<s>[INST] I am 62 years old, 6ft 2in and 290 pounds.  I have chronic A-Fib for 5 years, non symptomatic.  For one week now I have been feeling the blood flow, pulsing,  in my left upper chest with some pain, but not constant. I am taking a mild blood pressure medicine (losartan-hctz) and coumidin with BPs of 150 / 95.  What do you think? Thank you. [/INST] Thanks for your question on Chat Doctor. I can understand your concern. Atrial fibrillation (AF) is tacky arrhythmia. If not controlled, it can cause lethal and life-threatening complications. You are now symptomatic since last 1 week. So all these symptoms can be due to AF. And hence you need to treat AF as soon as possible. You are not improving with medical treatment, so you need Radio Frequency Ablation (RFA). Before this you need to get done Electrophysiologist study (EP study). So consult cardiologist and discuss all these. RFA is having excellent success rates. Hope I have solved your query. I will be happy to help you further. Wish you good health. Thanks. </s>