Atrial Fibrillation--Continue

  Other medicines, called anti-arrhythmic drugs, are used for the heart's coversion to a regular rhythm. These include sotalol (Sotalol--BC) (preferred), amiodarone (Cardarone) or flecainide (Flecatab). The best drug or combination for you often depends on whether you have underlying heart disease or high blood pressure.

PROMISING DEVELOPMENTS

• Researchers at the University of Buffalo have isolated a specific protein in the venom of Chilean tarantulas. It shows promise as the basis for a new class of drugs to block the aberrant electrical impulses causing atrial fibrillation.
• As study from Turkey revealed that magnesium can reduce the incidence of AF among patients undergoing bypass surgery. Only 2% of those who received magnesium supplementation experienced postoperative AF, compared with 21% of those who did not get the mineral.

Procedures
If your AF persists despite the drugs, there are a number of different medical procedures that might help. The least invasive is external electrical cardio-version, which can usually restore the heart's normal rate and rhythm. Performed under light sedation, this procedure involves delivering a high-energy electrical shock through two external paddles. The jolt briefly disrupts all electrical activity in your heart, and thus allows your normal heartbeat to re-emerge.
  For about 10 percent of AF patients, however, episodes continue despite these treatments. In such
circumstances, surgery may be the next best option. The most common procedure is called a catheter ablation. Here doctors thread a tiny eletrical wire (electrode) into your heart and actually destroy a tiny piece of heart muscle called the atrioventricular (or AV) node. This bundle of cells allows electrical impulses to pass from the atria down to the ventricles. If the hundreds of chaotic impulses from the fibrillating atria are blocked at the AV node, then your heart rate will slow down.  Unfortunately, without any electrical impulses from the atria, the ventricles start pumping on their own, but at a rate too slow to keep you alive. So at the same time the AV node is destroyed, the surgeon needs to insert a permanent pacemaker, which keeps your heart pumping  a steady rhythm fort the rest of your life.

>Does an episode of atrial fibrillation mean I have  heart disease?
Probably not. In many cases, a single, isolated case of AF is triggered by something unrelated to your heart (binge drinking, for example). And when that problem is treated or corrected, the fibrillation goes away. A full diagnostic workup, including an ECG (electrocardiogram) by a cardiologist, is warranted in any case to rule out underlying coronary heart disease, a heart valve problem or other heart-related conditions.

>Will I have to take heart rhythm medications for the rest of my life?
Not necessarily. If doctors can restore a normal heartbeat and your heart rhythm stabilises, you may be able to stop taking medications and see what happens. If episodes of AF continue to occur, however, you'll probably need long-term medication.

Another type of ablation, a minimally invasive procedure known as radio-frequency catheter ablation (RCA), can permanently cure cardiac arrhythmias in some patients. RCA is often effective in people whose AF is triggered by extra hearbeats that arise within the pulmonary veins that return blood from the lungs to the left atrium.
  Another choice is an implantable atrial defibrillator. This is similar to the external variety, except that instead of using paddles to give the shock, a catheter is inserted through a vein and threaded into your heart to deliver the shock directly. However, this technology is usually reserved for patients with life-threatening ventricular arrhythmias rather than the more benign atrial fibrillation.
  Primarily under investigation is a more aggressive approach called a maze procedure. Here the surgeon makes a series of maze-like cuts in the walls of your atria, and then sews the incisions back together.  When they heal, they form scar tissue that blocks the transimission of faulty electrical impulses, thus thwarting AF. After this invasive surgery,  AF is unlikely to recur, but you will probably need a pacemaker and, sometimes, drugs to maintain a normal heart rate  and rhythm.
  When other heart problems are the underlying cause of AF, surgery to replace a damaged heart valve or to bypass blocked coronary arteries may clear up the atrial fibrillation as well.

Lifestyle changes
Commonsense everyday strategies that you can follow to make your heart healthier;

• Adjust your diet. Reduce the saturated fats, cholesterol and trans-fatty acids that you eat. Concentrate on fruits, vegetables, legumes and whole grains; they should be 60 percent of your diet.
• Reduce your sodium intake. Salt can often raise your blood pressure, compounding any AF problem you might have.
• Control your weight. Excess kilos are taxing on the heart.
• Exercise vigorously. Try it for 30 minutes a day,  three to four times a week, to keep your heart healthy and your blood pressure down.
• De-stress. Adopt some relaxation exercises or stress management techniques, such as yoga, tai chi or meditation.
• Quit smoking. 
• Control diabetes. Make sure diabetes is  well under control.
• Limit alcohol consumption. Try to limit the number of alcoholic drinks you consume.
• Reduce caffeine intake. Too much coffee or cola can increase your pulse rate and your blood pressure.