What's next when cardioversion didn't work?

Question

It worked for a couple of days, then back to atrial fibrilation.

Answer 1

Sometimes it's not worth while to try and keep it in sinus rhythm. Presumably you have been checked for hyperthyroidism (overactive thyroid gland) which can cause A.F. High blood pressure is another treatable cause of A.F. I hope your blood is now thinned with Coumadin (Warfarin------so called rat poison). When the left atrium is in fibrillation for awhile, it may build up blood clots within its chamber. Then especially if your heart goes into sinus rhythm (normal rhythm) for a bit, the normal contractions of the atrium can kick this clot out into the left ventricle and on up the aorta and to the brain, where it causes a major stroke. Staying on blood thinner Coumadin will allow no more clot to build, and any old clot stabilizes so it isn't likely to get lose.



Amiodarone seems to be a miracle drug at keeping alot of people out of atrial fibrillation. The only problem is, if you look at the list of possible side effects, it can scare you to death. LOL Many people don't have any problem with it at all though. Check it out.



Yes, you can go to radio frequency ablation therapy from a cardiologist who does that. Or you can have surgical ablation. And you can wind up with an atrio-ventricular sequential pacemaker. The treatment can get complicated. Many people just learn to live in atrial fibrillation. If you keep the rate down to a normal level, perhaps with digoxin, and keep your blood thinned with coumadin to prevent strokes, you will probably do fairly well. There is always a small risk of strokes, even when on coumadin, and your cardiac output may be decreased somewhat from not having the normal atrial kick (the atria aren't beating in atrial fibrillation. they are just quivering). These are the main reasons some people go to great lengths to restore normal sinus rhythm.

Answer 2

Long-term treatment varies depending on the cause of the atrial fibrillation or flutter. Medication may include beta-blockers, calcium channel blockers, digitalis or other medications (such as anti-arrhythmic drugs) which slow the heartbeat or slow conduction of the impulse from the atria to the ventricles. Medications may also include blood thinners, such as heparin or coumadin, to reduce the risk of a thromboembolic event such as a stroke. For most patients with atrial flutter, radiofrequency ablation is the current treatment of choice. Some patients with atrial fibrillation and rapid heart rates may need the radiofrequency ablation done not on the atria, but directly on the AV junction (i.e., the area that normally filters the impulses coming from the atria before they proceed to the ventricles).

Answer 3

I have no disagreement with Nurse Annie.



I just wanted to add that atrial fibrillation is not a lethal rhythm.

Answer 4

pace maker may be among the treatments as well, depending on the ventricles ability to respond to the atria signals; doesn't cure the problem, but keeps the heart pumping at a pre-determined rate to help prevent blood pooling in the heart chambers and lessen risk of clots, along with an anticoagulant such as coumadin/warfarin

Answer 5

NurseAnnie is correct. The treatment strategy is dependent upon the type and severity of symptoms, and the type and severity of underlying heart disease. There are a myriad of approaches. You might consider checking the souces below.

Answer 6

Oblation

blood thinners

maze procedure

Answer 7

T Cardioversion