Hi,
Thanks for writing in.
I am a qualified cardiologist and I read your query with diligence.

WIth all details provided I assume that you do not have mitral valve disease and what you have is lone atrial fibrillation for long duration. Echocardiography must have been done sometime in past 5 years and that would have ruled in favor of rate control. Acute atrial fibrillation(AF) we go in for rhythm control.

However strategy of rate control (if ventricular rate is high to control it with long term therapy with- prescription drugs verapamil or diltiazem- to a strategy of rhythm control (cardioversion to sinus rhythm plus drugs to maintain sinus rhythm) has found no differences in stroke. Clinically silent recurrences of AF in the rhythm-control group are theorized to be responsible for the increased rates of thromboembolic events in this group. This underscores the importance of anticoagulation in both rhythm-control and rate-control patients.

One of the major management decisions in AF (and atrial flutter) is determining the risk of stroke and appropriate anticoagulation regimen for low-, intermediate-, and high-risk patients. For each anticoagulant, the benefit in terms of stroke reduction must be weighed against the risk of serious bleeding. Overall, approximately 15-25% of all strokes in the United States (75,000/y) can be attributed to AF. Known risk factors for stroke in patients with AF include male sex, valvular heart disease (rheumatic valvular disease), heart failure, hypertension, and diabetes. Additional risk factors, such as advanced age and prior history of stroke, diabetes, and hypertension, place patients with preexisting AF at even higher risk for further comorbidities such as stroke

Risk Factors for stroke:
1.Prior stroke or TIA
2.History of hypertension
3.Heart failure and/or reduced left ventricular function
4.Advanced age
5.Diabetes
6.Coronary artery disease

Apart from advanced age I do not find any other risk factor in you.
Most clinicians agree that the risk-benefit ratio of warfarin therapy in low-risk patients with AF is not advantageous. Warfarin therapy has, however, been shown to be beneficial in higher-risk patients with AF. A target international normalized ratio (INR) of 2-3 is traditionally used, as this limits the risk of hemorrhage while providing protection against thrombus formation.
The appropriate treatment regimen for patients with AF at intermediate risk is controversial. In this population, the clinician should assess risk factors for thromboembolic disease, patient preference, risk of bleeding, risk of falls or trauma, and likelihood of medication adherence. Warfarin is also superior to clopidogrel or a combination of clopidogrel and aspirin in the prevention of embolic events in higher-risk patients.
High-risk factors include prior stroke, TIA, and systemic thromboembolism. Moderate-risk factors include age older than 75 years, hypertension, heart failure, left ventricular function less than 35%, and diabetes mellitus. So in conclusion you need:
1.If your ventricular rate is high a prescription drug diltiazem or verapamil for rate
control
2.You fall in low risk of thromboembolism as per the available data a combination of
low dose enteric coated aspirin 75 mg with clopidogrel 75 mg once day after
meals is all you need.

As all are prescription drugs, a doctor need to see you and examine before prescribing, he may want to do an EKG, Holter and or echocardiogrpahy.
I hope the answer is useful, if you have further query you are welcome to ask, I shall answer asap.

With Best Wishes.

Dr Anil Grover, Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

---

Hi,

Thanks for your feedback. I get you what you mean. Let me explain Atrial fibrillation is such a chaotic rhythm of upper chambers (Atria) of heart that natural measure which are effective in upper chamber rapid rhythms (like supraventicular tachycardia for example) like:
1. Avoidance of stimulants like caffeine (tea or coffee), caffeine containing cold
drinks
2. Alcohol or any other precipitating cause
3. Those rhythms can be terminated by vagal stimulation (Gentle pressure on eye
balls, self induced vomiting, increasing vagal tone by exercise and termination
of abnormal atrial rhythm by diving reflex that is put you face in bowel of water)
These measures are not effective in the treatment of atrial fibrillation.
There is no Ayurvedic treatment I know of.
Anecdotal reports are there of natural therapy, I will urge you to read that may be you find anything of use in that. As a cardiologist, I do not find any. The reference is WWW.WWWW.WW It has big sounding opening I quote "Don’t Let Atrial Fibrillation Steal Your Life Away….

Atrial Fibrillation Can be Successfully Treated
Without Drugs or Surgery". This might helped some. I personally and as a professional is not trained to trust this and my 30 years experience as a cardiologist and seeing at least one case per day, by intuition, is unable to support.
I am sorry to disappoint you friend. Take care.

If you have any other query I will answer that happily.

Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

---

Hi XXXXXXX
Thank you for your kind words.
If you come across some research or anecdotal incidences; I shall be grateful if you can pass them on to me at YYYY@YYYY . In our field you never stop to learn.

It was pleasure interacting with you. Please close the query with comment.
Thanks

Dr Anil Grover,
Cardiologist
M.B.;B.S, M.D. (Internal Medicine) D.M.(Cardiology)
http://www/ WWW.WWWW.WW

---