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How Effective Is Cox IV Procedure In Treating Patients With Longstanding Permanent AFib?

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Posted on Wed, 13 Jul 2016
Question: I am in permanent AFib since 2007 and have CHF. Ejection fraction is 30-35. Heart is moderately enlarged. Taking are control meds. Coreg 12.5 2xday Lorsartan 25mg 2xday digoxin 1x day, warfarin 5mg 1xday lassie 30mg 1xday. Reading about Cox IV procedure for permanent AFib patients. High success rate.
My out of breathlessness and general decline means a poor quality of life. Previous to Permanent AFib in 2006 I was an athlete. Now completely sedentary lifestyle. Do you think Cox IV would be worth pursuing.

XXXXXXX.
doctor
Answered by Dr. Benard Shehu (45 minutes later)
Brief Answer:
Following advice

Detailed Answer:
Hi and thank you for asking!
I read your query and understood your concerns.

Cox IV procedure is effective iand is recommended to be done in patients with longstanding permanent atrial fibrillation.

This procedure has high success rates in restoring and mantaining sinus rhythm and in improving symptoms and quality of life.

The only disadvantage is that it's still to invasive and is done by cardiac surgeons. However if we compare with previous techniques (cox I-III) it's done with minimal invasive surgery.

Hope this will be of help!
Wish you health!
Dr. Shehu
p.s: Ifyou have more questions, pleasedon't hesitate to ask me again.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (57 minutes later)
I've already read your reply on websites explaining the Cox IV procedure. So you're not telling me anything new. I want to know if being in permanent AFib and the resultant CHF for 9 years would lessen the prospects for a good outcome. I'm under the impression that after a heart extensively remodels to accept permanent AFib there is little chance of ever restoring Sinus Rhythm. These procedures are hard on the body. I was on the table for 9 hours during the second ablation and my heart stopped completely for a minute or more. It also caused a massive onset of CHF. which slowly improved over the next year. The ablations were a failure. . Is it wise or risky to consider the Cox XXXXXXX Maze Procedure. ?
doctor
Answered by Dr. Benard Shehu (1 hour later)
Brief Answer:
Following advice

Detailed Answer:
Hi back,

It's true that since you have been for to many years on atrial fibrillation and both atrium are dilated (especially left atrium) these will interfer with Cox IV success rates. The above factors contribute to atrial remodelling reducing the success rates of procedure.

However Cox IV is the most efficient method in the treatment of atrial fibrillation. Although the successful rates are reduced by the above mentioned factors, still the success rates are high enough (around 50-70%).

Cox XXXXXXX maze procedure (or as i told before minimal invasive procedure) is a good strategy because it has still high success rates with less procedural complication.

As a conclusion I would suggest you to go for Cox XXXXXXX maze procedure.

Hope this will be of help!
Wish you health!
Dr. Shehu
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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How Effective Is Cox IV Procedure In Treating Patients With Longstanding Permanent AFib?

Brief Answer: Following advice Detailed Answer: Hi and thank you for asking! I read your query and understood your concerns. Cox IV procedure is effective iand is recommended to be done in patients with longstanding permanent atrial fibrillation. This procedure has high success rates in restoring and mantaining sinus rhythm and in improving symptoms and quality of life. The only disadvantage is that it's still to invasive and is done by cardiac surgeons. However if we compare with previous techniques (cox I-III) it's done with minimal invasive surgery. Hope this will be of help! Wish you health! Dr. Shehu p.s: Ifyou have more questions, pleasedon't hesitate to ask me again.