Heart Rhythm Conditions – Welcome to the group

@anjimlynch Flecainide is a very popular, and usually well-tolerated, anti-arrhythmic drug. Some people, when their episodes come and go, now and then, use what is called a PIP approach to Flecainide, or 'pill-in-pocket.' You keep a single tablet in your purse or wallet and only pop it down if you happen to have a run of SVT that lasts over 5 minutes. Many self-correct in just a few minutes, but if it persists, you get the tablet and wash it down. Takes about 40 minutes typically if your stomach has a recent meal in there. Many cardiologists suggest the PIP approach to their patients whose arrhythmia is transient.

Your cardiologist should, depending on how up-to-speed he/she is, offer to refer you to an electrophysiologist, or an EP for short. They are cardiac electricians, specialists, whose job is to assess your heart electrically and to then suggest a remedy for you, most often either drugs, a catheter ablation (more in just a minute), or a pacemaker. A lot depends on how symptomatic you are since occasional SVT and atrial fibrillation are not problematic. Only if the total 'burden' approaches 3% of all heartbeats in a 24 hour period. So, how you feel, and how you communicate its effects on you, will be as important to the EP and cardiologist as the disorder presents heart deterioration typically. Symptoms matter, especially if they make you miserable, and especially if they happen a lot.

Catheter ablation is day surgery where the EP enters your heart chambers with a thin hollow wire and causes scar tissue around places on the chamber walls where rogue electrical signals are causing chaos. This sounds drastic and terrible, but it's really very straightforward. The scar tissue creates a dam around those 'foci' by preventing the signals from spreading. It is the spreading electrical impulses that cause the atria to beat, but they're also still beating to the normal signal coming from the SA node, the 'sino-atrial' node with is the pacemaker for the heart. You can watch videos on YouTube about catheter ablation. I have had two. You're home that evening, and if it's done well, you can expect a normally beating heart for years afterward.

@gloaming I echo your advice. Ablation is the first line treatment for afib/flutter. With new pulsed field technique it’s safer than ever. Better than meds with all their side effects plus meds lose effectiveness with time. Ablation is not a cure all as I’m having. Infrequent arrhythmias now 8 yrs after my 2017 ablation but it appears to be the best approach to reducing or eliminating symptoms.

@chickenfarmer If it worked for a few years, would it be worth it to go back and see if a second ablation can buy you another five-eight years free of arrhythmia? I have thought about this....some....but not much or long. For me, the symptoms when my heart is fibrillating are just awful. Anxiety, need to get up and pace (which has a silver lining since I sit too much and have widened my girth some), the thumping and fluttering in my chest, the need to belch out loud which, when watching TV with the missus, goes a long way toward maintaining our relationship....you get the picture. No, I will go for a third ablation when my time comes, and I'm under no illusions that I'm good for life now...most ablations lose out in time and the recourse is yet another ablation or just live with AF...which virtually never kills their hosts. Fortunately, when he discharged me on that final phone call about three months post ablation and with the Holter results showing normal sinus rhythm, no blips, he invited me to call his office as soon as I need help again for my heart. I will take him up on that.

@chickenfarmer If it worked for a few years, would it be worth it to go back and see if a second ablation can buy you another five-eight years free of arrhythmia? I have thought about this....some....but not much or long. For me, the symptoms when my heart is fibrillating are just awful. Anxiety, need to get up and pace (which has a silver lining since I sit too much and have widened my girth some), the thumping and fluttering in my chest, the need to belch out loud which, when watching TV with the missus, goes a long way toward maintaining our relationship....you get the picture. No, I will go for a third ablation when my time comes, and I'm under no illusions that I'm good for life now...most ablations lose out in time and the recourse is yet another ablation or just live with AF...which virtually never kills their hosts. Fortunately, when he discharged me on that final phone call about three months post ablation and with the Holter results showing normal sinus rhythm, no blips, he invited me to call his office as soon as I need help again for my heart. I will take him up on that.