Atrial fibrillation post surgery

[Christina L]

Hello everyone,

I have not been on the computer because I have been trying to take it as easy as I can to prevent atrial fibrillation - well, yesterday, I went into atrial fibrillation. A real bummer. Just saw my cardiologist and he is putting me on Coumadin, Lovenox and Rhythmol.

His way of thinking is that when the blood is too thick (which mine is) that is what causes the a-fib. I have heard it is something to do with the swelling of the heart after surgery and electrical currents misfiring.

Needless to say, I am really down. Just as the pain is going away and I am feeling better in that way, this happens.

My cardiologist says it is just a "bump in the road" but I need some reassurance from you guys. Please share your experiences with a-fib with me and if/how it went away for you and how long it took.

Thanks everyone. I hope you all have a blessed Thanksgiving.

Christina L.
Colorado
Mitral valve repair (quadrangular resection with Cosgrove ring)
Cleveland Clinic by Delos Cosgrove
November 6, 2003

 

[JimL]

Hi Christina, I'm sorry you're having a-fib troubles after surgery. I think you're right about the electrical misfiring; as the Lewis Grizzard book says, They tore my heart out and stomped that sucker flat.
Since there is a danger that clots will form during a-fib, since the heart isn't then pumping efficiently, you are on blood thinners. I don't think thick blood causes a-fib.
I have spent time on amiodarone for a-fib, but that is wretched medicine. I took lanoxin, which helped to keep it in line, and it's not nearly as bad as amiodarone. You could give magnesium a try, which works for me. I get my magnesium at GNC, and take 500 mg a day; for me it has to be the kind of magnesium that says magnesium gluconate.
I hope you're feeling better soon. Naps help, and rest helps.

 

[Birky]

AFib

AFib

This happened to me 2 weeks afther the surgery ad I had to go back into the hospital. I am now on Cardizem and lanoxin and am doing great. Something with the electrical with the heart from the surgery. They say this is pretty common but not to me. I am on coumadin too since I now have a St. Jude mitra. Keep the faith, things will get better.

 

[LUVMyBirman]

Hi Christina!

Welcome home and back. One nice phrase to keep replaying in your mind....."I am going to be just fine"

Recovery can be a 'climb' as we say. Some have a smooth asscent, others....take a bit more work.

Like anything in life..we all find a way to adjust. Your not alone. We are all here to help

Keep yourself hydrated. You are doing the proper thing by trying to take it easy for a while. Make sure you are walking and getting around. Even if it's just in the house.

On the A-fib...don't have it myself because of an A/V Block. Which is an misfiring of upper chambers of the heart. 3 weeks post op I started with PAC's 'premature atrial contractions' which come from the same location as A-fib...just slower. By taking a beta blocker...it has assisted 98% in relieving this sensation.

They will find the proper regimen for you soon. Hang in there.

Not so sure that the consistency of your blood has anything to do with actual A-Fib?? Though, Coumadin therapy is recommended for A-Fib and will keep you in the 'safe zone'

Thinking about you. Take it easy and keep us posted.

 

[bvdr]

Hi Christina,

Sorry about your atrial fib. I know that is disappointing for you. I'm on flecanide and cardizem to keep me out of it. I'm not sure when or if I can come off of them. Give it some time for your heart to settle down and see what happens.

When you say "thick blood" are you referring to elevated hemoglobin and hematocrit levels in your blood count?

I'm glad you are doing well in your recovery...of course except for this "bump in the road". Take care Christina.

 

[Nancy]

Hi Christina-

I'm sorry to hear about the afib. It can be disconcerting to say the least and I hope that it will be a very temporary thing for you.

Best wishes.

 

[JAMES W]

A Fib

A Fib

Christine,

I too had an episode of A-Fib post AVR in Jan 03. I had to be electrically cardioverted twice to knock it out. Since, I've been on a low dose of Amioderone. I hope to get off this med soon, as it messes w/ your thyroid, causing me to gain 25 lbs. They never come off as easily as they go on....Damn..Wishing You and Yours a very Happy Thanksgiving....

