Patient: Description of condition (onset, main symptoms, hospital visited, etc.): Pre-excitation syndrome (supraventricular tachycardia) for 35 years, atrial fibrillation for 1 year, hypertension for 2 years, pre-excitation syndrome (supraventricular tachycardia) was successfully ablated by radiofrequency in April 2010 at Beijing Fu Wai Hospital. Afterwards, atrial fibrillation occurred 5 times from May 2010 to October 2010, and the ultrasound showed that the left atrium was enlarged (45mm). Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Atrial fibrillation and atrial enlargement are mutually reinforcing, one should control atrial fibrillation and then take medication to assist in treatment. It may be possible to recover some. Radiofrequency ablation therapy for atrial fibrillation can help. Patient: Director Chen Gang, I am a patient from Qinghai. On March 16, 2011, you performed radiofrequency ablation of atrial fibrillation on me, and I was discharged from the hospital on the 21st. Atrial premature occurred in the morning of that day, and the bedside doctor said it was not related, and after that, atrial premature occurred for 3 consecutive days, usually around 2:00 am. I added heart stabilizing granules and Ningxinbao capsules myself, and no more atrial premature occurred after that. Now my condition is basically normal, sometimes I have panic attacks and a slow heart rate of about 50 beats per minute. Is it possible to say that the operation is successful if AF does not occur again 3 months after the operation? I am still taking Betaloc 25mg/day and would like to know when can I stop taking it? How long do I need to take it? Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Generally speaking, 3 months is a threshold, and if no more episodes of atrial fibrillation occur after 3 months, it is considered successful. Don’t stop the medication yet, it will help your atrial recovery. Patient: Director Chen Gang, thank you for writing back during your busy schedule. I don’t understand now, since three months is the threshold, why someone has a relapse after five months of surgery? I am rather worried. Also, what else do I need to pay attention to during these three months? By the way, you are welcome to be a guest in Qinghai, which is very beautiful, with the beautiful Qinghai Lake and the mysterious Tar Temple. My whole family and I welcome you to come, and I will treat you with the best barley wine! Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Thanks a lot. The possibility of distant recurrence is always there, huh? Patient: Hello, Director Chen! After the surgery on March 16, I’ve been feeling better, but I’ve had a few premature beats. I would like to ask if this is normal and if it is an inevitable complication after RF ablation of atrial fibrillation. Is it okay to take cardioplegia? Thank you. Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: If the premature beats are controlled by cardioplegia, it is possible that they will occur within 3 months. Secondly, it is unlikely that premature beats can be completely eliminated. Patient: Director Chen Gang, I am your Qinghai patient (hidden here), I have been uncomfortable since I was discharged from the hospital until today. (Atrial flutter?). (atrial flutter?). The highest heart rate was 160 (atrial flutter?). The heart rate changed to sinus rate 1.5 hours after pushing the pump intravenously. Does this mean that the surgery was not successful? 2. Can too long atrial prematureness lead to atrial fibrillation? 3. I have uploaded today’s ECG, can you please take a look at it to see if it is atrial fibrillation? This is the ECG after rate conversion. Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Let’s wait for time, it’s not easy to say now. Patient: Director Chen: My INR was 1.56 on April 18, and this value is not 1.8-2.5 as required. Thank you! Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Increase the dosage by one quarter tablet. Patient: Director Chen: My INR was 1.96 on May 3, and this value reached the required 1.8-2.5. Is the dosage of Favarin adjusted (now 1 and 1/4 tablets daily)? Also, after the surgery (March 16), I had atrial fibrillation once on April 11, but I haven’t had it again until today, and my atrial prematureness is better, so is it still 3 months to evaluate the success of the surgery? Thanks! Good luck. Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Warfarin is not added. Evaluation to 3 months, in short, the more to the back without seizures, the better. Patient: Director Chen: Hello! I am your patient from Qinghai (hidden here), you did the radiofrequency ablation of atrial fibrillation for me on March 16, and it will be 3 months tomorrow. I am still taking Betaloc (half a tablet twice a day), followed by Warfarin 1 tablet. Am I the one who is delaying success? When can I stop the Betalac and Warfarin? Am I having a successful surgery? Good luck! Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Review a cardiac ultrasound and 24-hour ambulatory ECG. If you can, warfarin can be stopped. If you have hypertension, Betalactone can be taken all the time. If you don’t have hypertension, taking it again for a while may help your heart to recover. Patient: Director Chen: Hello! You performed radiofrequency ablation of atrial fibrillation for me on March 16, almost six months ago. Everything else is normal, is the surgery a success? I am still taking Betalac (25mg twice daily), is there any other problem with the swelling? Thank you and good luck! Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: Has the cardiac ultrasound been reviewed? Check the cardiac function. Also check the liver and kidney function. Patient: Director Chen: Hello! I am a Qinghai patient (hidden here). You and your team performed RF ablation of AF for me on March 16, 2011, and it has been one year since then. After the surgery, I had atrial fibrillation once on April 11, 2011, but since then I have been doing well, with occasional premature beats, but everything else is back to normal. Do you think so? I can’t say thank you enough to express my gratitude. I wish you and your family all the best in the New Year from the distant Qinghai plateau, Zahidler! Also: Do you still need to take Betalac? Chen Gang, Department of Cardiology, Shanghai First People’s Hospital: If you have hypertension, take Betalac as hypertension all the time. Also review the heart ultrasound to see how big the left atrium is now. Oh, I would also like to know if it has shrunk and how much it has shrunk. If you need to, you can call me at work on my cell phone 13371989320. if you don’t have hypertension and your heart is recovering well, stop the betalac, but reduce it to half a capsule twice, take it for 3 days, then reduce it to a quarter of a capsule twice, take it for 3 days, then stop it.