A Fib 8 Years Post-Op

[kasper]

Hi Everyone,

I haven't posted here in a long time....since around the time of my MVR in Oct 2002. I have a Carpentier Edwards porcine MV now. Went with the bioprosthetic because I was 25 and wanted the option to have children without dealing with anticoagulation (am 33 now). I'm finally getting married in May and have been told by my cardio that my valve's still OK (moderate leaking, but stable so my next replacement hopefully won't be too soon). In October I had my first ever episode of a fib, and have now had it 3 episodes in the past 10 days. I saw an EP and he gave me Rythmol to take (300 mg) when it starts. So far that's worked and my episodes have all lasted < 5 hours.

I'm really concerned because it started out of nowhere, and I'm now having it more often. It also makes me think that something could be getting worse with the valve although my last echo in October didn't show that.

My question is.....my EP does the ablation procedure called pulmonary vein isolation. I saw him after my second a fib episode, and he mentioned that being an option. Anti-arrhythmics are another option. Has anyone had the ablation procedure before for a fib? I'm nervous to do it because it seems like a scary thing to do to someone with an artificial valve. However, I kind of want to because he said it's around a 75% success rate. I'm not sure what to do. Anyone have any advice?

God Bless you all!

Kristie
Austin, Texas
MVR bioprosthetic 10/2002

 

[ALCapshaw2]

Before having an ablation, I would want to be sure you are minimizing your exposure to known triggers of A-Fib such as Caffeine (Coffee, Tea, Colas, Chocolate, and others I have forgotten.)

I think I would also discuss medications. Several of our members have good control / prevention of A-Fib using SOTALOL (generic form of BetaPace). The manufacturer recommends that it be started in-hospital 'just in case' a dangerous arrhythmia is triggered while your body adjusts to it. Mild dizzyness is an early side effect but usually goes away in a few weeks as you adjust to the medication.

Amiodarone is the Sledge Hammer of antiarrhythmics. There has been a LOT of discussion of this drug on VR (do an advanced search for Amiodarone and scroll down to select "any date"), or do a Google Search or ask your Pharmacist for an information sheet on this drug. It has a laundry list of potentially nasty side effects if taken for too long a time or in too high a dose.

That said, I know a lady who has had an ablation (or two) and has had a couple of heart surgeries including Valve Replacement. She is still around.

'AL Capshaw'

 

[kfay]

Kristie, I have had 3 ablations, 2 which were done last year after I received a tissue valve and a tissue patch on my asd. Though they weren't for A-fib specifically (I had a maze during my last surgery to try and prevent me from going into a-fib), I did develop other rhythm issues that they tried to ablate. I think this is a personal decision much like valve choice. You have to decide what you are willing to live with...taking medication every day, that may or may not stop your rhythm issues, or try an ablation, that has a low level of risk (I think it is around 1%), that again, may or may not work. If you are planning on having children, that may play into your decision more because a lot of those cardiac drugs are not something you want to be on when you are pregnant.

The only other thing I can suggest to you is to make sure you are going to an EP Dr. who knows what he is doing. I had a local guy tell me what I needed to have done couldn't be done. That's because he didn't know how! I've also known someone who got their tissue valve torn by an EP guy who didn't know what they were doing and had to have it replaced. I didn't have any problems with mine and the procedure definitely helped me. There have been a couple of others who have had ablations recently for a-fib who I think had success. Feel free to pm me with any questions.

Kim

 

[Jkm7]

We have a good friend who had a-fib for 12 years. He finally saw a Mass General cardiologist who recommended ablation. He is now post ablation for 7 months and is off coumadin and has been rid of a-fib. The procedure was very successful for him, happily.

 

[Bryan B]

I had A-Flutter (very similar to A-Fib) that started in late April of this year. I was in A-Flutter continuously with a resting heart rate between 135-140. They admitted me in early May and were planning on doing a cardioversion, but they found a blood clot in my left Atrium during the TEE they do to make sure there are no blood clots and they aborted the procedure. I had to be on Coumadin for 6 weeks and then went back into the hospital. This time they decided to do a catheter ablation. My docs gave me closer to a 90% success rate. Since the procedure on July 1st I have not had any type of Fib or Flutter lol. They wheeled me in with my heart beating like a drum and wheeled me out at 75bpm and it has stayed between 70-75bpm since then. Your case may be different than mine but I was out for the procedure, it was painless, and it worked. I was on Coumadin for another 6 weeks after the procedure as a precaution and then was taken off of it and have not been on it since then. They aren't sure if it was triggered by my worsening aortic root dilation (which is causing worsening aortic valve leakage) or if there was some other trigger. All I know is the only change I have made since then is to become more inactive as my aortic root has started dilating more rapidly which is also causing my regurgitation to increase more rapidly. I drink at most 1 diet pepsi a day and no coffee. I do use smokeless tobacco and drink 2-3 beers a day and still do those things, but not for long if my financial assistance comes though. My surgeon plans on me having surgery within 2 weeks once I get it (if I ever get it). I will be spending those 2 weeks getting some dental work done and weaning myself off of the tobacco.

I am glad I had the procedure instead of going on anti-arrhythmia medications. IMO if you are still planning on having children I would try the ablation as your first alternative...but that's just my opinion based on my positive experience with having it done.

 

[Cooker]

I had the pesky a-fib and the drugs helped but did not "cure" it ... I had ablation at the time of my AVR and it's been smooth sailing since ... I wish you luck...

 

[kasper]

Thanks everyone for the responses and info! It makes me feel better to know there has been some good success with this procedure for fellow valvers. I have cut out caffeine completely and recently cut out all alcohol too. Yeah, I'm definitely wanting to avoid meds since I still want to have a child. I got the bioprosthetic valve to keep that option and I don't want to lose it if I don't have to! I'm seeing my EP on Monday to discuss....am for sure going to ask him about his experience with doing an ablation in someone with a tissue valve. I've heard that patients come from all over the country to have ablations done by him and his group....gives me some confidence.

It's so comforting to know I can come here after almost 8 years and get support. Thanks so much!!!

Kristie
Austin, Texas
MVR bioprosthetic 10/2002