![]() Should he have been referred sooner? What factors should physicians consider when referring a patient with atrial fibrillation for ablation? Catheter ablation: Pulmonary vein isolation During the procedure, he was noted to have diffuse scarring and fibrosis of his left atrium, and afterward he continued to require antiarrhythmic drugs to maintain sinus rhythm. He was evaluated by our team and eventually underwent radiofrequency ablation. However, after reading about side effects of amiodarone, he decided to seek a second opinion. He was given flecainide for rhythm control but continued to have frequent episodes, so about one year ago he was switched to amiodarone, which controlled his rhythm better. Over the past 10 years, the episodes have become more frequent and longer-lasting and have required frequent cardioversions. At first, these episodes occurred about twice a year, and the patient was managed with a beta-blocker for rate control and an oral anticoagulant. The condition was first diagnosed at age 38, when he experienced palpitations and shortness of breath on exertion at times he also experienced decreased endurance and fatigue without overt palpitations. We do not endorse non-Cleveland Clinic products or services Policy Case vignetteĪ 64-year-old man with hypertension but without known structural heart disease presents for a second opinion on management of his atrial fibrillation. Advertising on our site helps support our mission. Cleveland Clinic is a non-profit academic medical center.
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