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Suffer From Recurrent Pulpitations And Associated Chest Discomfort. Cardio Angiogram Revealed Normal Epicardial Coronaries. Suggestions?
Respected Doctor,
I am V. Loganathan, 58 years, who is suffering from recurrent Pulpitations associated with chest discomfort since 45 days. Took treatment in Ramachandra Medical Cetre and for further management I was admitted in Global Hospital, Chennai. I was started on Inj. CARDARONE infusion over 24 hours and rate controlled. I was also underwent Cardio Angiogram on 29.07.2013, which revealed normal epicardial coronaries. Procedure and post procedure uneventful. On 30.07.2013 I underwent Electro Physiology Study which revealed non sustained atrial arhythmias-atrial tachy and fibrillation -probable flutter. I was advised Radio Frequency Ablation preferrably using 3 D mapping. On discharge I was given with the following medication: - 1. Tab. Clopivas AP 75/75mg. 0-1-0 and 2. Tab. Cardorone 200mg 1-0-1. In this juncture I enquired the hospitals I was told this Radio Frequency Ablation preferrably using 3 D mapping will cost around 4 lakhs. I am not in a position to spend this much amount since I am a retired person and getting only meagre pension. Kindly let me know the other positive was to control the above palpitation and chest discomfort by medication please.
I am V. Loganathan, 58 years, who is suffering from recurrent Pulpitations associated with chest discomfort since 45 days. Took treatment in Ramachandra Medical Cetre and for further management I was admitted in Global Hospital, Chennai. I was started on Inj. CARDARONE infusion over 24 hours and rate controlled. I was also underwent Cardio Angiogram on 29.07.2013, which revealed normal epicardial coronaries. Procedure and post procedure uneventful. On 30.07.2013 I underwent Electro Physiology Study which revealed non sustained atrial arhythmias-atrial tachy and fibrillation -probable flutter. I was advised Radio Frequency Ablation preferrably using 3 D mapping. On discharge I was given with the following medication: - 1. Tab. Clopivas AP 75/75mg. 0-1-0 and 2. Tab. Cardorone 200mg 1-0-1. In this juncture I enquired the hospitals I was told this Radio Frequency Ablation preferrably using 3 D mapping will cost around 4 lakhs. I am not in a position to spend this much amount since I am a retired person and getting only meagre pension. Kindly let me know the other positive was to control the above palpitation and chest discomfort by medication please.
posted on
Tue, 27 Aug 2013
Medically reviewed by
Ask A Doctor - 24x7 Medical Review Team
Fri, 30 Aug 2013
Answered on
Fri, 30 Aug 2013
Last reviewed on
Dear Sir
Thanks for your query to us.
1. Your diagnosis as written by you is not very clear. If it is atrial flutter or atrial fibrillation? Both have different treatment options.
2. At age of 58 years, A. fibrillation can be tackled with drugs (rate control or rhythm control strategies) or by ablation. A number of factors govern that ablation will be successful or not. A rate control strategy with control of heart rate and prevention of clot formation is as good as rhythm control in most scenarios.
3. Atrial flutter is usually associated with some structural heart disease (evident on ECHO). If it is not so, then you may expect it to degenerate into fibrillation with time. Treatment includes drug therapy or ablation. Ablation is a better option in these patients. Otherwise long term medication along with drugs for clot prevention help majority of them.
You can take a second opinion on this issue.
If you are somewhere near Kochi, I have heard that Amrita institute of medical sciences has very good cardiology deptt.
Sincerely
Sukhvinder
Thanks for your query to us.
1. Your diagnosis as written by you is not very clear. If it is atrial flutter or atrial fibrillation? Both have different treatment options.
2. At age of 58 years, A. fibrillation can be tackled with drugs (rate control or rhythm control strategies) or by ablation. A number of factors govern that ablation will be successful or not. A rate control strategy with control of heart rate and prevention of clot formation is as good as rhythm control in most scenarios.
3. Atrial flutter is usually associated with some structural heart disease (evident on ECHO). If it is not so, then you may expect it to degenerate into fibrillation with time. Treatment includes drug therapy or ablation. Ablation is a better option in these patients. Otherwise long term medication along with drugs for clot prevention help majority of them.
You can take a second opinion on this issue.
If you are somewhere near Kochi, I have heard that Amrita institute of medical sciences has very good cardiology deptt.
Sincerely
Sukhvinder
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