 

[catwoman]

Is atrial fib the same thing as atrial flutter?
Friend had MVR in Dec. 2002, had to be shocked while still in hospital, then a week or two after leaving hospital.

 

[warnerd]

As you can see, a lot of us feel your pain. I had to go into the hospital twice in the month after my AVR. Been on lanoxin since. I guess the good news is that when I went in the second time they discovered a fluid build-up around the heart and had to do a pericardial window. Probably saved me some headaches down the road. Everything happens for a reason. Dave

 

[Ross]

Chris Afib is so common. I think most people do have it at one time or another. For me, it started when I was in rehab. It got me down because as everyone here knows, all I wanted to do was get out of there and the Afib was an unwelcome set back. Mine lasted for 2 days and then stopped on it's own. I think it has more to do with your heart healing and the amount of excercise you get to help strengthen it. I think your mind has something to do with it too. I was in near panic most of the time while I was in rehab (50 days in ICU will do that to you!) so I was all sparked to start with. I was very apprehensive and jumpy. I don't think that helped anything at all. It seemed to calm down when I did.

Your expecting alot for being out of the starting gate this soon. I'm not scolding you. I'm only telling you that recovery is long and it is slow. It isn't something that you spring back from like a cold or whatever, this is a whole new beast of burden to deal with.

You'll be alright in time. It seems like forever, but it does come. Until then, try to ease your mind and talk to your electrical system and convince it that things are o.k. and that you can control it. Don't become so consumed with it that it disrupts your life.

I think you know what I mean. Hope so.

 

[sylviayasgur]

hi christine!
ross is right, it sometimes takes a little longer for some of the kinks to be worked out in the beginning.
joey was fine after his surgery, but went into afib on the fourth day post op.
we were both very discouraged, because we wanted everything to be perfect and go smoothly.
he was put on coumadin to prevent clot formation (which , incidentally, is what they worry about most. other than that, there are those like my father who live in chronic afib and on coumadin).
there are so many meds out there that can control afib. joey, presurgery, took betapace (sotolol) and it was very effective.
unfortunately, it did not do the trick post surgery. he ended up on amiodarone and is taking the most minimal amount in the hopes of getting off it by january. although it is effective medication, it is extremely strong and pataients need to be watched very closely for thyroid changes, retinal deposits, lung problems and more. not a med you want to be on for too long.
afib is really common after heart surgery, since they "provoke" and manipulate the heart so much during the surgery.
cardioversion is another option. joey had this once and has no recollection of it wahtsoever. it worked that time.
i hope this has helped some. please feel free to email me anytime at:[email protected] if you have any questions that i might be able to help with.
be well, sylvia

 

[bvdr]

Catwoman,

A-fib and A-flutter are similar but not the same. Both the arrythmias originate in the atrium but with the a-flutter one of the safety mechanisms (a block) kicks in to block out a good portion of the impulses before they reach the ventricles. The flutter is generally very regular but fib is very irregular.

 

[Christina L]

Thank you everyone. I am feeling sorry for myself pretty good right now. Lots of tears. Wayne is giving me the Lovenox injections in my stomach every 12 hours. Fun times.

I know I need to think positive and stop thinking that everything is supposed to go perfectly. This was a big operation and my heart is still in shock I am sure. But this a-fib is so irritating and scary - I have been told it is not life-threatening, and most get used to it after a while. I just want it to go away soon.

Thank you all - so much - I will try to become as strong as you all are - this is all so new to me - I pray I will toughen up and soon. God has brought me this far - like you said Ross - He won't leave me alone now.

God bless all of you - your help is so appreciated.

