New treatments for atrial fibrillation

[Jsnuggles]

I have had problems with atrial fibrillation since 1996.  I had my first cardiac ablation in Oct. 2002 with most of the work being done on the right atrium. I had my next ablation done in April of 2005 and I had a problem with my heart getting a hole in it so the procedure was stopped.  In August the cardiac ablation was finished.  I did fairly well until
late last year.  I had another cardiac ablation done in May.  I still am getting atrial fibrillation at times even with high
doses of amiodarone and metoprolol.  Over the years no other medications have worked.  My doctor is saying
a pacemaker would be the next step if this ablation does not work.  

I would like to know your thoughts and if you would recommend anything else.

[Michael J. McWilliams, M.D.]

that is a lot of procedures.  If the medications are not working to control your heart rates and you have slow heart rates with escalating doses of medicatoins, a pacemaker is the next step.  Sometimes we just can't get the afib to stop.  Depending on  your age, there are other medications.  I assume because you are on amiodarone, the others haven't worked either (flecainide, propafenone, sotalol, tikosyn).

The only other options is to consider a trip to Austin Texas to have Dr. Natale decide if he thinks he has something to offer the ablation.  Other large centers can help too, but Natale is very good and I trained under him.  That is where I would send afib ablations that weren't working for a second opinion.

I hope this helps.

[telboy9]

there must be an absolute fortune to be made by any drug company that can come up with a safe drug to arrest AF........I am relying on them to do just that

[StephPT]

Dr. McWilliams is so right...sometimes, you have to seek out an expert for those "stubborn" cases.  I had several failed ablations in Pennsylvania, and my doctor ended up referring me to Dr. Warren "Sonny" Jackman at Oklahoma University Medical Center.  He specializes in A-fib ablations with the additional ablation of ganglionated nerve plexi, which has been effective for those patients with a vagally mediated A-fib.  It may be worth seeking another opinion.  Good luck with the beast.
Steph