Q. I have AF with serious left atrium dilation. What is the level of risk for life?

Answered by
Dr. Naresh Kumar Monigari
and medically reviewed by Dr. Hemalatha
This is a premium question & answer published on Nov 27, 2019

Hello doctor,

I have AF for six years. Tried DCC and got sinus rhythm for 12 months, then back to AF six months ago. My echo showed serious left atrium dilation (more than 200% i.e. 180 ml compared to the normal 60 ml) and mild ventricular dilation. 24 hour tape ranges from tachycardia of up to 120 and bradycardia with up to two seven second pauses per night, but it was stable before one year. My ejection fraction is normal (60%). I have booked to have an ablation.

Could you please describe what is the level of risk to life of such serious dilations, and what can be done to get them back to normal?

Dr. Naresh Kumar Monigari

General Medicine Internal Medicine
#

Hello,

Welcome to icliniq.com.

I had gone through your query. So as ablation can prevent AF (atrial fibrillation) but the return of atrial size to normal is unlikely. The risk due to atrial dilation in AF is due to the formation of blood clots inside left atrial appendage and chance of embolism producing a stroke. We normally perform transesophageal echocardiogram to rule out the presence of thrombus before considering for DCC (direct current cardioversion). So if the size is more than 4.5 cms and some consider more than 5.5 cms there is a need for anticoagulation (blood thinners) to prevent thte stroke. Some may consider left atrial appendage closure device or surgical removal so that the chance of stroke decreases. So you need to discuss these issues with your consultant cardiologist who is planning ablation. I hope this helps.


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