Does anyone else have a slightly dilated left atrium? All my CTs and MRIs are normal, but my doctor says it’s slightly enlarged from being inside there during the ablation. Just curious. He says this causes AF.
LA slightly enlarged: Does anyone else... - Atrial Fibrillati...
LA slightly enlarged
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Amurray77
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32 Replies
•
Hi,
Back in the day, nearly 9 years ago now, that was almost identical to the write up from my Consultant to my GP. EXCEPT .................... I have never ever had an ablation! This diagnosis was one of several indicators that I had acquired paroxysmal AF right in the very first instance. My understanding is this can be part of a number of features which are the potential causes of an AF originated stroke.
I have no other underlying heart/cardiac issues.
John
Amurray77• in reply to
So having an enlarged LA can lead to AF related stroke?
• in reply toAmurray77
It's the pooling of blood at this point that can be the trigger for a stroke. I have been, and still am on Warfarin and am well anticoagulated so the prospect of stroke doesn't even enter my life. I am 74, am a practicing bus driver, have annual medicals to meet DVLA requirements - no sweat.
My left atrium has been slightly enlarged since I was diagnosed with a-fib in 2011. It might have been enlarged before then just not diagnosed.
A quick timeline: Diagnosed 2011. Cardioverted successfully and remained in normal sinus rhythm without meds til 2013. When a -fib returned, though cardioverted again remained in a -fib. Placed on meds-difficulty trying to find most effective meds. Diagnosis became permanent a-fib, heart still enlarged but size not increased.
2016 Pacemaker placed and AV node ablation done for Sick Sinus Syndrome. (Tachy-Brady Syndrome)
Present-2 weeks ago saw Electrophysiologist. EKG measurements for atrial size same for last three years. Doing fine-no deterioration in heart muscle or function no size increase. Feel fine and doctor says I'm in better cardiac shape than I was when diagnosed.
Even though I have persistent a-fib I seem stabilized and have very little anxiety now (at least about my heart.)
Hope this helps. irina age 74
Amurray77• in reply to
Thank you Irina! I have PAF. I got it once and five years went by then I threw a Pulmonary Embolism and now I get it every two months. Meds bring me out in less than 5 hours. You can almost set your watch by how regular the AF is. Just about ever two months for 5 to 8 hours. It’s very weird. I’m in my blanking period now post ablation and had one 5 hour episode. I guess we’ll just have to wait and see. A fib is no fun. No fun at all. I find I’m scared to do much. I don’t want to get my heart rate up. I’m 39 and I’m now afraid of everything when I used to have no fear. Is this going to set off my a fib? I ask myself that 1000 times a day now. It’s just so uncomfortable and I feel as though I have lost my freedom. I fee like a prisoner in my own body.
• in reply toAmurray77
Hi Amurray. I'm sorry you are having such a hard time. And being fearful about what might happen next is a terrible way to live. In the beginning I was very fearful-lots of anxiety. In fact I would have runs of rapid beats and chest pain and probably went to the ER unnecessarily at times. At least half of those visits turned out to be anxiety attacks,
I believe after a while we learn to live with a-fib's ups and downs though it can be scary.
I'm a retired nurse and though you would think knowledge would cause less anxiety I used to say I knew just enough to make myself nuts. The years from 2011 to 2013 when I was a-fib free I constantly worried it would come back.
Oddly enough when it did return and became permanent I relaxed; the 'other shoe had dropped' and I settled into treatment. I had a lot of difficulty trying to find the right med combination and had so many side effects my EP suggested the pacemaker and ablation.
As I said they both went well. I have no symptoms (no extra beats, etc) and take no cardiac meds except for a water pill daily, I wanted off anticoagulants so this past January I had a Watchman device inserted and slowly weaned off my warfarin.
I feel good and sometimes go several days without thinking about my a-fib.
The key, IMO, is coming up with our individual most effective treatment plan. This can be a lot of trial and error but when you find your most effective treatment I believe life gets comfortable again.
I hope this happens very soon for you.
Take care. irina
Really? I have not seen atrial enlargement on the long list of things that can happen during ablation and I rather thought things were very much the other way round. AF gets cooked up from who knows where and too much wild, erratic beating of the heart can cause the left atrium to enlarge.
