Now I have a-fib

[dornole]

So, a surprise detour this morning to the ER with irregular heartbeat around 185-200 bpm, where they found "atrial fibrillation with RVR (HC)," did a cardioversion which stopped the a-fib, and put me on Eliquis for a month. Following up with my regular cardiologist / valve guy on Friday.

Not sure what this means for me yet, but a-fib is a common complication of mitral stenosis and regurgitation, both of which I have. Maybe this will trigger another valve surgery? Maybe I'll be coming back to the pros here for warfarin management tips if my cardiologist switches me to warfarin instead of Eliquis? I still have my native valve (repaired in 2002), so only on 325 mg aspirin presently, but quick paper I read said anticoagulants are "mandatory for rheumatic mitral stenosis or regurgitation in the presence of a-fib" and recommends warfarin as the best choice so we will see what the cardio says.

I guess no burning questions? But interested in anybody's experience in developing a-fib alongside valve issues (especially mitral) and the course of treatment. I'm 56 and this is my first episode of a-fib as far as I know.

 

[ValveAdmin]

I'm sorry to hear of these complications. If your insurance does not cover the cost of Eliquis well enough, reach out to the company as my aunt started Eliquis this past year and it was going to be expensive per month after insurance, so she fill out some paperwork and now a prescription is down in the $10 or so range per month. And I don't hear her talking of the INR number as my other aunt on warfarin does.

Best wishes

 

[pellicle]

Hey there

Sorry to read this. I have a different issue (tachycardia) so it's just metoprolol (to control it) and warfarin (because I'm a mech valver)

Hopefully it's just that regime

Best Wishes

 

[3mm]

"Dr Afib" Peter Morales has a nice Afib you tube channel and website. https://drafib.com/. I found lots of information in a useful format. He is an electrophysiologist cardiologist.

 

[ejc61]

So, a surprise detour this morning to the ER with irregular heartbeat around 185-200 bpm, where they found "atrial fibrillation with RVR (HC)," did a cardioversion which stopped the a-fib, and put me on Eliquis for a month. Following up with my regular cardiologist / valve guy on Friday.

Not sure what this means for me yet, but a-fib is a common complication of mitral stenosis and regurgitation, both of which I have. Maybe this will trigger another valve surgery? Maybe I'll be coming back to the pros here for warfarin management tips if my cardiologist switches me to warfarin instead of Eliquis? I still have my native valve (repaired in 2002), so only on 325 mg aspirin presently, but quick paper I read said anticoagulants are "mandatory for rheumatic mitral stenosis or regurgitation in the presence of a-fib" and recommends warfarin as the best choice so we will see what the cardio says.

I guess no burning questions? But interested in anybody's experience in developing a-fib alongside valve issues (especially mitral) and the course of treatment. I'm 56 and this is my first episode of a-fib as far as I know.

I had mitral valve repair in 2009. My cardio always mentioned that a-fib is a possibility after MV repair especially after 60 years of age. I had my first a-fib episode at 58 and then 2 episodes within 3 months at the age of 60. Note: all episodes corrected by itself. So, he put me on Eliquis and Metoprolol Tartrate for a few months. Then just metoprolol 10mg and 2 low dose aspirin from then on. That seems to be working. My mitral valve remains mild regurg and there has been no discussion about intervention due to the afib or otherwise. He at one time recommended a Kardia 6L device to take your own ECG's. I take my ecg 2-3 times a week. If anything weird, you can save the report and send it to your cardio via your medical portal. I think it's good for my piece of mind. The 6 lead is currently on sale for $129.00. P.S. I dont work for them. Good luck. Keep us posted.

 

[dornole]

Thanks ej. How long did your a-fib episodes last before they self-corrected, if you don't mind sharing?

Mine was about 2 hours (253 bpm atrial and 105 ventricular) before I got to the ER, and then probably another hour or two before they did the cardioversion.

Now I have a nice rectangular burn mark on my chest. But, fair trade for normal sinus rhythm.

 

[Protimenow]

I got a new pacemaker that also has a defibrillator because my ejection fraction got below 30%.
This was because the risk of fibrillation rises when the ejection fraction drops.

I developed what my electrocardiologist called aortic fibrillation -- my heartrate went to around 135 when I got up and took a few steps. I don't think it went to 160 - even at its peak. It was enough to worry me, and I sent my pacemaker data to the doctor.

