Somewhat new to AFIB, need advice for long term plan

Hello-

I say "somewhat" because I just finished my second 48 hour hospital stay in the past three years. I do not have much faith in the cardiologist (not an EP) who treated me at the hospital, and am hoping to learn what to look for in terms of long term heart doc.

Background: I am 38, married w/ 3 young kids, nonsmoker, 6 feet 190 lbs, probably don't exercise enough. I am likely destined for lipitor based on family history, otherwise pretty lucky to be healthy. My first episode that I noticed was in 1996 at a sidewalk cafe in Hungary on a a college trip. Fortunately I was too immature/dumb to be concerned about it, but looking back is frightening. Occasional flutters here and there, but nothing lasting more than a few moments or even seconds. In Jan 2009, I had my first major one that wouldn't go away. It kicked in right after I jogged up a flight of steps, and after a few hours we went to the hospital, where I was formally diagnosed. Stayed there for a couple days on thinners, and overnight it self-converted. After that, I went to a cardiologist for stress testing on a treadmill and some other tests that I don;t recall, and was told not to take any steps other than monitor and let them know if anything occurred. Didn't notice a thing for 1.5-2 years.

About six months ago I began to get the small flutters, but again nothing lasting very long. January 3rd, I had my second major attack again after jogging up a flight of steps. (Almost three years to the day, which I know because it tends to happen when the Bengals are about to be embarrassed in the playoffs). To be forthright, I did overdo it a bit on New Years Eve. That is an extremely rare occasion, but probably did not help. Spent two nights in the hospital, a bit different this time because my heart rate spiked to 190 briefly, so I wound up on thinners and Lopressor. Self-converted again, and was sent home by the attending cardiologist (non EP, didnt know what that was at the time) with a beta-blocker script (metaprolol, i believe same as lopressor). I didn;t understand this, because my heart rate was normal by then, which for me has always trended toward the low side, blood pressure has never been an issue fortunately. On the first day of being home on the beta blocker, my heart rate dipped below 60 and I felt very lethargic and miserable enough to cause my wife a great deal of worry. Cardiologist pulled me off of it and told me to call his office as soon as possible for an appointment, which is where I am now.

I am researching doctors now, looking especially for AFIB specialists. I feel as though I should not have been prescribed the beta blocker as my heart rate was already normal and I have no history of high BP. This has me thinking that the cardiologist was simply going through the motions and sort of prescribing by the book based on trial and error. I may be off base, but it seems like this is partially the reason for EPs, would like some input on that.

Aside from taking the elevators and avoiding the Bengals, what jumps out at those of you about my situation? Any advice?

I happen to be located in Cincinnati, and have run across Dr. Wolf, and the Univ of Cincinnati AFib center, among others in my search. Plenty of EPs to choose from, all seems to be covered by my insurance. How to choose?

Thanks, and glad to meet everyone. Happy New Year!

Your brief summary would indicate an adrenergic trigger <[www.afibbers.org];, since exercise seems to set off afib. In some adrenergic cases beta blockers can be appropriate and effective for adrenergic afibbers as they keep your heart rate during exercise low, and may prevent afib.

Experimenting with the right dose would need to be done to minimize the effect of the BB while keeping the afib at bay. Rate in afib is another thing entirely. If you have a rate > 100 in afib, you should bring it down so you don't get cardiomyopathy from the high rate, if the afib persists for a few days or more.

George

I do a lot better on calcium blockers. But everyone is individual. The nice thing is that Magnesium performs a similar role as calcium blockers.