Atrial Fibrillation (AFib) Support Group
Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.
Petey posted this on the StopAFIB site. I thought you would all enjoy it. So I copied it over with his permission. Great stuff !!! ---gg---
Patient: What did you say I have?
Dr.: Atrial fibrillation. It's not a rare thing. It's the most common rhythm disorder.
Patient: So what can you do for my afib?
Dr.: Well, uh, our afib treatments are lousy.
Patient: Oh?
Dr.: We can give you a rhythm drug, but you may die suddenly. Sudden cardiac death. These drugs don't work half the time either.
Patient: That's not for me. What else have you got?
Dr.: Ablation.
Patient: What about ablation?
Dr.: You'll have to fail on a rhythm drug first. Also, to tell you the truth, we make like 60 burns in the left atrium to isolate areas that may or may not be driving your AF... sort of "carpet bomb" your heart. Bang Pow Zap! Love that sound.
Patient: What? That doesn't sound good.
Dr.: Well, if you wouldn't have gotten your self into this mess by eating Ho-Ho's at night, you wouldn't have to be subjected to these less than perfect treatments. We also have anticoagulants. Who boy! That's a whole 'nother subject.
Patient: I don't eat Ho-Ho's. So tell me about the anticoagulants.
Dr.: Well we have rat poison. I love saying that. Rat poison. Rodenticide is what we say in the business. Been around a long time. Works three fourths of the time. Maybe. But... you could get a brain bleed.
Patient: Damn! Brain bleed? Isn't there anything else besides rat poison? Something newer?
Dr.: There are 3 new anticoagulants. Can't measure how much is building up in your body. Can't reverse 'em either. Not sure of the long term effects. Not sure if they are better or not, but rat poison shouldn't be hard to top you would think. Let me let you in on a little secret. (whispers) The drug companies do the testing, so they have a vested interest in making the drugs look better. Can't trust those damn drug companies. But I will say the new anticoagulants are convenient though.
Patient: Well that's not good. What else have you got?
Dr.: Glad you asked. We also have rate control drugs. They work great! The medical community is quite proud of that! Keeping your ventricular rate down is key to preventing heart failure. We like to keep heart rate below 100 at rest.
Patient : Hey! this sounds great! No down side?
Dr.: Well actually, it will also lower your blood pressure. Make you feel tired. It will make it harder to do exercise. Light headed. You may even pass out. Try not to hit your head with the anticoagulants as you could die.
Patient: Really? Well, I would feel nervous about exercising with anticoagulants and rate control drugs.
Dr.: But you must exercise vigorously. Get your heart rate up.
Patient: But I thought you said raising my heart rate could cause heart failure. My resting heart rate is 80 now. It goes up to 130 while exercising.
Dr.: It's long term elevated rates we worry about, not 20-60 minutes or so.
Patient: So how much should I exercise?
Dr.: We don't know exactly. If you exercise too little, it can contribute to heart disease. If you exercise too much, you can increase calcification of your coronary arteries or worse yet.
Patient: Worse yet?
Dr.: Don't want to talk about that.
Patient: Oh? This whole thing is overwhelming. What is better, rhythm or rate control?
Dr.: We don't know for sure. Fewer complications with rate control. But the disease will progress with time on rate control.
Patient: That sounds bad.
Dr.: In some ways it's good. Your risk of stroke goes down when you aren't constantly flipping back and forth from afib to normal sinus rhythm and your afib symptoms will probably be less. You get used to it. But then your heart will be more likely to structurally and electrically remodel if you stay in afib.
Patient: Don't know what to wish for now. What about this cardioversion thing I've seen in the movies?
Dr.: Oh that. Forget it. Doesn't work much. Or for long. You could also have a stroke if you have a clot in the atrium when you get cardioverted. Plus you need to get it early as possible. Don't want to wait weeks for a cardioversion. Success goes way down.
Patient: Oh. I see. So how do you tell if there's a clot?
Dr.: TEE. Trans Es... nevermind, they stick a thing down your throat. Hurts afterwards. There's some risks too.
Patient: I'm not saying that I want this TEE thing, but what would you do if you found a clot. I couldn't have a cardioversion?
Dr.: We would put you on blood thinners for many weeks beforehand. We like to do that anyway before cardioversion.
Patient: But I thought you said it would be less likely to work if I wait weeks.
Dr.: Yeah. It's a real conundrum.
Patient: Listen, I gotta know. What did you mean by worse yet? What happens if I exercise too much?
D.: Well, uh...
Patient: Doctor, doctor... I must know! Tell me please. Tell me! What happens if I exercise too much?
Dr.: Well... too much exercise can cause atrial fibrillation.
Patient: This whole thing is impossible! Can't you do any better? I thought you said this is the most common rhythm disorder... it's not like it's a rare condition!
Dr.: Hold on now... if you hadn't gotten yourself into this situation with you poor health choices...
