Can PAF be resolved by a stent?

[Seankevan]

18 months ago I had a single DE stent placed in the LAD as a consequence of (entirely symptomatic) very irregular pulse after exercise and, when tested with a stress ECG, PAF when in recovery from the treadmill exercise. First cardiac consultant, who inserted the stent to alleviate the "75-90% blockage" of the LAD, advised me that "on the balance of probabilities" the stent would resolve the PAF; the subsequent NHS cardiac consultant rejected this advice and told me that once I have a diagnosis of PAF it's for life.

Since the stent (May 2014) I have monitored my pulse closely with Alive Corp device and Omron BP/irregular pulse device, and (crucially) in October 2014 I had a week long halter ECG monitor and no PAF of any kind was detected. I've been discharged from the care of the cardiologists with a CHADs score of 1 (to reflect my stable cardio vascular disease - aside from the bunged-up LAD, my other arteries were clear). I have not been prescribed blood thinners such as Warfarin and now, daily, take the following medication: 60 mg Statin (80 mg was too much for me), 75mg Clopidogrel (rather than Aspirin - I was given the choice of either/or one year post-stent) and 2mg of Candersartan. The latter was prescribed for the "prophylactic" benefits for the heart only as my BP is, was and has always been very good. My bloods re triglycerides, HDL, LDL and ratios are all now spot on. I am a 52 year old male.

My question is: which of the cardiac consultants should I believe? Given all of the above can I regard the PAF as having been resolved by the stent as the original cardiologist suggested was most likely or is the second one correct to say that even without symptoms or any objective measure of the presence of PAF I still "have" it?

This has been preying on my mind for sometime and I would be most grateful for any advice.

Thank you all very much indeed, in advance.

[paulh1]

I can only speak from my own experience. Have three stents and paroxysmal Atrial fibrillation. I take similar meds as you and I still have afib. Had my stents put in about the same time as you. I believe the blockages in my arteries along with the afib caused me to end up in the hospital. This is just a supposition , but since all my afib is brought on by stress on my body such as exercising,I believe the stress of clogged arteries trying to keep up with the demand during exercise brought on an already existing condition(afib). Will your afib go away? It might but mine is still there. The stents ONLY increase the blood flow through the arteries. They have nothing to do with the erratic electrical impulses that cause afib. There is plenty of info on this site and others to gather your own information concerning afib. As others have said on this site Knowledge is Power.

[Seankevan in reply to paulh1]

Thanks very much Paul: food for thought. I will certainly look further into the excellent resources here - but with Bob's imprecations not to over do it at the fore-front too!

All the very best with your situation mate.

Sean

[BobD Volunteer]

I think it unlikely that a stent will stop AF since all it does is increase blood flow into the heart. I think it important to understand that most cardiologists are merely plumbers and know little about the electrical side of things which is the domain of an electrophysiologist. AF can occur as a one off but is almost always progressive although that may take many years. My advice would be to get on with the rest of your life and not worry unless it does. You can learn all you can from the AF Association website and this forum but please don't let it take over your life.

[Seankevan in reply to BobD]

Many thanks for the prompt reply - and sound advice re not obsessing! I guess my query was based on trying to draw a line under this scary episode. Any ideas as to how I contact or get referred to an electrophysiologist? Is the GP the only route? Best wishes, Sean

[BobD Volunteer]

Hi Sean, unless you get more events you won't be referred to an EP. There is no point after one event. If things get more frequent then ask your GP to refer you. There is a list by area on the main AF Association website under patient information.

Read all you can from the fact sheets there as well as knowledge is power. Sorry --dashing about-- relatives for the weekend.

Bob

[Seankevan in reply to BobD]

You're a star Bob! Many thanks once again. Very best, Sean