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"Dear Steve, I saw a patient this morning with your book [in hand] and highlights throughout. She loves it and finds it very useful to help her in dealing with atrial fibrillation."

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"Your book [Beat Your A-Fib] is the quintessential most important guide not only for the individual experiencing atrial fibrillation and his family, but also for primary physicians, and cardiologists."

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"Steve Ryan's summaries of the Boston A-Fib Symposium are terrific. Steve has the ability to synthesize and communicate accurately in clear and simple terms the essence of complex subjects. This is an exceptional skill and a great service to patients with atrial fibrillation."

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"Steve, your website was so helpful. Thank you! After two ablations I am now A-fib free. You are a great help to a lot of people, keep up the good work."

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Long-standing Persistent

FAQs Coping with A-Fib: Living in A-Fib vs. Ablation

 FAQs Coping with A-Fib: Living in A-Fib

FAQs A-Fib afib20. “In one of your articles it said that having an ablation was better than living in A-Fib.  I’m 73 years old and have Paroxysmal A-Fib. I’ve been taking 75 mg of propafenone 3X/day for seven years and have only had 5 A-Fib attacks in 7 years. If your article means all types of A-Fib including Paroxysmal, then I will consider an ablation.”

You really aren’t living in A-Fib. You’re taking an antiarrhythmic treatment meant to stop or limit your A-Fib. (Unlike rate-control drugs which only try to limit or control heart rate while leaving you in A-Fib.) For now it’s working fairly well for you.

Drug therapy tends to become ineffective or stop working over time.

Five A-Fib attacks in seven years is very few. With paroxysmal A-Fib like yours, most doctors would say to continue on propafenone till you start having more or longer A-Fib attacks.

(As a point of reference, about 54% of those in paroxysmal A-Fib will go into permanent A-Fib within one year. You’ve made it 7 years!)

A-Fib is a progressive disease that tends to get worse over time.

Consider this. By the time propafenone loses its effectiveness (which is probably inevitable), how permanently damaged will your heart be? How much will your A-Fib have progressed? Will your A-Fib be harder to cure than if you had had a catheter ablation earlier? 

For future reference, you need to know the physical diameter or stretching of your left atrium.

What to Do Now

You need to know the physical diameter or stretching of your left atrium. Electrophysiologists normally perform this measurement when giving patients a stress and Echo test.

For your own records, you should get the actual physical diameter measurement in mm or cm and/or the volume of your left atrium. Don’t settle for words like “mildly dilated” or “normal.” You want a benchmark measurement to compare to in the future.

Check for “silent” no-symptom A-Fib which you aren’t aware of. ‘Silent A-Fib’ is common. Up to 30%−50% of A-Fib patients are unaware they have A-Fib, often only learning about their Atrial Fibrillation during a routine EKG in their doctor’s office. 

Ask your doctor to check for ‘Silent A-Fib’ because it puts you at risk for blood clots and stroke.

Any type of longer-term monitoring (such as a Zio patch which you wear like a Band-Aid for 1-2 weeks or the Reveal Insertable Cardiac Monitor which is inserted just under your skin) could give you this info.

It’s important to know if you have ‘Silent A-Fib’ because it puts you at risk for blood clots and stroke.

The Bottom Line. Propafenone may be just prolonging the inevitable. Since you now have very few A-Fib attacks, you would probably be a relatively easy fix with a catheter ablation.

On the other hand, you may be one of the fortunate few who will never progress into more serious A-Fib. Everybody’s A-Fib is unique.

See 2015 AF Symposium: Living in A-Fib More Dangerous Than Having an Ablation. Thanks to Thomas Scheben for this question.

Last updated: Friday, August 7, 2015

Back to FAQs: Coping with Your A-Fib

Steve’s Lists of A-Fib Doctors by Specialty

Steve's Lists of Doctors by Specialty - Atrial Fibrillation, afib, a fib, A-Fib

Doctors by Specialty

Steve’s Lists of A-Fib Doctors by Specialty 

Steve has prepared these lists of doctors treating atrial fibrillation patients by specialty to help you find doctors with a particular expertise.

