afib again - back in hospital

[sandyz]

Larry is back in the hospital. He was feeling terrific all week, even started driving a little, & then his heart rate went wacky on Sunday. After spending 4hours at the local ER (because they could not tell if he was in afib-although his heart rate was 116) I signed him out & took him to Penn Presbyterian where he had his surgery. They admitted him & he is scheduled for a TEE today.His biggest fear was going back in the hospital again.
Has anyone had recurrent episodes of atrial fibrillation after OHS?
Thank you all for your input. These forums give me tremendous support & information on the experience of others.
Sandy

 

[WayneGM]

Sorry to hear this. I can't offer any insight on the afib as it didn't happen to me. However, I hope this is resolved quickly and he is back on the smooth road of recovery soon.

 

[Cooker]

I had one episode and had to be cardio-converted (sp?) I had the ?ablation? along with my AVR. I was told that it would be maybe six months before we would know If it was permanent fix. I was also told (at the time of cardio -conversion ) not to be surprised if it happened again.

I has not happed again, thank goodness. But I had to be converted twice before OHS so I know how he feels. At least you know this is not life threatening. Try not to get too discouraged?..

Tom

 

[Karlynn]

It is not uncommon for Afib to surface. If you saw the surgery, you'd be very surprised at how "indelicate" a surgery it is. The heart doesn't take to kindly to being manhandled, and afib can be one way of expressing it's unhappiness.

For some, the afib is just a temporary thing. For others it winds up being a more permanent issue. For Larry, it's too soon to tell. You did the right thing by taking him back to the hospital he had his surgery at.

I noticed that he is also on Amiodarone. Please be very careful of this medication. I don't know why he was placed on this, but it is intended to be used when no other medications for arrhythmia have worked. Someone recently described it as "The sledge hammer of anti-arrhythmics." But it also has very significant side-effects that you need to be aware of. I would question the doctor on this. It apparently isn't helping the afib, so I'd ask why he's on it. But also know that just because it appears the amiodarone isn't taking care of the afib, doesn't mean there are no other meds that will. We all react differently to medications.

I'm glad to see he is on Coumadin. (Which is why I checked the med list in your profile.) That is needed when someone has recurring or continual afib.

Best wishes.

 

[ALCapshaw2]

MANY of us have had Post-Op bouts of A-Fib.

Mine came and went after about 3 hours, treated or not treated, 3 days post op and then again 5 and 6 weeks post op.

A couple of years later I became more sensitive to "triggers" (primarily the Caffeine in CHOCOLATE) and developed "exertion induced A-Fib". Other triggers include Stress, Alcohol, Nicoteine, and more that I forgot.

My Cardiologist put me on SOTALOL (generic for BetaPace) which controls my A-Fib with only a very low dose, twice a day. It took a few weeks for the minor side effects (mostly a slight dizzyness) to go away as my body adjusted to the medication. It may also take some time (days to a week or two) for the medication to become fully effective. It is recommended to be started IN a Hospital 'just in case' of medication induced arrhythmias.

SEARCH for Amiodarone, Sotalol, or A-Fib and you will find links to MANY discussions on this subject.

'AL Capshaw'

 

[frankd]

I'm in permanent A-fib since my second AVR 2 years ago. My resting heart rate , however is around 60, so Afib is not necessarily associated with a high heart rate. I can't myself sense any difference being in Afib, and I can keep up with my wife no problem when hiking, biking, etc. Afib alone is not a big deal if it does not cause symptoms, BUT other risk factors (diabetes, high BP, poor cardiac function, increasing age, etc) can push the risk of a stroke for someone with Afib up to 5% per year, or higher ( if not on coumadin/aspirin etc). Need to review risk factors carefully with a good Cardiologist to make a decision what to do.... if anything.
Hopefully they will quickly figure out the cause of Larry's high heart rate and/or AFIB.

 

[Karlynn]

Frank - just a FWIW - my brother-in-law found out he was in constant a-fib because he had a stroke. I realize that there are a few studies out now that talk about low risk factors etc and the need for no anticoagulation. I would question whether someone with a replaced valve is considered low risk, even if it is a tissue. But Coumadin is still the standard protocol. It's Russian Roulette in my opinion. Coumadin is not a horrible medication. Laying in a nursing home debilitated from a stroke is a nightmare.

) You're busted - I saw your post before you edited out the comment that you're resisting taking Coumadin because you chose a tissue valve to avoid Coumadin.)

 

[frankd]

Frank - just a FWIW - my brother-in-law found out he was in constant a-fib because he had a stroke. I realize that there are a few studies out now that talk about low risk factors etc and the need for no anticoagulation. I would question whether someone with a replaced valve is considered low risk, even if it is a tissue. But Coumadin is still the standard protocol. It's Russian Roulette in my opinion. Coumadin is not a horrible medication. Laying in a nursing home debilitated from a stroke is a nightmare.

) You're busted - I saw your post before you edited out the comment that you're resisting taking Coumadin because you chose a tissue valve to avoid Coumadin.)

Haha... actually my edit was for something else, I guess I deleted that part by accident. I will freely admit that I am resisting Coumadin at this point. I am 54, take aspirin and 10 mg ramipril, and in my mind have no real stroke risk factors other than afib...which alone is has about a a 1% per risk per year of stroke. I know all you folks happily on coumadin may try to get me to make the plunge...

 

[67walkon]

Sandy, it is controllable. Go to affibers.org for some great info on afib. I had a maze procedure as part of my AVR/Aneurism surgery. In the first week post surgery, I had 3 episodes of afib, one of which landed my in the local podunk hospital. It has been just over a month since then and I have been afib free.

