Beta Blockers vs. PVA

[jbhl4]

Hello, I'm 55 yo, long time runner, cyclist, who recently developed Afib during runs. Happens only during a run, but not every run.Will happen one day, last 2-4 hours then pass and go out and do the same run the next day with no issue. Hasn't happened yet during a bike ride and I've purposely gone on hard hill and long distance rides without an event. My cardiologist has suggested  beta blockers and coumadin as a treatment plan. My problem is I have Reynaud's Syndrome and do not want to aggravate that condition, which I understand is a distinct possibility with beta blockers. I would prefer a PVA procedure as that is, from what I've researched a "cure" in a high percentage of patients rather than try to control it with meds with unwanted side effects.
Any thoughts?
Thanks,
jbhl4

[chuparosa]

I have atrial flutter with one foci in the pulmonary veins. My ep doc strongly urged me to have the pv ablation especially since I do not like taking any drugs, can't take beta blockers due to having bradycardia also but most importantly because dr felt it would surely be cured. I'm saving up money for my ablation. My dr did say the ablation for a fib was more complicated as they have to go near all the pv but I think you should seriously consider the procedure. I'm really frightened to have it done but that's just me.....once I have the money I will definitely have the ablation.

[LindaTX]

That's a great question, ireneo.  I would like to know the answer as well.  Beta Blockers don't seem to keep me out of a-fib.  Before ann episode I usually notice that my blood pressure may go uo, systolic comes back down but diastolic lags and it seems to allow a-fib to creep in somehow.  Diastolic Dysfunction?  

jbh14.... a great old thread on here about triggers is "Welcome to the Palpitations Room." Your heart has a memory, one of my Dr.s told me once, so you really do have to know what triggers it.  You may just have to do a little adjusting....caffeine......antihistamines....alcohol..  nicotine...sugar, lots of things can have an effect.  I would get both my blood sugar levels and thyroid levels checked as they can also effect your heart rate and maybe try to give yourself a little bit of a break on your extensive runs. It would be really great if you could avoid both heart meds and an ablation. :)

[ireneo]

I have atrial issues but not a-fib. I did have some a-flutter during my first ablation but I'm pretty confident they zapped that one out of existence. Ablation for a-fib is much more involved than the type I had for my PSVT. So although it might help, it will have a bit more risk. Even in my simple case, there was the talk of possible pace maker needed. Didn't happen but it made me think.

I wonder - can calcium channel blockers be of any help for a-fib? That's what I use for my tachy and chest pain. It has also helped my Raynauds. CCB's are usually prescribed for Raynauds anyway.

[jbhl4]

Thanks for the reply. Yeah, had read where the more afib episodes you have, the more you're going to have. Reason I asked about ablation is that it's usually a one shot deal and you're done. I really do not like the possibility of getting on a med cycle; this didn't work, try this, etc. My brother had it done and hasn't had any episodes since, but we live vastly different lifestyles.
I'm lucky that I take no meds of any kind now. Kind of hard to figure out what the triggers might be. I do the same thing prior to every run or ride.
I'll see the cardie in a couple of weeks and see what he has to say.
jbh

[LindaTX]

Hi, I've dealt with a-fib for about 12 yrs and I have controlled it with medications which after a period of time can cause the meds to turn against you and start causing the episodes.  It  is a progressive condition and the episodes get more frequent and longer in duration.  One thing that really helped me the first 10 yrs or so was that I exercised a lot and kept my heart in good condition.  The last couple of yrs for various reasons I haven't exercised regularly and although I stopped my rhythm meds months ago I am about as well off without them as with them.  I would like to look into taking that new med Multaq as I've heard you can take it when you go into a-fib and it gets you out of it.  My problem is that once I'm in it, my episodes last anywhere from 12-30 hrs. That really s uc ks!  I wouldn't rush into an ablation if I were you.  You might be able to stayt away from certain "triggers" and not push yourself quite so hard when exercising and not have it again.

[Jerry_NJ]

PVA, are you talking Ablation?   If yes, my experience there is Cardiologists (and EPs) will not recommend the risk of Ablation for AFib if the symptoms are mild.

You didn't mention your age, but I'm surprised you can't get by with an aspirin rather than coumadin/warfarin for clot reduction.

One thing I understand is that your type of AFib is usually (ofter?) responsive to low dose beta blocker.  I think most men (larger body) can take up to 50 mg of Toprol or equivalent and not have serious side effects... well that's my experience.  I'm over 200 pounds.  More BB and I think it causes some fatigue, not sure, the AFib causes fatigue too.