When I came into his office, he told me that I was having Aortic Fibrillation -- he told me that I need an ablation of one of the nodes that was causing the fibrillation. I'm having this done on Tuesday.

While I was in the office, he had the defibrillator on the pacemaker defibrillate me - he put the monitor device over the pacemaker, charged it up, and WHAM - my heart went back into normal rhythm. For eve
yone who he defibrillates, he moves the chair away from the wall because, when this happens, they often jerk their heads backward and would hit the wall if they're too close to the wall.

(If it went badly, he had the crash cart ready to start me up). The jump start he gave me worked. Next week, I think it will be an oil change.

My electrocardiologist criticized the ERs - he said that this would cost me thousands of dollars (I had it done using adenosine a few years ago, and it WAS expensive). I'm not sure what he charged my insurance, but I'm sure it was a fraction of what an ER would have charged.

One other thing about the high drug prices -- I'm taking Inpefa - a very expensive drug, and I was able to get on a program that provides me with the medication (that I otherwise could NOT afford).

One other thing - Eliquis IS expensive and I'm not sure it does much different than Warfarin (which may cost a few dimes a day). If you doctor puts you on Warfarin instead of Eliquis, (s)he is probably doing you a favor --- not only will you save money, but you may also be able to self-test and, perhaps, self-manage, and it might be easier to reverse the effects.

Lots of stuff in this post - thanks for reading it.

 

[ejc61]

Thanks ej. How long did your a-fib episodes last before they self-corrected, if you don't mind sharing?

Mine was about 2 hours (253 bpm atrial and 105 ventricular) before I got to the ER, and then probably another hour or two before they did the cardioversion.

Now I have a nice rectangular burn mark on my chest. But, fair trade for normal sinus rhythm.

In all 3 cases, it peaked at about 185 bpm. The first time was the day after Christmas 2021. At that time, I was comparing the data on my Fitbit and my Kardia and they were similar. It lasted at most 2 hours. I drove myself to the ER. By the time I was being checked out, the HR went back down to normal. A few months later, 2 similar 180's readings. What was messed up about these 2 cases in early March is that I had fractured my pelvis skiing the previous month and was on no weight bearing so I was pretty immobile to get up and run to the ER. In these cases, it settled down with in the hour. I will point out that the month before, February, my cardio had me do a 30 day event monitor and the results were unremarkable. One side note about all this is that my cardio told me no more than one drink a day while on Metoprolol. Well ok.

 

[dornole]

Thanks for the info. Looks like I’ll get an echo, be on warfarin for a month, and then holter monitor to see if any events before they consider taking me off.

 

[ejc61]

Thanks for the info. Looks like I’ll get an echo, be on warfarin for a month, and then holter monitor to see if any events before they consider taking me off.

Heart care never really ends. The 30 day monitor was weird in the sense that It recorded nothing in the month between my afib events. 21 pages of babel. But necessary for piece of mind. Good luck.

 

[Nelle]

So, a surprise detour this morning to the ER with irregular heartbeat around 185-200 bpm, where they found "atrial fibrillation with RVR (HC)," did a cardioversion which stopped the a-fib, and put me on Eliquis for a month. Following up with my regular cardiologist / valve guy on Friday.

Not sure what this means for me yet, but a-fib is a common complication of mitral stenosis and regurgitation, both of which I have. Maybe this will trigger another valve surgery? Maybe I'll be coming back to the pros here for warfarin management tips if my cardiologist switches me to warfarin instead of Eliquis? I still have my native valve (repaired in 2002), so only on 325 mg aspirin presently, but quick paper I read said anticoagulants are "mandatory for rheumatic mitral stenosis or regurgitation in the presence of a-fib" and recommends warfarin as the best choice so we will see what the cardio says.

I guess no burning questions? But interested in anybody's experience in developing a-fib alongside valve issues (especially mitral) and the course of treatment. I'm 56 and this is my first episode of a-fib as far as I know.

Hello Dornole, I hope you are feeling better after the afib episode. I also had a visit to the ER this past April 15 for Afib, and I also had a mitral balloon valvuloplasty in April 2003 due to rheumatic valve disease. I'm just a few years older than you. Post valvuloplasty, the mitral valve had improved stenosis but added mild regurgitation..and has stayed steady enough not to require any other intervention for these past 21 years. I'm wondering how long it will be before it needs replacement which at this point would also include replacing aortic valve as there is now some stenosis there too. For the afib I am now taking Warfarin and Sotalol. My heart rate is in mid 50's and my body is just starting to adjust to it. The cardiologists told me that Eliquis was not an option due to the rheumatic valve, nor is ablation or pacemaker. This is all new and I am happy to have this site and @pellicle 's input to help me with the Warfarin especially for when I need a procedure like colonoscopy which will be soon. Best of luck with afib.

