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Having Atrial Fibrillation From Smoking Pot. Taking Alcohol And Marijuana. Suggest The Permanent Cure?

Posted on Tue, 5 Nov 2013

Question: My husband started in AF when he was about 46. He had a 30 yr g hx of alcohol and marijuana use. He went to rehab 3 times and finally quite drinking. He has continued smoking pot on off all of that time. Although he is very careful about hiding his addiction from me, I know when he smokes it because he looks bright red, and complains of his heart hurting in the following days...I am certain that marijuana is contributing to his AF, but his cardiologist went as far as to write a letter that it wasn't. My husband went 4 months without smoking pot, but eventually succumbed, smoked it and went back into AF within a few days of when I suspected he smoked it. Now he has scheduled another cardio ablation. Its clear to me that he using cardio ablation and cardio-version to mitigate the effects of smoking pot because he doesn't want to quite. Is there such a thing as too many cardioversions and ablations? Would they seriously consider a pace maker or open heart so he doesn't go into afib from smoking pot? Very frustrated... Thank you for you input in advance.

Answered by Dr. Anantharamakrishnan (6 hours later)

Brief Answer:
Ablation helps in long term

Detailed Answer:
Hi friend,
Welcome to Health Care Magic

Cardioversion is a rescue procedure
It is just symptomatic treatment
It is for immediate results
It has no long term benefits or harm

Ablation is definitive approach
It is an attempt to address the cause of the underlying problem
An abnormal nerve pathway, if located, can be ablated… / Recurrence is possible – newer tracts may show up…
‘Pulmonary vein isolation’ is another approach – the origin and spread of most cases of A-fib are in that area
Surgery is rarely done nowadays – multiple incisions in the atrium, to break the circuit.
Pacemaker is not an option in such cases / If the rhythm can not be controlled, one goes for rate control.

The association between marijuana and heart is known…
WWW.WWWW.WW
We empathize with you / care taker fatigue is well known phenomenon…

Psychiatric assessment and assistance can help in addiction…

Take care
Wishing all well
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar

Follow up: Dr. Anantharamakrishnan (30 minutes later)

As a cardiologist, how many cardioversions and oblations would you give to a patient. Is there risk with having too many? Do you feel its ethical to keep providing treatments such as the above mentioned even though the patient doesn't plan to stop, but is using these treatments to make his addiction/residuals feel better.

Answered by Dr. Anantharamakrishnan (1 hour later)

Brief Answer:
Needs treatment / Needs rehab

Detailed Answer:
Hi

     There is no limit to the number of attempts, over a period of time. In a given day though, if 2 or 3 attempts do not succeed, one goes for rate control for the time being (leaving rhythm control, for a later time).
Done under proper conditions, the risk if practically negligible.

     If an attempt fails or if a new pathway comes into effect – another ablation is necessary. The need is dictated by the clinical situation, not the number.

     Is not withholding available treatment ethically, morally and legally wrong?
     In prolonged A-fib, the danger of embolism is high. Depending on the site, it may lead to consequences like paralysis and so on. Anticoagulants are given in such situations and it has its own problems – dose titration, frequent follow up, bleeding complication and so on

     This has no direct effect on his addiction – which should be addressed by a Psychiatrist, specialized in the field. The cardiologist can only suggest / refer and is unlikely to have expertise in the other area…

Regards

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Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar