Hi: Is nonspecific ST-T abnormalities on a treadmill test, low exercise tolerance, and 4.2cm left atrium showing on echo (woman) associated with diagnosed afib and can it be reversed with drug treatment?
Dr. Abdullah Mohammed
Dr. Abdullah Mohammed
Cardiologist, Internist
Enlarged left atrium and reduce exercise tolerance are more directly associated with atrial fibrillation and would usually improve with restiringb AF to sinus rhythm with medications occasionally but more likely to be successful with electric shock under sedation. Maintaining sinus rhythm long term can be achieved with medications or ablation therapy if medications are not successful.
non-specfic ST-T changes can happen for several reasons but are not important themselves to worry about with symptoms directly linked to them such as chest pain which can be investigated separately if they symptoms persists after correcting atrial fibrillation.

Dr. Shaumik Adhya
Dr. Shaumik Adhya
Drugs themselves are unlikely to make this better.

It is important to treat risk factors such as blood pressure and drugs can be helpful for this.

Also very important to deal with lifestyle issues such as being overweight / obese. There is fantastic data from Australia showing that reduction in weight significantly improves atrial fibrillation symptoms, and also has effects on diabetes and blood pressure. Not a great deal of data to support other lifestyle measures, but caffeine doesn't seem to make a difference. Intuitively exercise, eating healthily and not being stressed would help.

Of course, we do have lots of medications and procedures that can help and I'm sure your cardiologist would be very happy to discuss this with you

Dr. Matt Faircloth
Dr. Matt Faircloth
The ST changes on the treadmill test are common in AF. However, the real question to me is over the AF and whether this relates to the reduced exercise capacity - or is it something else such as coronary artery disease. It sounds to me like you need to discuss this with a cardiologist as often this needs a long discussion to go through everything.

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