Atrial Fibrillation

[faulcon]

I'm male, aged 67 years, a former professional athlete (I played pro. soccer). I've been in sustained AF for over 15 years after an attack of viral myocarditis reduced my cardiac output by 25-30%. Attempts to get me back into sinus rhythm through cardioversion were not successsful. I am currently treated with 0.125mcg digoxin and 5mg of warfarin to be taken daily. I know that my cardiac output is decreasing - I am becoming increasingly breathless on physical exertion, and consequently my capacity for exercise is reduced. What are my options?

[Jerry_NJ]

I am 70, and was up to age 67 a runner for exercise, not a pro. I have suffered from AFib since about he age of 57 and used to respond well to electrocardioversion, getting about 18 months of NSR before reverting back to AFib. In November 2007, I had a mitral valve repair (open heart surgery) and a maze procedure. The valve still checks out well and my EF is 60%, which is good. However, the left atrial measured (echo) 5.11 cm diameter, well over the normal max of 4.0 cm. Subsequent attempt to convert with stronger drugs and with an electrocardioversion did not hold.

I am in what I call Permanent AFib, I assume that is the same as what your describe as Sustained.

Depending on how much the AFib symptoms trouble you, my main concern is I can't (or don't) run when in AFib due to lack of energy due in part to the beta blocker medication I take, you may consider an ablation. Still the loss of ejection efficiency (I take that to be you 25-30% number) is the most important. Have you had an echocardiogram to determine the physical condition of your heart? That test may identify something repairable that will improve your EF. And, if they have to open your heart a maze (I think there are some newer better - research it before if the opportunity comes up) procedure would be a good effort to address the AFib.

Good luck,

[faulcon]

Thanks Jerry. I'm having more tests this week - X-ray, 24hrs monitor and and ECG so hopefully these will reveal the state of my heart.