  1. US EPs with FHRS-designation performing A-Fib ablations: Listed by State/City
  2. US EPs Using Cryoballoon Ablation
  3. US EPs Installing the Watchman Device
  4. US Surgeons performing Maze and Mini-Maze operations
  5. US Centers performing the Hybrid Surgery/Ablation procedure
  6. EPs Specializing in Persistent/Long-Standing Persistent A-Fib (US and International)
  7. EPs using Contact Force sensing catheters

Return to Directory of Doctors Treating A-Fib: Medical Centers and Practices

Notice: unlike other directories, A-Fib.com offers no preferential listings or placement. No doctor or facility pays, provides services, etc. to be listed. We accept no fee, benefit or value of any kind for listing a specific doctor or medical center. A-Fib.com is not affiliated with any practice, medical center or physician.

If you know the name of the doctor or practice, use the “Search our site” box (upper right on this page) to get to the right Directory page. Then, open your browser’s ‘Find on Page’ feature (‘CTRL+F’) to locate the name on the page.

Disclaimer: this directory is provided for informational purposes only. We make no endorsement of a specific physician or medical facility. Choosing a physician is an important decision and should be based upon your own investigation of each physician’s training, education and experience. These listings offer you the opportunity to locate and contact a healthcare professional directly. 

A-Fib.com is your independent source of unbiased information about Atrial Fibrillation, resources and treatments.

Last updated: Tuesday, September 6, 2016

EPs Specializing in Persistent/Long-standing Persistent A-Fib (US and International) a List from A-Fib.com

Steves List logo 200 pix at 96 resDoctors Specializing in Persistent/Long-standing Persistent A-Fib (US and International)

Persistent A-Fib and Long-standing Persistent A-Fib are often difficult to cure. If you are highly symptomatic, you may need a highly skilled, experienced specialist. This list is a starting point for you.

HOW TO FIND THE CONTACT INFO

Return to Steve’s Lists of A-Fib Doctors by Specialty

DOCTOR OR MEDICAL CENTER US CITY/STATE OR COUNTRY COMMENT
The French Bordeaux Group Bordeaux, France Step wise ablation technique with 95% success rate in curing Chronic A-Fib after two ablations.
Dr. Robert A. Schweikert Akron, OH  —
Dr. Fred Morady Ann Arbor, MI Developed Ablation Frontier’s Multi Electrode catheters for Chronic A-Fib still in clinical trials (11/20/09)
Dr. Patrick M. Hranitzky Durham, NC Uses stepwise approach.
Dr. Kevin J. Makati Tampa, FL  —
Dr. Andrea Natale
Dr. J. David Burkhardt
Austin, TX  —
Dr. Andrea Natale
Dr. Steven C. Hao
Dr. Rick Hongo
San Francisco, CA  —
Dr. James Ong Tarzana, CA  —
Dr. Carlo Pappone Cotignola, Italy Uses step wise technique, though different than Bordeaux group.
Dr. Sidney Peykar Sarasota, Florida Uses Bordeaux step wise technique and trained in Bordeaux.
Dr. Robert Eckart Sarasota, Florida
Dr. Vivek Reddy New York, NY Uses step wise technique, though different than Bordeaux group.
Dr. Darryl S. Wells Seattle, WA Does CryoBalloon ablation.
Dr. William H. Sauer
Dr. Ryan G. Aleong
Aurora, CO Modified step-wise approach.
Dr. J. Marcus Wharton Charleston, SC  —
Dr. Wilber Su Phoenix, AZ  —
NOTICE: we offer no preferential listings. We accept no fee, benefit or value of any kind for listing a specific doctor or medical center. A-Fib.com is not affiliated with any practice, medical center or physician.

HOW TO FIND THE CONTACT INFO: Use the “Search our site” box (upper right on this page) to get to the right Directory page. Then, open your browser’s ‘Find on Page’ feature (‘CTRL+F’) to locate the name on the page.

Disclaimer: this directory is provided for your convenience only.  We make no endorsement of a specific physician or medical facility. Choosing a physician is an important decision and should be based upon your own investigation of each physician’s training, education and experience. This directory offers you the opportunity to locate and contact a healthcare professional directly.

♦ ♦ ♦

Last updated: Saturday, May 14, 2016

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