An echocardiogram should show up any enlargement present and I think many AFers (if not most) may have it to some degree. It's my understanding that it can be a tell tale sign of AF having taken place and is thus an aid to diagnosis for those who fail to capture AF on an ECG and get fobbed off with a diagnosis of panic attacks.
I understand atrial enlargement does not have to be not a one way thing. Cessation of AF can allow the atrium to reduce in size.
• in reply to
PS - I am really sorry you feel imprisoned by AF. Feeling frightened by everything and having the sensation of being years older than you really are is not at all nice and it is really pleasing when you lose that. I hope your relationship with AF will relax a little - although you might be able get rid of it and enjoy freedom!
• in reply to
My "enlarged heart" as it was labelled was picked up on an echocardiogram several years before developing AF. For me I don't think there was a connection with my ablation as after I had it my atrium never got any bigger.
• in reply to
Yes, I had a mildly enlarged atrium when first diagnosed with SVT (after some 20 years of occasional fast rhythm) - and ablation and AF came later. I should perhaps have been less specific above. I was subsequently found to have moderate enlargement. I don't find it bothersome in any way and have no idea of the current state of play. It's a few years since I last had an echo.
• in reply to
To me now 'enlarged atrium' is just another statement on my echos and ekg's. It doesn't bother me, doctors don't seem concerned about it and I'm not either now.
seasider18• in reply to
I am told that my enlarged left atrium means that another cardioversion would not be successful but if I have an ablation it may reduce the left atrium size.
AF itself can cause dilation of the atria - from the stretching action of the arrhythmia. My echocardiogram showed mild enlargement of both atria although I do not have heart disease and haven’t had an ablation.
I believe the atria can become less enlarged in the absence of AF.
I had a conversation about an enlarged left atrium with a doctor at the arrhythmia clinic.
I had read that restricting the flow of blood through the heart which can happen due to frequent episodes of AF (think of a balloon being overstretched and not fully regaining its previous shape ) can cause enlargement of the left atrium so I asked the Dr about this and if my echocardiogram showed any enlargement. He said age alone can cause a degree of enlargement as the heart muscles along with those in the rest of our body lose some elasticity. I understand high blood pressure can have an effect too.
I would guess during an ablation there may be some bruising and temporary swelling as there is when any part of the body experiences a degree of trauma but that should disappear again in a short time.
I am not a doctor but based on the things I have learnt I would say any degree of enlargement of the left atrium is due to the reasons I have stated and not the ablation.
Someone more knowledgeable than I may wish to contradict me 
• in reply todoodle68
I have not heard of anyone I know having ablation related enlargement.
Just my personal experience. This was never mentioned to me by my Electrophysiologist during discussion before my ablation. Sometimes all side effects are not presented but he is so thorough I can't imagine he wouldn't mention this.
Amurray77• in reply to
I think the enlargement was there all along. Sorry for the confusion. He just was able to better see it during ablation.
BobDVolunteer
I support most of what has already been said. AF can cause left atrial enlargement. Ablation does not although it creates scar tissue within the atrium which could reduce flexibility of the muscle a small amount. On the other hand excess exercise can cause enlargement of the atrium which can stretch pathways and result in AF . This is the reason why atheletes often get AF.
Sounds like your doctor is confused which isn't unusual where AF is concerned . If your tests come back OK then stop worrying. AF often has no reason.
• in reply toBobD
Also along these lines maybe the steroids that some athletes take contribute to AF.
When I was diagnosed with AF and flutter the echo showed an enlarged aorta and I do not understand why as I do not have high blood pressure or any coronary heart disease. Is having an enlarged aorta typical for people with AF?
NO Aortic aneurisms are a completely different problem quite unrelated. This probem is usually down to a structural weakness in the aorta and not related to blood pressure I understand.
Yes, I have been told I have this. I also have PAF. I was told by the consultant that he was referring me for an assessment for an ablation (end of January). He told me that otherwise my heart would continue to enlarge, “your heart will become enormous and it will ruin your life”. At present I don’t have symptoms like breathlessness etc.. The implication seemed to be that the PAF causes the enlargement not the other way round. PAF certainly causes me much anxiety and I haven’t really come terms with it after being diagnosed in June of this year.
