Editorial: Leaving the Patient in A-Fib—No! No! No!
Recently I corresponded with a fellow who just found out he was in “silent” Atrial Fibrillation with no symptoms.
I commend his family doctor for discovering he was in A-Fib during a routine physical. Otherwise, he might easily have had an A-Fib stroke. (Of those with untreated A-Fib, 35% will suffer a stroke.) We don’t know how long he might have been in A-Fib before being diagnosed.
I wish I could commend his cardiologist too, but I can’t. His cardiologist just put him on the rate control drug, diltiazem, and left him in A-Fib.
That is so wrong for so many reasons!
Rate control drugs aren’t really a “treatment” for A-Fib. They slow the rate of the ventricles, but they leave you in A-Fib.
Rate Control Drugs Don’t Really “Treat” A-Fib
Rate control drugs aren’t really a “treatment” for A-Fib. Though they slow the rate of the ventricles, they leave you in A-Fib. They may alleviate some A-Fib symptoms, but do not address the primary risks of stroke and death associated with A-Fib.
Effects of Leaving Someone in A-Fib
A-Fib is a progressive disease.
Leaving a patient in A-Fib can have long-term damaging effects with disastrous consequences. Atrial Fibrillation can:
• Enlarge and weaken your heart often leading to other heart problems and heart failure.
• Remodel your heart, producing more and more fibrous tissue which is irreversible.
• Stretch and dilate your left atrium to the point where its function is compromised.
• Lead to progressively longer and more frequent A-Fib episodes and within a year can progress to chronic (continuous) A-Fib.
• Increase your risk of dementia and decrease your mental abilities because 15%-30% of your blood isn’t being pumped properly to your brain and other organs.
I’m So Angry at Doctors Who Just Leave Patients in A-Fib!
I can’t tell you how angry I am at cardiologists who want to leave people in A-Fib.
Even if a patient has no apparent symptoms, just putting them on rate control meds and leaving them in A-Fib can have disastrous consequences (and verges on malpractice).
What Patients Need to Know
The goal of today’s A-Fib treatment guidelines is to get A-Fib patients back into normal sinus rhythm (NSR).
Treatment options includes antiarrhythmic drugs, chemical and electrocardioversion, catheter ablation and mini-maze surgery.
Unless too feeble, there’s no good reason to just leave someone in A-Fib.1
Don’t let your doctor leave you in A-Fib. Educate yourself. Learn your treatment options. And always aim for a Cure!
- A cardiologist may cite the 2002 AFFIRM study to justify keeping patients on rate control drugs (and anticoagulants), while leaving them in A-Fib. But this study has been contradicted by numerous other studies sinse 2002.↵