2019.10.15 00:45
2019.10.15 01:04
2019.10.15 04:15
Your editorial comment as a cardiologist regarding this article is
quite valuable to elderly persons like us and we appreciate it greatly! KJ
2019.10.15 05:11
Thank you, Dr. Hwang, for your comment.
In the last few months one avid golfer, age 70, I know experienced PAF
while on golfing trip.
One cardiologist friend of mine underwent ablation therapy quite recently
after dealing with recurrent PAF a number of years.
This article does not recommend this PIP approach for people over age 76, however,
because of drug side effects, although I feel that each case can be individualized.
I believe the side effect has to do with bradyarrhythmia such as transient asystole or
heart block at the moment cardioversion takes place after taking the drugs.
I observed this when I was doing it on my patients in ER while on heart monitor.
Many elderly first develop paroxysmal atrial fibrillation(PAF)prompting visits to ER.
Then would experience recurrence of AF causing multiple visits to ER.
This continues for a number of years, then AF persists requiring daily medication including
anticoagulants, some of the patients electing to undergo ablation procedure which often takes
4-5 hrs with small incidence of complications.
This pill in pocket approach described here in detail applies to those patients who have been
diagnosed to have recurrent PAF and is an excellent idea of self help, obviating the need to go to ER,
minimizing the development of left atrial thrombus and preventing the stroke by quickly converting
PAF to normal sinus rhythm.
The success rate is very high so that the patient can certainly discuss with the cardiologist regarding
this approach.