Any A-fib, low resting heartbeat (50s), pacemaker, AVR folks here?

[gary]

After a first bout with A-fib Friday, (y'all talked about it iin earlier threads like it's a walk in the park!), top rate of 180, an ambulance trip and 2 day stay in the ICU, I was discharged on a 10/5/2.5/5 regimen of warfarin ( I like this name better than Coumadin and they gave me the generic anyway) for the first 4 days. ( One of my main reasons for going Tissue has possibly been co-opted by my left left atrium).

Second blood draw will be friday and then open ended Warfarin and a children's aspirin once a day, likely till the next A-fib event,
if it happens.

Thanks to whoever posted the real skinny on Warfarin NOT being a blood thinner. It prevented me from asking my doctor why I should not stop taking my children's aspirin. Made me even look like I knew what I was talking about to tell the difference between an anticoagualant, like Warfarin and a thinner, like aspirin.

Disappointingly they are already talking about a possible pacemaker if my low resting beat becomes a permanent trigger to a predisposition to an occasionally vibratingly mad left atrium, which has stretched in the 2 years since my AVR. (This is another mystery no one seems to know the answer to).

It's early days, and may not happen but as you know, the hopelessly curious here, most get ravenous for information early on if they can get it.

If any of you have gone that route, your experience of how you got there, would be appreciated.

AVR CCF 4/00
Cosgrove Bovine Pericardial

 

[Mb]

Hey Gary:

A-fib............My husband has been in chronic a-fib for at least a year and a half. In other words, he is always in a-fib. His heart rate goes from resting at 40 BMP, up to 210BMP on exertion. He is on a beta blocker, and other meds. The beta blocker, as you can see by the HR, is not adequately controlling the a-fib. A-fib decreases your cardiac output by between 20 and 25%. Some people can handle that.........some can't at all. Add to that, any additional problems that affect cardiac output, and voila! A sick person for sure. Be that as it may, my husband has been told by 5 doctors that he should have a pacemaker. (seems pretty obvious, doesn't it?,) and we are seeing the cardio in July to get that scheduled. He has been resisting the pacemaker, saying he is too young at 55 to go onto battery. It is my understanding that a pacemaker often helps a person feel better..........but it does not get rid of the a-fib.

Many people who have heart surgery get a-fib.......it is a common arrythmia. Sometimes meds work, or even a cardioversion. For some folks, like my husband, the cardioversion only worked for four days, and after the trip to the ER, etc., back into a-fib.

I wish you the best in determining what is best for you, with God's help, and your doctor's help.....the solution will be there.

Marybeth

 

[gary]

Thanks for your reply. From what I gathered

Thanks for your reply. From what I gathered

in earlier threads it is fairly common but pacemaking was not.

I am genuinely surprised that anyone can function at all with A-fib of that magnitude since I thought for sure I was on the way to the Promised land, with diffused weakness and near blackout with 180 bpm, wrong meds by the EMT on the way in, treating SVT instead of A-fib.

Surprised, heck I'm shocked anyone can live with it and exercise with it but from what I've learned so far the next episode, should it occur, might result in less panic on my part.

"Just when I thought I was out, they PULL me back in...!!"

 

[Nancy]

Hi Gary-

Joe's been in chronic a-fib forever. His heart started acting up just like Marybeth's Wayne, but didn't get as high, probably around 160-180, but the lows were 40 and below, with what must have been long pauses. These low beats caused him to faint several times and come close a few other times. He was well known to the EMTs, some of whom live in the neighborhood and spent much time in the ER.

He had a pacemaker implanted to keep the heart from going too slow and is on beta blockers to control the high beats. It's worked just fine, and he hasn't had any more fainting. His heart many times is in normal sinus rhythm, but not always.

Pacemakers are good if you need them. He never feels his going off or anything like that. The internal workings of pacemakers are truly amazing and can be programmed to do just what your cardiologist wants for you.

Here's a link to read about the Guidant ones.

http://www.guidant.com/products/pulsar.shtml

 

[sylviayasgur]

hi gary!
sorry to hear that you have to deal with this.... isn't it too bad that we don't all have it easy and really uneventful?
my dad lives in chronic a-fib, has a st. jude's so he has to take coumadin anyway. it doesn't bother him one bit.he's an avid golfer, runs someitmes, walks, and plays tennis and loves to travel. go figure..
joey, on the other hand, hates it when he goes into afib. he had a few bouts with afib several times a year prior to his surgery. that was when his cardio decided to put him on sotolol (betapace), preventatively. it worked amazingly until he had his surgery and went into afib 3 or 4 days post-op. the sotololl did not work at all and after much discussion he decided to take amiodarone. i know it is a very potent drug and can be dangerous. joey, however, is monitored closely and since he has a thyroid problem, and amiodarone affects that, he is checked every few months for that.
his eyes get checked, his lungs get checked, etc. it seems to be doing the trick and that makes us very happy and comfortable. i don't know when they plan on taking him off the stuff,but for now it's fine. (a day at a time)
there must be other meds out there that can work as well. have you asked about that?
wishing you all the best in getting down to the bottom of this one.
please keep in touch and be well, sylvia

