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A-Fib Post Valve Replacement Percentages?

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  • A-Fib Post Valve Replacement Percentages?

    Seems we read here so many people who get A-fib in the weeks/few months following Valve Replacements.

    Two things have struck me and I'm wondering if I am mistaken or my 'casual impressions' from reading are somewhat accurate.

    I wonder if it could be as high as 75% or so of Valve Replacement patients have at least a few A-fib episodes but it seems to be more Aorta valves than Mitral. It seems there are fewer of us that have mitral replacements but unless I've missed many threads, do Mitral valvers have fewer A-fib events?

    Mind if I ask who had/has A-fib and who doesn't.... who never had an episode?

    I'm three years out from surgery and every now and then I think of it and continue to hope I remain A-fib free but know it can happen to anyone at anytime including people who never had a valve problem.

    Thanks.

  • #2
    I had A-flutter after my aortic valve replacement. While I was in the hospital for the A-flutter, one of the nurses told me that they see about 30% of all OHS patients after surgery for A-fib or A-flutter, and a higher percentage of those are valve replacements. She said that she thought the number of valve patients that had A-fib or flutter was upwards of 60%, and many more of those are aortic. I think she was saying that they SEE 60% of valve patients, which means that they were re-hospitalized. With that said, it may be that your number of 75% is accurate, as I am guessing that some people who have short bouts of A-fib or flutter don't go back to the hospital, particularly if they live a ways away. She related that when they are cutting for the aortic valve, they are very near one of the nodes for electrical impulses in the heart, and this causes a high rate of flutter or fib.

    Keep in mind that this is all from my memory of what she told me, and I have no personal knowledge of this stuff to know if what I am saying is fact. I do know that I had it with an aortic replacement (3 separate bouts of A-flutter in 5 days) and I don't want it again!
    Last edited by Jason; May 11th, 2011, 03:50 PM.
    BAV...AVR March 7th, 2011 / Carbomedics mechanical 25mm
    Ascending Aortic Aneurysm replaced with Dacron at same time
    Sanford Heart, Fargo, ND, Dr. Roxanne Newman

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    • #3
      I had a-fib before my AVR and we controlled it pretty well with meds but I elected to have an ablations done along with my AVR to ho;fully get rid of that pesky a-fib for good and get off the hammer drug .... I went into a-fib a week or so post AVR (was told to expect it), was cardioverted and it has never returned (5 plus years) ...

      I think a-fib is like a lot of things, just happens ....
      No shoes, no shirt, no problem
      AVR with Ablation -St Jude Mechanical--2006
      ~Easy Does It~

      The early bird get the worm but the second mouse gets the cheese.

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      • #4
        As far as I know, I have never experienced A-fib or A-Flutter in any significant way. I have had very short periods of skipped beats, eratic beats, etc. a number of times since my OHS. In the community where I live, there are several of us on warfarin and the vast majority have never had valve surgery and they are on ACT because of the A-fib.
        Starr-Edwards mechanical AVR 1967 at age 31.....University of Kentucky Med. Ctr., Drs. Richard Wood & Gordon Danielson surgeons. No surgery (heart or otherwise) since. On Warfarin ACT since surgery with no diet, lifestyle, or activity restrictions....and I live one day at a time.

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        • #5
          I was told similar statistics regarding afib and even pacemaker implants after aortic valve surgery. I, too, was told that the main nerve bundle that carries the electrical impulses to the chambers of the heart was very close to the aortic valve, and that sometimes in order to remove a badly calcified valve these nerves are disrupted or damaged. The resulting rhythm disturbances can be either temporary or permanent. In my case, in the few days immediately following valve replacement, I had everything you could think of -- afib, a-flutter, bradycardia, tachycardia and, most frighteningly, long 15 to 20 second pauses between beats. Knowing all this, I readily agreed to the pacemaker implant. I think I'm getting used to it, and will just get on with living my life.
          Go Class of 2011!

          Steve Epstein
          9 Years in The Waiting Room, then on February 28, 2011,
          AVR with 23mm Edwards Bovine Pericardial Tissue Valve, Model 3300TFX, Pacemaker - Boston Scientific Altrua 60 DDDR IS-1 and CABG (LIMA-LAD) at Northwestern Memorial Hospital, Chicago by Dr. Patrick McCarthy and the most wonderful team of professionals I could ask for.

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          • #6
            Thanks. Interesting. I'm mitral and so far no a-fib or flutter and keeping my fingers crossed.

