Question: I have atrial fibrillation and have had seven cardioversions in the past six years as well as an ablation six years ago. I take Coumadin, Avapro, and Toprol. What more can I do?

Dr. Hibberd's Answer:

Atrial fibrillation (AF) is an irregular heart rhythm of the upper chambers (the atria). This causes a part of the heart beat abnormally, and often allows blood clots to form, placing its victims at a very high risk for stroke.

Coumadin has been conventionally recommended for long-term anticoagulation, but a newer medication called Pradaxa (dabigatran etexilate) seems poised to take Coumadin's place in treating atrial fibrillation not related to heart valve abnormality.

Pradaxa is a different kind of blood thinner. It offers similar stroke protection, but has a lower risk for bleeding. In addition, it makes the weekly/monthly blood testing often needed with Coumadin obsolete.

Ablation treatments are used to cure AF by destroying selective pathways in heart tissue responsible for the irregular rhythm. Since your ablation, techniques have improved, so it may be worth a second attempt using newer techniques. Ask your cardiologist or primary care physician for a referral to an EP cardiologist for consultation on options that are reasonable for you. Be warned, though, ablations are very costly and can cost $40,000 to $60,000. In some cases, the costs may be as much as $120,000.