Dear Dr. Roach: I am an 88-year-old female in relatively good health. A year and a half ago, I did experience atrial fibrilliation and had two cardioversions. (The first was good for a year; the second lasted only three months.) The diagnosis is paroxysmal AFib.

My cardiologist has recommended a third cardioversion, which would require taking 400 mg of Multaq twice a day prior to the procedure, and remaining on this medication for the rest of my life (presuming the procedure is successful; if not, a stronger medication would be required). Or — my choice — I can do nothing, as long as I can tolerate these episodes of fatigue, shortness of breath and palpitations. At the present time, I must be in “remission,” as I am not experiencing any symptoms. (However, when I take an EKG test, it always shows I have AFib.) My blood pressure, cholesterol, triglycerides, etc., are all at good levels. My question: In your opinion, if I choose to “tolerate” intermittent episodes of AFib, in the long run, would this not eventually lead to the development of congestive heart failure? — S.S.

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