 

[dornole]

Hello Dornole, I hope you are feeling better after the afib episode. I also had a visit to the ER this past April 15 for Afib, and I also had a mitral balloon valvuloplasty in April 2003 due to rheumatic valve disease. I'm just a few years older than you. Post valvuloplasty, the mitral valve had improved stenosis but added mild regurgitation..and has stayed steady enough not to require any other intervention for these past 21 years. I'm wondering how long it will be before it needs replacement which at this point would also include replacing aortic valve as there is now some stenosis there too. For the afib I am now taking Warfarin and Sotalol. My heart rate is in mid 50's and my body is just starting to adjust to it. The cardiologists told me that Eliquis was not an option due to the rheumatic valve, nor is ablation or pacemaker. This is all new and I am happy to have this site and @pellicle 's input to help me with the Warfarin especially for when I need a procedure like colonoscopy which will be soon. Best of luck with afib.

Wow Nelle, we are like twins! The afib episodes seem to be getting farther apart and less severe (less tachycardia along with them, less of the paired / double beats), but not gone. Right now they have me on Eliquis, not warfarin, and nothing else.

I am busy advocating for myself because I feel like my doc isn't as on top of this as I would like. Usually he is VERY attentive and listens carefully. When I went in post-ER, he was like a different person. Kinda blew me off, said take the Eliquis for 30 days and do a Holter for 24 hours and then go off it. And he had shaved his head and was brusque. Did he get divorced? Is he prescribing himself something he shouldn't be? Tons of mixed messages talking to the cardiac nurses too. For example "stop the Eliquis and just take aspirin." ME: "But I just had a cardioversion and ER said I should be on it for at least 30 days. Also I told you many times that I am stilll having afib." THEM: "Oh yeah just keep taking it." I am now additionally concerned based on what your docs are telling you about Eliquis and the rheumatic valve.

I have an appointment with electrophysiology set up to try to get answers and hopefully get my confidence back in this team.
My consolation is that the episodes only last for a few hours and they are down to more of a weekly things. So the overall afib burden is relatively low.

Thanks for sharing your experience, it's really helpful.

 

[ejc61]

Wow Nelle, we are like twins! The afib episodes seem to be getting farther apart and less severe (less tachycardia along with them, less of the paired / double beats), but not gone. Right now they have me on Eliquis, not warfarin, and nothing else.

I am busy advocating for myself because I feel like my doc isn't as on top of this as I would like. Usually he is VERY attentive and listens carefully. When I went in post-ER, he was like a different person. Kinda blew me off, said take the Eliquis for 30 days and do a Holter for 24 hours and then go off it. And he had shaved his head and was brusque. Did he get divorced? Is he prescribing himself something he shouldn't be? Tons of mixed messages talking to the cardiac nurses too. For example "stop the Eliquis and just take aspirin." ME: "But I just had a cardioversion and ER said I should be on it for at least 30 days. Also I told you many times that I am stilll having afib." THEM: "Oh yeah just keep taking it." I am now additionally concerned based on what your docs are telling you about Eliquis and the rheumatic valve.

I have an appointment with electrophysiology set up to try to get answers and hopefully get my confidence back in this team.
My consolation is that the episodes only last for a few hours and they are down to more of a weekly things. So the overall afib burden is relatively low.

Thanks for sharing your experience, it's really helpful.

Thanks for the info. Looks like I’ll get an echo, be on warfarin for a month, and then holter monitor to see if any events before they consider taking me off.

Well I spoke too soon. Last week I had an episode of 185 HR for about 15 minutes before it subsided within 30 minutes. I felt alittle off which is not the norm. I recorded several readings on my Kardia 6L and sent them to my cardio via MyChart. He replied it was either an atrial flutter or A-fib but it resolved. I sent him 6 readings over 2 days whether it was possible Afib, unclassified or normal and he reviewed them. Basically told me to take a reading every other day and it it gets more frequent, he'll put me on a another blood thinner medication instead of my 162mg low dose aspirin. I'm thinking he's going to put me on Eliquis eventually possibly sooner rather than later. I also take Metoprolol currently.