← Return to Medicine without ablation for SVT or AF

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Medicine without ablation for SVT or AF

Heart Rhythm Conditions | Last Active: Dec 8, 2025 | Replies (11)

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Profile picture for gloaming @gloaming

I agree fully with sjm46. As long as the burden is under about 8% of all beats in a measured 24 hour period, as long as it comes and goes on its own, and as long as the person isn't suffering unduly due to symptoms, then keeping a lid on AF and ectopy via calcium channel/beta blockers and probably a DOAC (direct-acting oral anti-coagulant) might be all you need. Or, you could experiment with propafenone, flecainide, Sotalol, or Multaq, as examples of anti-arrhythmia drugs if they help. But it must be kept in mind that AF is a progressive disorder. It will cascade through four stages in the majority of patients, each on more intractable than those previous. So, if you find that it is becoming more intrusive, less pleasant, or that your heart is showing evidence of 'remodelling' itself (atrial wall enlargement, possibly also with ventricular enlargement, mitral valve prolapse, collagen deposition in the myocardial substrate, and fibrosis showing up on MRI), the gold standard of care these days is catheter ablation, whether PFA or RF delivery. A successful ablation stops any progression attributed to remodelling, which will keep your heart healthier longer.

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Replies to "I agree fully with sjm46. As long as the burden is under about 8% of all..."

@gloaming You are so knowledgeable! How can I become familiar with these types of parameters for how to treat arrhythmias? Right now I have a not-very -troublesome case of SVT but I know the situation for a 75-year-old goes beyond perceived symptoms. Can you point me toward the right learning experiences please?

@gloaming. Thank you for that info .Having Watchman done next month and was on fence with Oblation . I have Proximal AFib and 71 yrs old going to research more .Had no clue about what Oblation was until recently.