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Atrial Fibrillation

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Question: Atrial Fibrillation? A friend of mine recently became very sick, and was told she had Atrial Fibrillation, she is only 30 years old. She went through a stress test and an echo and now has to wear a heart monitor for 30 days. What can the Atrial Fibrillation be caused from and do patients with Atrial Fibrillation usually have it for the rest of their lives?

Answer: Almost always, once afib, then always prone to afib and it may be a chronic on-going condition. The good news is that most people with afib do fine regardless. They may never be participating in Iron Man competitions, but are fine for day-to-day needs. The difficulty in converting atrial fibrillation back to sinus rhythm is not dependent on age, rather is dependent on the source of the afib. If the left atria is dilated and large, it predictably will not go back to NSR and stay there very easily. Mentioning specific medications is not too useful here (there are at least four separate classes and a number of choices among them) because each patient is individual and often requires a unique treatment - and there are new agents being introduced. Most recently, conventional wisdom has been to convert to NSR (normal sinus rhythm) if there is a reasonable chance of conversion and staying in NSR. If NSR was unlikely, then rate control (and chronic anticoagulation with Coumadin depending on patient age) has a the same likelihood of death as NSR and that then becomes the goal. In other words, a controlled rate is almost as good. A recently published article showed however that QUALITY of life is significantly reduced if a patient remains in afib. Its early but this may mean there is more effort to convert to NSR in the future, possibly with more use of surgical intervention/pacemakers...time will tell. The fact that your friend has a 30 day monitor means to me that the doctors are evaluating her current treatment to see if it is effective in keeping the heart rate either regular or at a regulated rate. One common source of afib in young people is sleep apnea. If there is ANY possibility that sleep apnea may be at play(people who are overweight for instance) in this case, then your friend should go for a sleep study to have it evaluated. Its entirely treatable and can make a big difference in her long term cardiovascular, lung function, and day-to-day well being. I hope this helps. Good luck.

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