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In a message dated 12/9/04 2:37:48 PM Pacific Standard Time, lendavis@...

writes:

> I hope I

> might just revert...but I have a feeling I may have converted to

> continous.

>

I wouldn't jump to that conclusion. I thought that the first time I had an

attack that lasted 18 days. And I thought it again because my bouts were

coming closer together and lasting longer. Then when I got so sick this summer,

I

was in a-fib for six weeks. Converted September 1st. Since then, it's been

more like a year ago, which is way better than it's been since June. Attacks

about once a week ... sometimes only an hour or so, sometimes 14-18 hours,

sometimes a day or two. But usually a week or so in between ... and not nearly

as

symptomatic as I was before. So it's almost like it's reversing or

something. And this is after a bout that lasted six weeks. My suggestion is to

continue your life as best you can (I'm not so good at that when it goes on too

long). I bet you convert at some point. Just some positive thoughts to help

....

hopefully!

Toni

CA

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I wanted to consult all the sages on this list, who have been so

helpful, with my latest developments

As you may remember, I am 55. I've had AF for about three years.

The episodes have been intermittant, and I have no heart disease

(other than AF)...so am " lone " as they say.

My last post I told you that my cardiologist had taken me off

Toprol. I'm just taking .50 mg. of digoxin. How great that was. I

had one or two brief AF episodes in the last two weeks, mostly not.

And I've gone off alcohol completely, which really helped. On Sat.

night I had a fight with my wife, and during the night I started

AF. I've had it now since then...which is the longest I have

consciously had it. I saw my cardio today, and she put me on

coumadin, which I start tonight (hope to hold onto my hair). She

also suggested Amiodarone right away. After this discussion, I

begged off. So we are keeping me on the digoxin, 25 mg of Toprol

(which she thinks I probably should drop). She said, and I hadn't

heard this, that perhaps I should just stay in AF, considering that

I had no valve problem and a good ejection ratio, and said that

paroxymal was more dangerous for ischemia than continuous, since

the return to the full force of the atrium could shake clots out.

Any thoughts? Should I go on the Amiodarone to get back into

rhythm? When I asked her about flecanaide she was very dismissive.

Said that it was not being used anymore...too prorhythmic. Yet I

read that it was the treatment of choice of me (lone, paroxymsmal?)

in the recommendations of the American Cardiologists Assoc.

I'm going to see Halperin in NYC (wrote the guidelines) and Bruce

Lerman (Cornell EP) at the end of January. Meanwhile???? I hope I

might just revert...but I have a feeling I may have converted to

continous.

Lenny

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> consciously had it. I saw my cardio today, and she put me on

> coumadin, which I start tonight (hope to hold onto my hair). She

> also suggested Amiodarone right away. After this discussion, I

> begged off. So we are keeping me on the digoxin, 25 mg of Toprol

> (which she thinks I probably should drop). She said, and I hadn't

> heard this, that perhaps I should just stay in AF, considering that

> I had no valve problem and a good ejection ratio, and said that

> paroxymal was more dangerous for ischemia than continuous, since

> the return to the full force of the atrium could shake clots out.

If it was *me* in this situation, I'd look for second opinions. Esp

when the doctor seems to be implying that Amiodarone is your first-

line anti-rhythmic. Amiodarone is the *last* line of resort as far as

I can tell for lone-af! Also, I feel that 55 is a bit young to " give

up " and no longer aim for NSR. That's just my opinion.

Has your docto tried to convert you chemically? When I go into AFIB

and can't pop out, a Cardizem (a rate control drug) pops be back into

NSR. How about a electric " shock " conversion? ANd like you said,

flec. or other anti-rhythm drugs.

Sure, there's a risk in all these approaches, but why is your doctor

*so* reluctant to try any of them? Your " permanent " afib is *way* too

new to give up, methinks. A few days or weeks (or even months) of

afib isn't enough to permanently remodel your heart... so why give up

and/or go on the worst drug out there?

I'd also start eyeing up ablation techniques - the risks are still

there for ablation, but once someone is being offered Amiodarone,

*my* opinion is that ablation starts looking VERY good in comparison.

I recommend you start crunching numbers (risks on Amiodarone vs risks

with ablation) and factor in quality of life issues as well... and

THEN get some more doctor feedback.

Joscelyn

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In a message dated 12/9/04 5:37:55 PM Eastern Standard Time, lendavis@...

writes:

> I'm going to see Halperin in NYC (wrote the guidelines) and Bruce

> Lerman (Cornell EP) at the end of January. Meanwhile???? I hope I

> might just revert...but I have a feeling I may have converted to

> continous.

>

> Lenny

>

Lenny,

Good day. I hope you and your better half have reconciled. She's probably

right, we don't listen!

I'm 55 as well and had AF actively for sixteen years. I had a Pulmonary Vein

Ablation a little over two years ago. It worked. No more AF. I've read and

talked with people that had successful PVA's and other's that had PVA's that

weren't a complete succes, but it improved their quality of life significantly.

You have options. Amiodarone is a drug of last resort and also one with

significant side effects, if left un-checked. Serious side effects. I believe

this

drug is not even approved for AF treatment. It will now come with a warning

label regarding these side effects.

I seriously question Cardio's who go right to prescribing amidarone. It tells

me they are not up to date on AF treatments. Some EP's are guilty of this as

well.

It puts you into a tough situation! Who can I trust? The answer? Education.

You have to invest your time, learning all you can about AF and it's

treatments. There are many resources available to you. Only until then, will you

know

who to trust.

Ouir web page has many resources. Another is www.affacts.org. The Atrial

Fibrillation Foundation. The Cleveland Clinic also has great information. Post

more questions here.

The worst thing you can do is nothing.

You gotta work at it!

Rich O

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