Earlier in the conversation you had mentioned that medication can help, but do a lot of patients go on with medication and never have it corrected?
Dr. Lishan Aklog:
Yeah, so if you are talking about medication we should talk sort of in two categories – the first category are a pretty straightforward and those are blood thinners. So patients who have atrial fibrillation because the atrial chambers are not contracting properly there’s stagnation of blood and people are prone to developing blood clots. So, it’s absolutely mandatory that patients be on some type of blood thinner, preferably Coumadin or Warfarin to decrease, not eliminate, but to decrease the risk of blood clot formation and thus the risk of stroke.
Then, the other broad category of medications are a little bit more challenging and those are medications that attempt to treat the rhythm itself, and there are whole variety of medications that are utilized for that. The bottom line is however, that there are no medications that are shown to cure atrial fibrillation. The best we can do is, keep the rate down, which is important. You know, if you have atrial fibrillation it’s a lot more comfortable to have your heart rate at 60, 70, 80 than it is at 130, 140, 150.
So general, most we can get medications that will keep the rate down, but none of the medications actually can cure atrial fibrillation and in fact, many of them are potent medications, which any patient who has lived with atrial fibrillation for a while will know these names and very often when we see them cringe when we discuss them medications like Amiodarone, Rythmol, Flecainide and others, not only is their effectiveness, they are not that effective at keeping you out of them, they all carry their own, they have a cost associated with them in terms of, you know, sometimes quite severe and long-term side effects.
So it’s not something that generally in the long-term we like to keep patients on because they have really serious and sometimes even life-threatening side effects. So, the bottom line, Todd, is that medications do not cure atrial fibrillation.