New FAQ about Asymptomatic Long-Standing Persistent A-Fib
We’ve posted a new FAQ and answer based on an email I received from a fellow with a very challenging case of Long-standing Persistent Atrial Fibrillation:
“I am 69 years old, in permanent A-Fib for 15 years, but non-symptomatic. My left atrium is over 55mm and several cardioversions have failed. My EP won’t even try a catheter ablation. I exercise regularly and have met some self-imposed extreme goals. What more can I do?
My answer: As you may know, being in permanent (long-standing persistent) Atrial Fibrillation can cause other long term problems like fibrosis, increased risks of heart failure and dementia. So you are wise to be concerned.
I’m not surprised your electrophysiologist (EP) is reluctant about performing a catheter ablation. Being asymptomatic with 15 years of long-standing persistent A-Fib and a Left Atrium diameter of 55mm, most EPs wouldn’t recommend or perform a catheter ablation on you.

Tikosyn: (dofetilide)
Drug Therapy Option: Tikosyn
Have you tried the newer antiarrhythmic drug Tikosyn (generic name dofetilide)?
Tikosyn was designed for cases like yours. It’s a Class 1A drug that works by blocking the activity of certain electrical signals in the heart that can cause an irregular heartbeat. …Read more of my answer…