My father has AFib. How often should the echo be repeated?

Question

Hello doctor,

My father is 67 and was recently diagnosed with atrial fibrillation after having palpitations and shortness of breath. His ECG showed irregular rhythm, and the echocardiogram reported mild left atrial enlargement. He is on Metoprolol 50mg and Apixaban 5mg twice daily.

His INR is stable, but he still gets occasional dizziness. So, I need your advice on the following -

Should we ask the cardiology specialist if an ablation procedure would help, or continue just with medicines?
Also, does AFib increase stroke risk even when on blood thinners, and how often should we repeat echocardiograms?
Is there any specific diet or salt restriction that can improve heart rhythm control in his condition?

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Your father’s treatment with both a rate-control medication (Metoprolol) and an anticoagulant (Apixaban) is standard initial management for atrial fibrillation (AFib), particularly with his age and left atrial enlargement.

Even while on blood thinners, there remains a small residual risk of stroke, but anticoagulation like Apixaban reduces that risk very significantly compared to no treatment, and continuing it as prescribed is critical.

Catheter ablation can be considered if symptoms such as palpitations, dizziness, or shortness of breath remain bothersome despite medications, though its success rate is somewhat lower in older patients or those with enlarged atria compared to younger patients with recent-onset AFib; discussing his individual candidacy with a cardiologist or electrophysiologist would be appropriate.

Echocardiograms are usually repeated every one to two years, or sooner if symptoms or clinical status change, to monitor chamber size and heart function.

As for diet, while there is no specific food that controls heart rhythm, maintaining a heart-healthy lifestyle limiting salt if he also has high blood pressure or heart failure, avoiding excess alcohol and caffeine, managing weight, and following a balanced diet rich in fruits, vegetables, lean proteins, and whole grains can support overall heart health and sometimes reduce AFib triggers.

Regular follow-up with his cardiologist is key to adjusting therapy as needed.

Regards.