At 72, can catheter ablation cure my atrial fibrillation?

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

In your cases, irregular heartbeat due to atrial fibrillation (AFib) leading to palpitations and shortness of breath. High blood pressure and mild kidney dysfunction worsen the risk profile.

AFib with high blood pressure (BP) and kidney issues can be tricky but manageable. Blood thinners are very important in AFib because stroke risk is much higher if left untreated. The decision between Warfarin and newer non-vitamin K antagonist oral anticoagulants (NOACs) (Apixaban, Rivaroxaban) depends on your kidney function, cost, and how easy it is for you to monitor International Normalized Ratio (INR).

Warfarin (an anticoagulant) needs regular blood tests. Also, food or drug interactions are common. NOACs are usually safer for brain bleeds and do not need regular INR checks. But dose adjustment is needed if your kidney function is low.

Catheter ablation is an option, but not always first line at your age. We usually try medicines first to control the rate and rhythm. Ablation is considered if symptoms are bad despite medicines or if your heart rate control is difficult.

However, I advise you of the following tests;

1. Echocardiogram (you already had with good results).
2. Kidney function test (before and during anticoagulant use).
3. Congestive heart failure, hypertension, age ≥75 (doubled), diabetes, stroke/TIA (doubled), vascular disease, age 65 to 74, and sex category or CHA₂DS₂-VASc score (to assess stroke risk).
4. Hypertension, abnormal renal/liver function, stroke, bleeding history or predisposition (HAS-BLED) score (to assess bleeding risk).
5. Holter monitoring if symptoms are frequent.
6. Thyroid profile (to rule out hyperthyroidism as a trigger).

Also, you can follow the following treatment plan:

1. Anticoagulation: Prefer Apixaban (better kidney safety profile) if estimated glomerular filtration rate (eGFR) is more than 30.
2. Warfarin only if NOACs are contraindicated or unaffordable.
3. Beta blockers or calcium channel blockers to keep your heart rate under control.
4. Avoid alcohol and excess caffeine, as they trigger AFib.
5. Low salt, to keep your blood pressure under control.
6. Regular walking and weight control.
7. Control sugar and cholesterol to reduce heart strain.

I hope this information helps you.

Feel free to ask further queries.

Thank you.