 

[Mb]

Dear Gary:

I did not mean to sound blase about a-fib. As I said, you do loose between 20-25% of cardiac output. This does cause extreme fatigue, etc. - I perhaps also did not make clear that when my husbands' heart rate goes up, he does get very faint. Even though the heart is beating very very fast, the blood cannot pick up enough oxygen on its way through the lungs to adequately supply the brain. That's why the fainting spells. Obviously he has exertional limitations. In other words, he doesn't do any excercise anymore. I think the cardiac rehab folks got scared more than once!!!! (so did he by the way) - You have just had you very first expereince, and obviously it came on quickly......sort of out of the blue. This could very well throw you for a loop. After by husband was cardioverted, four days later, he went back into a-fib sometime during the night. When he got up, went downstairs, it was too much for him. Right to the ER we went. He looked really horrible. Back onto the meds, and I would say maybe 1-2 weeks later, he did feel better, although in permanent a-fib. As I said before, some folks compensate for the fatigue, CHF, etc. and find a way to live with it. Some folks it throws them for too much of a loop....especially at first. The beta blockers do help with the high end,. although when he was monitored, thats when his rate went to 210. I can't imagine what his heart rate would be without the beta blockers.

Again, best wishes to you. Take a class on stress management, and do what your cardio tells you to do.

Marybeth

 

[gary]

Nancy

Nancy

Since you and the EMT's are intimate, maybe you can help prepare me for this should it happen again. The EMTs gave me the wrong drip in the Ambulance.

Upon getting to the ER I overheard that the EMT's treated me for SVT and not A-Fib and that is why my heart rate was so high after nearly an hour on the drip. They should have used something else to treat it, likely Caridzem.

Can you tell the EMT on the repeat episodes what Joe should be given over some other treatment that might be in error?

 

[Nancy]

Hi Gary-

I really believe in medical advocacy for yourself or a loved one in any medical experience. No one does everything perfectly, and mistakes can and do happen, more than we would want them to. If you can minimize them, it's important to do so. I watch everything that's done to or for Joe. I'm a super PIA, but things have happened that would have been disastrous for him, and not just once, but lots of times. He has very difficult medical conditions. Each person who treats him sees a very small part of the picture. Joe and I are probably the only ones who see the whole picture. I don't have any problems speaking my mind to anyone.

I always have a typed and up to date list of all of Joe's meds available quickly, I also have a typed and up to date list of all his surgeries including the date and where they were performed. I also have a list of his known medical problems and drug allergies. He has a Medic Alert card and medallion and taped to that card I have the list of all his meds and all the necessary emergency numbers. I used a very reduced font and covered it with clear contact paper front and back.

It's quite fair to write down what you thought happened last time the EMTs were there and ask them to make very sure of what they're treating you for. Heart rhythms are tricky. I don't think I would advocate telling them what should be given, but I do think you should point out what happened last time. Just because you had one rhythm last time, doesn't mean that this would be the same next time. Things can vary. If they know you're vigilant, they'll be extra careful.

I hope you never have to see the EMTs coming to your home.

Good luck, Gary.

 

[Mb]

Dear Gary:

SVT (sustained ventricular arrythmia) can trigger ventricular fibrillation, which is paddle time. The heart is beating very very fast, like yours, at 180 BMP. A-fib in and of itself is NOT a fatal arrythmia. The EMT's aren't doctors, and do not do an EKG on the way to the hospital, so it sounds like they saw the signs of SVT, and treated you for what could have been a fatal event. Obviously the meds they gave you do not do anything for the a-fib, but then again a-fib is not fatal (unless you faint, and get a really bad knock on the head). The long term results of a-fib are not good. Persons in persistent a-fib have double the risks for any cardio event. Since you had no prior history of a-fib, they probably listened to your heart racing away, and treated you with the knowledge they had. It doesn't sound as though they did you any harm, and if you were in V-tach they might have saved your life. The long and the short of it now you are more informed, and can do the things that Nancy suggests above, so that it doesn't happen again. I am sure your cardio will get you onto the proper meds, get the coumaden thing straightened out, and you will be almost, but not quite, back to normal.

I really do NOT mean to downplay a-fib. Any arrythmia is serious, just some are more harmful than others. A-fib is the most common arrythmia, and has a different impact on different people.
There is a plethora of information on the net. Do some research, and you will feel a bit better about it.

As an aside, on two ER trips we have made, the doctors wanted to treat my husband with nitro for chest pain. His heart cath last year had showed NO cardiovascular disease, so therefor nitro was contraindicated due to his other conditions with his heart. If we hadn't been informed, both of us, and insisted they call the cardio before administering nitro, then my husband could have had a problem. You need to be knowledgeable, and so does your significant other in order to help the doctors, help you.

Best wishes.

Marybeth

 

[Nancy]

Hi Gary-

Here's a link for you on atrial fibrillation.

http://www.affacts.org/.

 

[gary]

Thank you both for the information

Thank you both for the information

Nancy: Thanks for the link.