lone a.f.-need help on decision

I have lone paroxysmal A.F...on tykoson and coumaden for 3 years. Electrophys has reccomended procedure to correct.consistig of PVAblation with cryotherapy as well as tying off the atrial appendage. Approx. 2 hours on the pump. Incision to be made just below the right breast to insert camera and "tools" of the trade. Says success rate is 85 per cent.I am new to all of this . Would appreciate any input for making a decision.Has anyone had a similar procedure?A.F. has not been bothersome to me except depressing to deal with. Able to function normally,jog and bike etc. Thought about just stay staying on coumaden but warned this could have problems long term as well. Also concerned that if becomes chronic more difficult to correct. Thanks for any help......jack

Jack:
In looking for answers for you, I ran across this interesting article about a transcatheter approach to dealing with the left atrial appendage. Don't know how much it is being used yet, or if it's still experimental.

Percutaneous Closure of the Left Atrial Appendage
STEFAN OSTERMAYER, MADLEN RESCHKE, KAI BILLINGER, THOMAS TREPELS, FRANZISKA BÜSCHEK, YVES BAYARD, and HORST SIEVERT, M.D.

Patients with atrial fibrillation (AF) are at high risk of stroke. More than 15% of all strokes are due to atrial fibrillation. So far anticoagulation is the treatment of choice with a risk reduction of almost 70%. On the other hand, anticoagulation has many side effects such as intracranial or gastrointestinal hemorrhage. Closing the left atrial appendage (LAA) might be an alternative in patients who cannot take anticoagulation treatment due to contraindications or conditions in which the hazard of hemorrhage is greater than the potential clinical benefit. The PLAATO system (Percutaneous Left Atrial Appendage Transcatheter Occlusion) is a new device to close the LAA by the catheter technique. The device consists of a self-expandable nitinol cage that is covered with ePTFE. It is delivered via a specially designed 12F transseptal sheath. Small anchors along the struts prevent the occluder from embolizing. After device implantation patients are placed on aspirin only. The results of the dog model and the first clinical experiences in humans have been very promising. (J Interven Cardiol 2003;16:553-556)

Here is another link:

[www.ncbi.nlm.nih.gov]

After some research, it seems there are a number of ways to deal with this, all seemingly new. Your decision is a tough one considering that your afib is not that symptomatic, or you say that it is not that bothersome. Could you answer a few more questions? Your age, any other major health problems, the frequency of your afib episodes, the duration of those episodes.
The pursestring occlusion of the left atrial appendage, using a transthoraxic approach on heart and lung maching for 2 hours seems quite invasive, risky and perhaps still experimental for a person who describes their atrial fib as "not that bothersome".
Jack, I'm sure you will get lots of suggestions and helpful hints from this BB. Although the ultimate decision is yours, you can benifit from those who have been, and are, where you are.

Pam

Jack:

It also seems that this LAA occlusion is being done without the bypass machine and just through a catheter. I will look for more one that. One other question - have you ever had a problem taking Coumadin? Have you read anything yet about the new anticoagulant Exanta? That will improve things for those of us who must remain on anticoagulation.

Pam

Pam,thanks for reply. I am 66 and with this exception seem to be in good health. I am just beginning to learn a little about my options and it appears that most patients I am reading about are having more problems than I am presently....but I do not wish to delay treatment until it becomes more difficult to treat ( I am told when it becomes chronic sucess rate lowers).My a.f. usually lasts 10 to 15 hours and approx. 5 or 6 times a week.Often starting late afternoon and lasting until a.m. when I take 25 mg. lopressor . It normally stops then or I can usually stop it with 5 to 10 minutes of jogging. Have not had a problem with coumaden. Thanks for your help....jack