Thanks OPSYN:

I have been on sotalol at 80mg and 120mg, rhythmol 325mg extended release, metaprolol 50mg &100mg extended release, and multaq 400mg, dizeltam drip for rate and rythmn control. Sotalol I had the worst side effects. It depended on the maufacturer. I would have chest pain, chest tightness, arm tingling, arm pain and breathing problems. Also within 24hrs of each new and increased dose I went deaf in one ear. It's a very rare side effect that I researched and found on internet. For me each pill was an exact 14hr length in my system. Rhythmol was interesting. The 325mg extended release did crap for me agter surgery. The hospital accidentally switched up my dose type and put it as an immediate release type and it actually worked better for me than the extended release. Well the only side effect was my EP thinks it contributed to my congestive heart failure. So I was off it after 1 month and put on multaq. I've been on multaq for 7 months post 2nd ablation and have not had any side effects. I also take metaprolol at first at 100mg and then a decrease to 50mg. The first 3weeks of taking it I was real tired and felt really low. With multaq and metaprolol I feel great. The dizeltam drip was only given to me in hospital to lower my heart rate when I had andafib and atach episode. Only thing that worked. They had also tried cardioversion at 120, 240 and 340 jolts and it didn't work. I also had 2 ablations with in 8 months of each other. Having the ablations the ablations was the best decision I've made.
Good luck with new EP and I hope thry can find something that will work for u other than an ablation.

Id just stay on the anticoagulants if you are not symptomatic. If your old and trying to get a few more years, anti-rhythmics are ok. Most of the time the eventually stop working plus you have to take a beta-blocker to be safe.

Oh yeah, you don't need an EP for the drugs. They have no way to determne which one is right for you until you try them.

Today I saw the new electrophysiologist. I must say that I really liked this woman. She specializes in, teaches, and does research on AFIB. Really sharp. I was able to bring periodic, EKG's, Echo's, and holter monitoring's going back 4-5 years. She said she could she the progressive deterioration of both atrium over this period, both are dilated, caused by the ongoing AFIB (I'm guessing that's what you call remodeling - I'm not sure). She also said that I now have a heart murmur (leaky valve) that was not there before. My heart rhythm is extremely chaotic, and blood pressure too high. The rhythm control drugs would most probably not be effective for me. What I need is a cryoballon pulmonary vein ablation. She said it was much safer tha RF ablation which has the risk of damaging the esophagus. I asked about FIRM, she says it was not indicated for me, and it was a much more radical procedure than the cryo.
The cryo will take 2-3 hours (no bladder catheter - I'm sold). Better than 80% success rate, she's done 100's.

We can't do the procedure until three months after the stroke, so I'm looking at April, and we need to get my blood pressure under better control and I need to have a test called a Transesophageal Echocardiogram (TEE) to make sure nothing else is going on.

Well, gang wish me luck, I've been putting this off for so many years, I hope it works. It really doesn't sound like I can put it off any more.

So glad you are happy with the new EP and you feel good about her recomendations. Best of luck to you!

Hi Paul,

I am so happy that you found an ep that you like. She sounds great. 80% success rate is a lot better than rhythm control would provide you so feel confident that you made the right choice.

Coincidentally, I went to my ep yesterday to review my cardiologist recommendation for an ablation. The ep agrees and I have scheduled one for April.

Who would have thought - two guys growing up in the Bronx, meet in an afib forum, and both have ablations in the same month. Maybe they should make a movie.

Anyway I moved to the west coast many years ago to avoid the cold and so I will be getting an rf ablation rather than cryoablation.

opsyn

Good luck Paul and opsyn.

Good luck Paul and Opsyn. I am excited for you both for the chance and hope for NSR. Good luck to you both!

Dear Opsyn and Paul,
Positive thoughts going out to both of you:) I am sure u will be happy with ur choices! Please keep us updated.
Hugs
Christine

Paul and Opsyn thats great news! Wishing you both all the best. Ive got my fingers crossed that both ablations turn out perfect! And, for an addition push of luck, Ill be holding my thumbs too (thats what you do for luck here in Switzerland).
Take care,
From across the pond

I read the comments here frequently without comment but thought I'd add my two cents to this one.

Paul I'm four months post cryoablation and my experience has been nothing but good. It was a short procedure (3 hours) and an easy and uneventful recovery. I had a Foley catheter since it's not only procedure time but the time afterwards when you're kept in bed.

Good luck to both of you.

So good to be off the fence and have a Plan. Nice to have a Buddy to go through this at the same time too.
May all the Best of Blessings come to to you Paul and to opsyn~

I'll pee in the bottle, anything to avoid the catheter.

Paul,
Cryo will not fix your condition as you are too far advanced. This EP may have good bedside manners but do not be fooled into thinking a PV isolation ablation using CRYO will stop your afib. RF is not any more dangerous than CYRO especially with a top doc. You probably need work all over including your your posterior and anterior wall, coronary sinus and maybe the LAA.

She said it was much safer tha RF ablation which has the risk of damaging the esophagus.

Bullshit-Sorry but this doesn't happen anymore with high volume centers and she is trying to scare you. Actually CYRO has higher complication rates in damaging the phrenic nerve because the cyro balloon doesn't always fit into the PV openings and can cause major complications in untrained hands..
Cyro is a easy way out for doctors who don't have the manual dexterity to perform continuous overlapping point by point RF PV isolation that are solid trasmural burns.
How is she going to hunt for rotors and hotspots that are present in all persistent cases of AFIB using CRYO? You Can't because these are circular caths that can't be used in any other area of the atrium. You will most likely need work in the SVC, CS, roofline isolation to break up the atrial substrate and several focal hot spots around the atruim and base of his LAA, so you need to ask her these questions.

My advice RUN FOREST RUN!

McHale.