Christina L.
Colorado

 

[pillarpaul]

Chris,

I know what you mean. I got my a-fib 11 days post-op. I thought I was on my way to setting recovery records. That really took me aback and depressed the heck out of me. I wound up back at CICU for a drip to convert me to normal sinus rhthym (I was well over 200 beats per minute). Had to stay there for three days, just as long as my initial stay. Talk about bummer. Then taking drugs that I thought I wouldn't have to take. The whole a-fib was for me the worst part of the surgery. But again this community came through and I began to realize that I was far from alone (1/3 of all open-heart patients get a-fib, albeit ususally within 4-5 days of surgery). Never heard of blood thickening causing it. No one knows for sure but you were right that swelling of the heart and electrical misfires are the two most common theories. Really no way to do a scientific test (who would want to be the "control group"?).

The drugs your cardio prescribed sound reasonable. It can't be too bad or you'd be hopsitalized somewhere. One piece of comfort is that I was told by all my docs that a-fib, when due to an insult of the heart, rarely becomes a permanenet condition if it is controlled for a while with the medication. Doesn't mean an episode here and there won't pop up but it shouldn't be like some of the folks here who had a-fib before the surgery.

Take care and continued good health.

Paul

 

[Nancy]

Some guidelines on afib.

http://www.acc.org/clinical/guidelines/atrial_fib/af_index.htm

 

[ALCapshaw2]

My first A-Fib event really got my attention,
but after seeing the ho-hum reaction of the
cardiologists, I came to realize that A-Fib is
the 'common cold' of cardiology.

After my AVR, I had 3 events, one in the hospital,
two others a few weeks. ALL 3 resolved in 3 hours
regardless of how they were (or were NOT) treated.

It sounds like yours are a little more persistent
which is why they have you on Coumadin. There
are LOTS of tricks the doc's can use so try to stay
calm and hopefully all will resolve in time.

One word of caution, if ANYONE recommends
Amiodarone, ask them if they have tried
EVERYTHING ELSE first. Amiodarone has
serious side effects if taken in large doses or
for too long and it has a VERY LONG Half Life
which means it takes another 6 months to fully
leave your body.

FWIW, I have found that a low dose of Toprol XL
controls mine (most of the time). If / when I get
a short spell of arrythmias (irregular heartbeat),
I just relax and double my dose (with my card's
approval). Works for me.

'AL'

 

[pillarpaul]

The Truth is Out There

The Truth is Out There

Just in case your cardio switches you to amiodarone (a drug frequently mentioned in these forums), I can clear up some misconceptions. I was on it for six months and during that time I did about as much research as a lay person could do. I believe this to be (in Fox News's words, "fair and balanced"). Here's what I've gleaned from sitting in front of the computer on the net for hours about this drug, talking to pharmacists (including a PM with our own Al Lodwick), various doctor opinions, etc, etc:

1) Amiodarone should almost never be taken longer than six months. Do everything you can to get off it in six months;

2) Amiodarone frequently shows side effets within two weeks of starting, especially if taking the large dosage required for conversion. If you have no side efects the first two weeks, odds are very good you'll have no side efefects for the rest of the six months (but no guarantee beyond - see #1 above);

3) Once converted, you can stay on a maintenance dosage;

4) Yes, you can indeed turn blue, get lung problems and liver problems. However, 85% of all people who take the drug suffer NO side effects;

5) Amiodarone is generally considered the drug of LAST resort for people with "normal" a-fib, i.e., the a-fib is not due directly to an insult to the heart such as open-heart surgery.

6) Amiodarone is sometimes the drug of FIRST resort (depending upon the cardio) when the a-fib is a result of an insult and if it is considered very serious;

7) While on amiodarone, stay very in tuned with your body and have your PCP monitor your blood levels.

8) The half-life of amiodarone is 45 days, not 4, 5 or 6 months as some members have stated.

I am not making a recommendation for or against. It appears to be a strong weapon albeit one with potentially devastating side effects. I watched very, very carefully while on it and hope I never have to take it again. I also stayed completely out of a-fib since my post-op episode.

Paul