It takes 2 or 3 months for the heart to settle down. Hang in there!

JOhn

 

[ALCapshaw2]

Frank - just a FWIW - my brother-in-law found out he was in constant a-fib because he had a stroke. I realize that there are a few studies out now that talk about low risk factors etc and the need for no anticoagulation. I would question whether someone with a replaced valve is considered low risk, even if it is a tissue. But Coumadin is still the standard protocol. It's Russian Roulette in my opinion. Coumadin is not a horrible medication. Laying in a nursing home debilitated from a stroke is a nightmare.

) You're busted - I saw your post before you edited out the comment that you're resisting taking Coumadin because you chose a tissue valve to avoid Coumadin.)

Coumadin is not a horrible medication. Laying in a nursing home debilitated from a stroke is a nightmare.

AMEN ! AMEN ! AMEN !

You must be TERRIFIED of Coumadin to take such an outrageous RISK.

I strongly suggest that you READ AL Lodwick's website www.warfarinfo.com

FYI, I wanted a Bovine Pericardial Tissue Valve (so I wouldn't have to be on Coumadin) BUT due to Radiation Damage, my surgeon gave me a St. Jude Mechanical Valve and I am on Coumadin for Life. I've had some relatively minor issues with bleeding and minor surgery BUT, living with Coumadin on a Daily Basis is NO BIG DEAL.

Living a Life compromised by STROKE is a VERY BIG DEAL!

AFTER you tell your Cardiologist to put you on Coumadin, I suggest you also talk with him about trying SOTALOL which is the Generic form of BetaPace and specifically targets A-Fib. It Works For ME with a very Low Dose twice a day.

IF you can get your A-Fib under control by medication or other procedure, THEN perhaps you can discontinue Coumadin (after an appropriate 'waiting period').

'AL Capshaw'

 

[frankd]

Coumadin is not a horrible medication. Laying in a nursing home debilitated from a stroke is a nightmare.

AMEN ! AMEN ! AMEN !

You must be TERRIFIED of Coumadin to take such an outrageous RISK.

I strongly suggest that you READ AL Lodwick's website www.warfarinfo.com

FYI, I wanted a Bovine Pericardial Tissue Valve (so I wouldn't have to be on Coumadin) BUT due to Radiation Damage, my surgeon gave me a St. Jude Mechanical Valve and I am on Coumadin for Life. I've had some relatively minor issues with bleeding and minor surgery BUT, living with Coumadin on a Daily Basis is NO BIG DEAL.

Living a Life compromised by STROKE is a VERY BIG DEAL!

AFTER you tell your Cardiologist to put you on Coumadin, I suggest you also talk with him about trying SOTALOL which is the Generic form of BetaPace and specifically targets A-Fib. It Works For ME with a very Low Dose twice a day.

IF you can get your A-Fib under control by medication or other procedure, THEN perhaps you can discontinue Coumadin (after an appropriate 'waiting period').

'AL Capshaw'

Thanks so much for the advice Al based on your own experience and research. I will certainly look into those options...

FrankD

 

[Karlynn]

Haha... actually my edit was for something else, I guess I deleted that part by accident. I will freely admit that I am resisting Coumadin at this point. I am 54, take aspirin and 10 mg ramipril, and in my mind have no real stroke risk factors other than afib...which alone is has about a a 1% per risk per year of stroke. I know all you folks happily on coumadin may try to get me to make the plunge...

With a tissue valve (without a-fib), you have the same stroke risk factors as a properly anti-coagulated mechanical valve. The most popular numbers get debated at around 1-3% per year. My concern in your circumstance is that your tissue valve does not make you low risk as far as over-all medical classifications go. The low risk factor percentage that you quote I have seen in reference to people who's only problem is a-fib, not a-fib associated with other cardiac issues, such as replaced valves. You say you are on your 2nd AVR - this also increases the risk factor.

I'm not trying to convince you. It's truly your decision what to risk. I'm just responding to present a view point that I think is important for others to know who face the a-fib problem.

 

[frankd]

Thanks Karlynn, I fear I am in denial still about Coumadin, having been able to make decisions that allowed me to avoid it for the last 15 years, since before my first AVR. But I also fear I hijacked this thread so will let get back on track to the real concern at hand in the first post. Maybe we will continue the afib / coumadin /stroke discussion later elsewhere. Thanks for the sincere advice you all are giving me...

FrankD

 

[ruth]

Hi Sandy -

Sorry to hear that Larry is having aFib. Yes, it is common post-op but that doesn't mean that if your heart is racing and your symptomatic that you feel any better with it. I had it for 6 weeks and it was AWFUL. I ended up needing cardioversion which despite my fears was the best thing I could have done. In the end I got through it and Larry will too. I hope for him it is a short bout.

Take care,
Ruth

 

[linda d.]

Hi Sandy,

So sorry to hear about Larry's a-fib. I too, had a-fib 3 days post-op and then after 3 weeks at home ended up in the hospital again with a heart rate of 180. I converted in the ER with medication. It was very scary but my heart rate stayed between 100-120 for about 2 mos. even with 100 mg. of toprol every day.

The good news is.....my heart finally did settle down and now at 6 mos. post-op, I feel great. I have never had any more a-fib issues but fyi.....I didn't drink any coffee or caffeinated drinks for about 4 mos. I was so worried that a-fib monster would pop up again.

My understanding is , that a-fib is very common in the healing process of open heart. Hang in there ........ it will get better.

LInda D.

 

[Bina]

I hope Larry is doing better.....post op I had SVT, with a HR of 170, very scary for sure. Sotalol worked well.
Now I take metoprolol and avoiding caffeine and salt helps my heart stay calm.