Absence of PAF following angioplasty

[Seankevan]

First visit here and I am after some general views from your knowledgeable membership.

Last May, on my 51st birthday whilst on holiday in the Canaries following my usual 4 mile run, my mother - a retired nurse - for no particular reason whatsoever, asked to check my pulse: I looked and felt absolutely fine. Pulse however was hugely erratic and when she monitored it over the next ten days, after even slight exertion it was the same but with no symptoms at all.

Anyway, long story short (ish), when back in the UK went from GP to a cardiologist; stress ECG showed PAF; angiogram confirmed 90% blockage of left atrial descending ('Widow maker" LAD)!! Close call! (The other arteries were fine).

Angioplasty - single drug-eluding stent - within a week; now on 40 mg Statins, clopidogrel until next May, aspirin daily and 2.5mg ARB daily. Lost 1.75 stone with changes to diet (didn't realise I had that much to lose!) running better than ever, stopped drinking alcohol (not on doctor's orders, just fancied a change) and feeling very good. Blood pressure, as before this episode, is spot on. However, the second (NHS) Consultant states that one episode ever of PAF means you have the diagnosis for life, even though I don't need any blood-thinning medication save clopidogrel and aspirin for one year, and then one or the other thereafter.

Had 24/7 ECG via the cardiology department and been using am AliveCorp pulse and heart rate monitor (highly recommended bit of kit, fits on to iPhone) and have had ZERO detectable episodes of PAF since the angiogram, just occasional slight bradycardia (again told nothing at all to worry about).

A very long-winded way to get to my question but it is this: can I regard myself as having been 'cured' of the PAF by the clearing of the sizeable blockage in the artery? Could the huge blockage have caused or otherwise been responsible for the PAF, which only occurred in rest after exercise?? The consultant who carried out the procedure predicted that "more likely than not" the procedure would resolve the PAF but the later consultant (a different guy) suggested, effectively, that this was misconceived. All very confusing. Does anyone have any insights or thoughts?

Finally, after the one year of dual clopidogrel and aspirin I was told that I can discontinue one or the other: any views as to which I should continue with out of those two?

Sorry for such a long post and thanks so much for any thoughts.

[BobD Volunteer]

Hi Sean and welcome. AF is usually a progressive condition but it is quite possible that in your case it may have been triggered by other cardiac conditions. There is really no "cure" for AF although those like myself who have had successful ablations can go many years without symptoms. I never consider myself cured. I just don't currently have AF It is a very mongrel condition which seldom affects two people the same so there is no guarantee it won't come back nor that it might not.

I would mention that whilst your aspirin/clopidogrel may well be appropriate for your current situation post stent, aspirin is no longer recommended for stroke prevention for those with AF so at some point should the AF return you may need to go onto a proper anticoagulant.

AF Association website has a huge range of fact sheets and booklets about AF which I commend to your reading as knowledge is power.

Bob

[Seankevan in reply to BobD]

Thanks very much indeed, Bob. I guess it is, as I suspected, a question of keeping tabs as best one can. As my CHAD marker is only at '1' (ie stable coronary heart disease) the consultant suggests that formal blood thinning medication is jot presently indicated but at 65 years' I will necessarily move up to CHAD marker of '2' and therefore ready for the 'thinners'. I suppose, even with the "mongrel" condition of AF as you vividly describe it, there is always the hope of further progress in treatment.

I'm really very grateful for your night and advice.

All the best, Sean?