Health Hotline: Doctors respond to atrial fibrillation questions via email

Atrial fibrillation is a common heart arrhythmia that primarily afflicts older people. It's an electrical problem in the heart and causes the heart to quiver, rather than beat, so that it doesn't pump adequately. Blood can pool, resulting in stroke. And the wear and tear on the heart muscle can also result in heart failure. But it's treatable.

January's Deseret News/Intermountain Health Hotline focused on atrial fibrillation and Dr. John Day and Dr. Brian Crandall, both interventional cardiologists at Intermountain Medical Center fielded dozens of calls regarding Afib, as it's often called. They also agreed to answer questions that are e-mailed in. Here are those questions and answers, which have been edited to avoid repetition and to protect personal information:

QUESTION: My husband has had atrial fibrillation for five years. His cardiologist has suggested "shocking" his heart to get it to return to its normal rhythm. Will the heart do that after it has been out for so long?

ANSWER: While it would be great to have your husband back in normal rhythm, unfortunately, when people have been continuously out of rhythm for many years the chance of a cardioversion (shocking the heart) working long term is quite low. The chances of a successful cardioversion are improved if your husband does not have any other heart problems, other than his atrial fibrillation, and if the size of the left atrium of his heart is not too enlarged (this can be easily seen on an echocardiogram or ultrasound of the heart). Your physician may also prescribe an anti-arrhythmic medication to help hold his heart in normal rhythm after the cardioversion. If the atrial fibrillation is impacting his quality of life and medications and cardioversions are not working, you may want to consider being evaluated for a possible catheter ablation procedure to potentially eliminate atrial fibrillation.

QUESTION: I have been diagnosed with a slight heart murmur. I have had it all my life. I also took Fen-Phen for about five months back in 1997-98. I had the exam and was diagnosed with "mild mitral regurgitation" by the Fen-Phen Trust physicians. Now that I am in my mid 50s, I am having sleep problems and am awakened a couple of times a week with a fast heartbeat or noticeable hard, rapid pounding. I know I'm over my ideal weight and my diet is just now being addressed and modified.

Can taking the Fen-Phen be catching up with me now? I have had ultrasounds and EKGs in the past three years and the doctors were never overly concerned, but now with the night wake-up calls to the rapid heartbeat, I'm wondering if the Fen-Phen and my extra pounds are taking their toll. What should I do? Call a physician and then the Fen-Phen Trust people?