My husband has perm a-fib. has had maze, conversions, hcm, mitral repair, pacemaker/defib, tikosyn (dofetilide) (stopped). left atrium 6.4 cm. will the afib lead to heart failure?

A Fib: With a left atrial size of >5 cm, he is in a high risk category. There is an nih trial that compares a number of procedures and summarizes the latest thinking on surgical and electrophysiological approaches to the problem: http://clinicaltrials.Gov/show/nct01298986. Ask your husband's cardiologist to check into this trial. It might be the best bet for him!

Not necessarily: I really can't say what the risk of heart failure is for your husband. I would need more information and test results. In fact, one reason for a difibulator is heart failure. Atrial fibrillation can definitely impact heart failure. But there are many in heart failure w/o afib. Other issues: does he still have mitral regurgitation? Did he have complete maze? How big is his lv?

Usually not. : Your husband has had several intervention. If his lv function is normal then the likelihood of congestive heart failure is low. As he does have hcm he may develop heart failure if his heart rate is not controlled. For hcm he needs medical therapy to prevent diastolic heart failure. To manage all his problems he needs to see a cardiologist on a regular basis. Good luck!

Afib and HF: A fib could lead to heart failure if it the rate is not controlled for a long time.