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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Have TB, Inflamatory Cardio Miopathy, Have Racing Heart. What Is Going On?

I am 42 yrs male. I staretd getting afib abour 1 years back. It was detected that i have Tuberculosis and because of that there is inflamatory cardio miopathy developed. i have afib lasting for about 1.5 hours and it goes without any medicine. my left atrium size was 57 mm. after taking traeatment of tb, there is significant change in overall condition with improvement in skin color and size of left atrium comes to 40 mm. However, i have atleast 3 episodes of afib than but it seems more laike a racing heart . i wonder, whether reduction in size of left atrium will help overcome this episods,
Wed, 20 Mar 2013
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General & Family Physician 's  Response
Hi, thank you for the query and welcome to hcm forum.

The exact mechanism of atrial fibrillation (AF) is poorly understood and complex. You got it right that left atrial enlargement or dilatation is associated with AF. But whether reduction of it's size can abolish AF,i think, is not evident. because atrial enlargement can cause mechanical and electrical remodelling. so the size may be decreased to normal but the micro or macro structural change can never be reverted to normal again. Inflammation almost always do some fibrosis which is permanent that can cause AF. I hope you got your answer.
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Critical Care Specialist Dr. Arshad Hussain's  Response
Hello

Welcome to health care magic

Dear patient, after inflammatory myocarditis, even if left atrial size returns to normal, it does not guarentee that AFib wouldn't happen again, so after recovery from inflammatory myocarditis after taking ATT if you had 3 episodes of AFib it is not a surprise , because after inflammatory myocarditis there are some scar areas in the artia around which the current of heart beat keeps on rotating as well as there are other ectopic foci formed which generate impulses like the hearts pacemaker and together these two mechanisms give rise to disorganised electrical activity in the heart in the form of atrial fibrallation (AFib). you consult a cardiologist who will assess your AFib and will decide which drug he will like to give for rate control or rhythem control , wheather there is any need for anticoagulatio (blood thinner) medicine or not or wheather you need to go for EPS (electrophysiological study) and radiofrequency abilation or not

wish you good luck

thanks

D Arshad
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Have TB, Inflamatory Cardio Miopathy, Have Racing Heart. What Is Going On?

Hi, thank you for the query and welcome to hcm forum. The exact mechanism of atrial fibrillation (AF) is poorly understood and complex. You got it right that left atrial enlargement or dilatation is associated with AF. But whether reduction of it s size can abolish AF,i think, is not evident. because atrial enlargement can cause mechanical and electrical remodelling. so the size may be decreased to normal but the micro or macro structural change can never be reverted to normal again. Inflammation almost always do some fibrosis which is permanent that can cause AF. I hope you got your answer.