rgds Diana

[Dr. Andrew B. Chung, MD/PhD]

uplbet wrote:

> I have paroxysmal afib, and a dual-chamber pacemaker that was
> inplanted mid last year against a very slow heartbeat and AV block
> 1st degree and God knows of what else.

Yes, God knows :-)

>
> Yesterday, as a result of my PM control (third check), my cardio's
> response was the following:
>
> 1. (good news) my PM device works fine
> 2. (good news) drop Coumadin [after eight years, yahoo!], since my
> afib episodes, though quite frequent, never lasted more than 3-4 hours
> over the last 18 months
> 3. (so-and-so news) start Aspirin

Good news once you start it :-)

>
> 4.( bad news): double the present dosage of my antiarrhythmic drugs,
> Flecainide and Sotalol; get re-checked in a couple of months and,
> should my afib situation stay as today (or worse), seriously consider
> ablation.
>
> For the moment, I have just a few questions, please:
> - why should I now get on aspirin, in your opinion?

Prevents heart attacks.

>
> - what are the success statistics of ablation against afib?
>

Varies from center to center. Would suggest you have your EP doc tell you
his outcomes.

> - after an eventual ablation surgery, would my heart pump (i.e. my
> life) become totally dependent on my pacemaker?
>

It shouldn't unless there is a complication.

>
> Thanks in advance
> --
> uplbet
> (in email reply delete 01234 from the address)

You are welcome.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

[uplbet]

On Fri, 05 Dec 2003 16:54:43 +0100, uplbet <uplbet01234@tin.it> wrote:

thank you, Diana and Dr. Chung!

Dr. Chung, can you tell me what is the current success rate at your
center, concerning radio frequency ablation procedure against
afib/flutter?

And, still at your center, what is normally done to handle the
unsuccessful case patients?

Regards
--
uplbet
(in email reply delete 01234 from the address)

[Dr. Andrew B. Chung, MD/PhD]

uplbet wrote:

> On Fri, 05 Dec 2003 16:54:43 +0100, uplbet <uplbet01234@tin.it> wrote:
>
> thank you, Diana and Dr. Chung!
>
> Dr. Chung, can you tell me what is the current success rate at your
> center, concerning radio frequency ablation procedure against
> afib/flutter?
>

The EP folks whom I rely on are reporting a 75-85% success rate.

>
> And, still at your center, what is normally done to handle the
> unsuccessful case patients?
>

Continued standard medical therapy.

>
> Regards
> --
> uplbet
> (in email reply delete 01234 from the address)

Hope this info helps.

Humbly,

Andrew


--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com/

[uplbet]

On Sat, 06 Dec 2003 17:07:13 -0500, "Dr. Andrew B. Chung, MD/PhD"
<cardiologist@heartmdphd.com> wrote:

>[...cut...]
>Hope this info helps.

Yes, it does.

Regards
Umberto
--
uplbet
(in email reply delete 01234 from the address)

[Dr. Andrew B. Chung, MD/PhD]

uplbet wrote:

> On Sat, 06 Dec 2003 17:07:13 -0500, "Dr. Andrew B. Chung, MD/PhD"
> <cardiologist@heartmdphd.com> wrote:
>
> >[...cut...]
> >Hope this info helps.
>
> Yes, it does.

Then may God receive all praises.

Humbly,

Andrew

--
Dr. Andrew B. Chung, MD/PhD
Board-Certified Cardiologist
http://www.heartmdphd.com