Yes I have and cardiologist said it is what's caused the AF, among other things.
After being diagnosed with PAF 11 years ago, I had my first Echocardiagram 4 years ago and I was told I had a slightly enlarged LA. The EP said it was because I am overweight and a slightly enlarged LA is common in overweight people.
Mine is the same af causes it as does high BP if you can reduce it you can reduce the af I understand
I thought the mild left atrial enlargement found prior to my ablation 3 weeks ago was caused by Afib. However, my EP just told me it was probably from sleep apnea which in turn caused the Afib. At the sleep center, they said there’s twice the chance of Afib recurring after ablation if one has sleep apnea. So I’m going to try to be more diligent about using CPAP, even tho I only have mild sleep apnea when I sleep on my back. Perhaps there are other reasons for left atrial enlargement, too. Best of luck sorting it out!
Interesting discussion. I think it can work both ways. Given all the possible causes of LAE, and who knew that obesity was right up there, that AF causing LAE was less common than the other way round
I have a dilated aortic root...and AF...and a few years ago, my cardiologist said that the two are related, the enlarged aorta is the likely cause of my AF...but since then, subsequent cardiologists (we moved to a different location in the province) and my EP did not say anything about it. I've since had an ablation for my paroxysmal AF and my aortic root is now at 4.2.
When I first learned of the dilated aortic root, I got into some pretty serious anxiety...and researched the heck out of the subject, learning what options I would have if/when the enlargement got to the point of possibly needing surgery (I found there are a number of options). I also found many anecdotal information from others with similar issue.
As well, when I went to my cardiologist a second time to chat about it (I made the appointment specifically for that discussion) he said (with a reassuring smile on his face) that I'm fine and that I can safely continue living my life as I was...we just have to keep an eye on it. Whew, I thought...and that (plus the occasional dose of Ativan) helped me to feel better about it.
I am currently getting my root checked every 6 months (could be a year if I didn't also have a history of AF)...otherwise, I'm pretty much back to living life as I have.
4 months ago, a TEE showed what they termed an enlarged right atrium and a grossly enlarged left atrium. I think this happened during a particularly long 12 day afib episode.
On the 19th of this month I had a heart ultrasound, then saw Dr. Natale. My right atrium is still a bit enlarged at 3.4 cm, but my left atria is back to normal size.
Prior to developing afib, my right atria was slightly enlarged, but the left was normal in size.
I am in permanent AF and was told I had an enlarged left atria and the EP said that is the reason I was not a good candidate for an ablation. I had a failed cardioversion (only was in normal rhythm for 48 hours). It wasn't until after I was diagnosed with AF that I realized that I even had it - meaning yes, I had many instances where my heart was beating fast and furious at times for about a year and I never knew what it was nor did I have it checked out (I wish I had but oh well). Since being diagnosed (which occurred by happenstance as I went to the doctor for something else), I have been on the meds (10 mg. Bisoprolol, 5 mg. Lisinopril, and 2X daily Pradaxa), I have not had any AF-related symptoms and I feel perfectly fine. BTW, I've never had shortness of breath, nor have I ever felt impaired by AF. So quite frankly, I just take my meds daily and go on with my life. One thing I do wonder about though is - should I get a second opinion about having an ablation? My cardiologist told me about six months to just take my meds and come back in a year to see him. Is that okay?
• in reply tombheart
Would it be better to start a new thread with your reply, it might get more attention. Perhaps add your left atrial size and how long you have been in persistent AF.
I was diagnosed with PAF 18 months ago and the echo showed a severely enlarged left atrium which my gp said was because of the attacks. The consultant did not seem concerned so I don’t worry about it!
Hi i had a four day monitor in March 2017 which showed a very irregular heart rythymn and paramedics ecg said 'atrial fibrillation '. However by the time I left A & E I was told it wasn't as my heart was back in sinus rythymn. After an angiogram in June 2018 my left atrium is severely dilated and in Sept was diagnosed with paroxysmal af which has now become persistent af. A severely dilated LA can be caused by AF I assume because of the pressure the LA is under when the heart is beating so irregularly and at a much faster rate than normal. I don't have much luck with my gps, appnts waiting up to four weeks and I feel like giving up. Good luck
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