← Return to Isolated Atrial Fibrillation Episodes: Is Ablation a Good Fit?

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@gloaming

As a general rule, treat AF early. However, too early may mean that your re-entrant foci will be difficult to locate, and an EP doing ablation might just default to a simple PVI (pulmonary vein isolation) because that is where the re-entrant for the AF-inducing signal is found in the heavy majority of patients...at first.

As you know, an ICU nurse (bless you!), symptomology, the worst of it, drives a LOT OF medicine. You say you tolerate AF reasonably well. I didn't, and won't if I have any say in the decision-making that follows. But you do okay, and there's no harm, in my thinking, to staying calm, minimizing medicines (except apixaban or rivaroxaban...those you should take if you ask me for my opinion). It is when your AF begins to be intrusive, to come maybe two/three times each week...that is when you might want to enlist the help of a really top-notch EP who can offer you relief, but also help to stem the onset of heart insufficiency or mitral valve prolapse...IF...IF... those lie ahead of you (we're all on our own journeys with our aging hearts, so our stories will differ).

You are your own best coach. I think you are dealing with this sensibly. Just, please, don't err on the side of caution and let your heart get too far into AF before you recognize that it's time for an ablation, or some other remedial measure, including anti-arrhythmic drugs. Spend as little time in arrhythmia as you can so that you don't speed or encourage the remodeling that is sure to take place with collagen deposition interstitially and with fibrosis.

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Replies to "As a general rule, treat AF early. However, too early may mean that your re-entrant foci..."

Appreciate the many pearls. As more episodes increase in frequency or perhaps intensity, the approach will have to change. You have given me a lot of food for thought.

Will you please say more about "treating AF too early" and identifying re-entrant foci?