Surgery or meds for atrial fibrillation?

[Marytew]

The following article has been sent to me (the title as above) which I thought I would share as it is a quandary for some of us. It was written by Dr Michael Roizen M.D., and Dr Mehmet Oz, M.D. (both of the Wellness Institute at Cleveland Clinic) in answer to the following question posed to them:

Q: I’m 76 and have been taking heart medications for AFib for a few years now. I think they make me feel lousy all the time. Isn’t there some other way to address this problem? -- Katherine J., Wildwood, New Jersey

Their response:

A: There might be, but whatever you do, do not -- repeat, do not -- stop taking your prescribed heart meds without talking with your cardiologist. According to Dr Mike’s Cleveland Clinic, what used to be considered an annoyance is, as we now know, a very dangerous condition. Untreated AFib doubles your risk of sudden death and ups your risk of stroke five to seven times compared with someone who doesn’t have AFib.

That said, we’re learning more about AFib and how to treat it all the time, so please set up an appointment with your heart doc. Researchers in Europe have recently defined subtypes of AFib, which may help make for better-individualized treatments. Ask your doc about that when you discuss your options. Also, AFib can be the result of other cardiovascular problems or kidney problems, so tell your doc about how you feel. Best bet: Write out questions about your concerns for your doctor, then write down the answers during the appointment.

You also may be a candidate for a minimally invasive surgical procedure to control the irregular heartbeat. Catheter ablation allows a cardiologist/electrophysiologist to create a type of scar called a conduction block in the heart muscle, to prevent erratic electrical signals from travelling through the heart. Sometimes AFib surgery is combined with minimally invasive surgery addressing simultaneous heart problems, such as valve and/or artery issues.

As for whether your meds are making you feel lousy, you can be tested. Sometimes biomarkers in the blood can tell your doc a great deal. If surgery isn’t an option, you should be able to change up your medications so they’re more tolerable. We’re getting pretty good at treating AFib these days, so stay with it and ask the questions, but don’t stop taking your prescribed medications.

[BobD Volunteer]

Sounds like a typically US doctor response. Life style is alos very important and remember that any and all treatment is only EVER about quality of life (QOL). If your drugs make you worse then why take them? The AF journey as all about finding the best fit for you.

[Marytew in reply to BobD]

Whilst I agree with you Bob about the importance of lifestyle and acknowledge it was not commented on, I nevertheless liked that the doctors were open to the possibility that medication could be problematic for individuals but at the same time cautioned that AFib is a serious condition and therefore medication should not be stopped without further discussion with their specialist. The doctors also advised the questioner of the possibility that biomarkers in the blood might be checked and reassured them that it should be possible to change to more tolerable medication if surgery turned out not to be an option for them. The doctors also advised the questioner about European research having recently defined subtypes of AFib which might lead to better-individualized treatments. All helpful pointers (I thought) for the questioner to raise with their specialist in order to achieve a better quality of life.

[etheral in reply to BobD]

No doubt life style changes can help. But at least in US we have access to meds such as Dofetilide which has kept me in NSR for over a year without side effects. I am thankful I am not subject to European constraints and resent your derogatory comment on US medicine.

[Finvola]

I like this response for the way it looks at drugs/intervention and invites the patient to find out more about AF and the different drug regimes.

It would have been better with lifestyle changes discussed, although that probably wouldn’t have addressed the lousy feeling complained of but could have been an additional item of help.

Thank you for posting Mary.