- Cardiologist, New Mexico Heart Institute
- Clinical Professor of Medicine and Emergency Medicine, University of New Mexico School of Medicine
- Consulting Professor of Medicine, Duke University School of Medicine
Q: I am 54 years old and I have been diagnosed with a heart arrhythmia called atrial fibrillation. I was told by my doctor that I need to go on a blood thinner that is called warfarin. I looked it up and it’s used for rat poison. He told me that if I didn’t take it I was at risk for a stroke. I am really frightened and worry about the side effects of the drugs. Lately I have read about a procedure called an ablation. What are your thoughts about my condition and is ablation for me? It must be pretty rare since I had never heard of it.
A: First, you are not alone. Two and a half million people in the United States have atrial fibrillation. We probably see 10 or 15 patients a week referred for evaluation. It is a disease that can cause fast and irregular heartbeats, fatigue and shortness of breath and yes, it can cause a stroke. Because there are several types of atrial fibrillation, he treatment has to be highly individualized. I have some patients who hardly are bothered by the irregular pulse whereas others have shortness of breath, fatigue and are quite unwell. They all are at a variable risk for stroke depending on risk factors like diabetes, hypertension, heart failure or a previous stroke. Your doctor can estimate your stroke risk by assessing each risk factor to determine if you need warfarin. It’s true that it was originally rat poison but it has specific effects to keep you from having a stroke if you need it. Some patents do very well with aspirin. Albation is a procedure where an invasive electrophysiologist uses catheters to locate the spots that are causing the fast heart beat (fibrillation) and zaps them either with heat or more recently cold. It is being used successfully for patients who don’t respond to medication. In some patients, it can eliminate atrial fibrillation and even allow them to stop blood thinners, but like all invasive procedures, there are risks as well as benefits. Atrial fibrillation sometimes requires sophisticated evaluation by a cardiologist specializing in treating heart rhythm problems called an electrophysiologist.
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