Patient: What did you say I have?
Dr.: Atrial fibrillation. It's not a rare thing. It's the most common rhythm disorder.
Patient: So what can you do for my afib?
Dr.: Well, uh, our afib treatments are lousy.
Patient: Oh?
Dr.: We can give you a rhythm drug, but you may die suddenly. Sudden cardiac death. These drugs don't work half the time either.
Patient: That's not for me. What else have you got?
Dr.: Ablation.
Patient: What about ablation?
Dr.: You'll have to fail on a rhythm drug first. Also, to tell you the truth, we make like 60 burns in the left atrium to isolate areas that may or may not be driving your AF... sort of "carpet bomb" your heart. Bang Pow Zap! Love that sound.
Patient: What? That doesn't sound good.
Dr.: Well, if you wouldn't have gotten your self into this mess by eating Ho-Ho's at night, you wouldn't have to be subjected to these less than perfect treatments. We also have anticoagulants. Who boy! That's a whole 'nother subject.
Patient: I don't eat Ho-Ho's. So tell me about the anticoagulants.
Dr.: Well we have rat poison. I love saying that. Rat poison. Rodenticide is what we say in the business. Been around a long time. Works three fourths of the time. Maybe. But... you could get a brain bleed.
Patient: Damn! Brain bleed? Isn't there anything else besides rat poison? Something newer?
Dr.: There are 3 new anticoagulants. Can't measure how much is building up in your body. Can't reverse 'em either. Not sure of the long term effects. Not sure if they are better or not, but rat poison shouldn't be hard to top you would think. Let me let you in on a little secret. (whispers) The drug companies do the testing, so they have a vested interest in making the drugs look better. Can't trust those damn drug companies. But I will say the new anticoagulants are convenient though.
Patient: Well that's not good. What else have you got?
Dr.: Glad you asked. We also have rate control drugs. They work great! The medical community is quite proud of that! Keeping your ventricular rate down is key to preventing heart failure. We like to keep heart rate below 100 at rest.
Patient : Hey! this sounds great! No down side?
Dr.: Well actually, it will also lower your blood pressure. Make you feel tired. It will make it harder to do exercise. Light headed. You may even pass out. Try not to hit your head with the anticoagulants as you could die.
Patient: Really? Well, I would feel nervous about exercising with anticoagulants and rate control drugs.
Dr.: But you must exercise vigorously. Get your heart rate up.
Patient: But I thought you said raising my heart rate could cause heart failure. My resting heart rate is 80 now. It goes up to 130 while exercising.
Dr.: It's long term elevated rates we worry about, not 20-60 minutes or so.
Patient: So how much should I exercise?
Dr.: We don't know exactly. If you exercise too little, it can contribute to heart disease. If you exercise too much, you can increase calcification of your coronary arteries or worse yet.
Patient: Worse yet?
Dr.: Don't want to talk about that.
Patient: Oh? This whole thing is overwhelming. What is better, rhythm or rate control?
Dr.: We don't know for sure. Fewer complications with rate control. But the disease will progress with time on rate control.
Patient: That sounds bad.
Dr.: In some ways it's good. Your risk of stroke goes down when you aren't constantly flipping back and forth from afib to normal sinus rhythm and your afib symptoms will probably be less. You get used to it. But then your heart will be more likely to structurally and electrically remodel if you stay in afib.
Patient: Don't know what to wish for now. What about this cardioversion thing I've seen in the movies?
Dr.: Oh that. Forget it. Doesn't work much. Or for long. You could also have a stroke if you have a clot in the atrium when you get cardioverted. Plus you need to get it early as possible. Don't want to wait weeks for a cardioversion. Success goes way down.
Patient: Oh. I see. So how do you tell if there's a clot?
Dr.: TEE. Trans Es... nevermind, they stick a thing down your throat. Hurts afterwards. There's some risks too.
Patient: I'm not saying that I want this TEE thing, but what would you do if you found a clot. I couldn't have a cardioversion?
Dr.: We would put you on blood thinners for many weeks beforehand. We like to do that anyway before cardioversion.
Patient: But I thought you said it would be less likely to work if I wait weeks.
Dr.: Yeah. It's a real conundrum.
Patient: Listen, I gotta know. What did you mean by worse yet? What happens if I exercise too much?
D.: Well, uh...
Patient: Doctor, doctor... I must know! Tell me please. Tell me! What happens if I exercise too much?
Dr.: Well... too much exercise can cause atrial fibrillation.
Patient: This whole thing is impossible! Can't you do any better? I thought you said this is the most common rhythm disorder... it's not like it's a rare condition!
Dr.: Hold on now... if you hadn't gotten yourself into this situation with you poor health choices...
I have NOT been in any doctor, specially EPs or cardio, that spent more than 3 minutes tops with the patient :-( Specialist are usually very short and bitter :-)
So, I am NOT sure what petey is talking about, hahahahaha
Scott