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            • #7
              I knew about the potential issues with A-Fib so I elected to have a MAZE procedure done while they were in there doing my mitral valve.

              So far, 5 months later, no issues that I am aware of.
              VT and ICD '02. Diag went from HCOM > idiopathic cathecholamine triggerd VT > MV Prolapse Syndrome. MV rep Da Vinci, Dec 27 '10 Mayo. Finally on mend. "I don't think the objective should be optimization of athletic performance" - John's Cardiologist : )

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              • #8
                I had a-fib 2 wks after my aortic valve replacement. Amiodarone controlled it, and after one more short episode a couple wks after that (might have been caused by my stupidity - got dehydrated) it hasn't come back since. I remember one of the caridologists telling me he thought the percentages were higher than the 30% I'd been told up to that point, he thought it was more like 2/3 of the time that OHS patients get a-fib while things are healing up. Whether it's really 30%, 50% or 75%, it's clear that quite a few folks get it, which is understandable considering the scar tissue the electrical current has to get used to traveling through. But the good news is, it also seems fairly common for it to go away within a few weeks/months after surgery. Mine hasn't come back and it's been a year now.
                - Andy
                Born with BAV; Moderate/Severe Stenosis/Regurgitation by age 49; AVR Surgery 5/5/10 by Dr. Robert Emery, St. Josephs Hospital, St. Paul, MN; St. Jude Regent Mechanical Valve

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                • #9
                  PS - I was only on amiodarone for about 3 mo (and that was just a precaution that I was on it that long). They said as long as I got off it that quickly, there wasn't much risk of the bad side effects it can cause. Would have gotten nervous if they wanted to keep me on it longer than 3 mo though.
                  - Andy
                  Born with BAV; Moderate/Severe Stenosis/Regurgitation by age 49; AVR Surgery 5/5/10 by Dr. Robert Emery, St. Josephs Hospital, St. Paul, MN; St. Jude Regent Mechanical Valve

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                  • #10
                    I'm 10 wks post AVR and have had no Afib....so far. I consider my self lucky. I'm taking 12.5mg Metropol 2x/day
                    AVS diagnosed 12/08
                    Av .9 01/10 Mean pressure grad 31 01/10
                    Av .8 01/11 Mean pressure grad 34 01/11
                    3/04/11 Av replacement with asending aorta graft ,Datascope#IGW0026-30
                    Edwards Perimount 25mm 3000TFX

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                    • #11
                      Had A-fib before and after MVP! I was also cardioconverted, and put on Amiodarone. It's been almost 2 years and no more A-Fib.!!!!

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                      • #12
                        Luckily, I was trouble-free.
                        sigpic
                        Brigham and Women Hopsital -Dr.Shekar OHS- June 1,09
                        AVR-St.Jude Mechanical Valve. (25VAVGJ-515)
                        Ascending/Transverse Arch Aortic Replacement


                        Nelson :cool:

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                        • #13
                          My A-Fib and surgery history

                          Aug 2006 - A-Fib episode corrected by medication after 20 hours
                          Nov 2006 - Mitral Valve replaced (porcine)
                          Feb 2011 - A-Fib episode that lasted 3 days went into sinus on its own (with lots of meds on board too).


                          I had no episodes (certainly sustained ones) after my surgery. I am one of those who feels every skipped/extra beat so apart from daily multiple palpitations that could be this or that (usual SVT when I've had a monitor) I have not had anything since surgery until recently. I am 4 and a half years out.

                          Interestingly about 30 minutes ago I had 30 seconds of palpitations which I think was A-Fib. I rarely get bouts that last that long. Mostly I get 5-10 second bursts at worst. This was too the point if it had lasted a few minutes I would have gone to the ER. My last A-Fib episode I was able to walk around for the first few hours, but by the evening I was exhausted and could not stand without my heart rate shooting up. I'm waffling! bye
                          Ingrid
                          MVR (bovine) November 29 2006 - Dr Patrick McCarthy, Northwestern Memorial Hospital, Chicago, IL
                          AVR, MVR (On-X, St. Jude's) March 20 2014- Dr Patrick McCarthy, Northwestern Memorial Hospital, Chicago, IL

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                          • #14
                            It will be 3 years next Thursday the 19th. Never experienced A-fib or flutter before or after surgery (knocking on wood right now).:D
                            Chris
                            Livin' Life At A Snail's Pace
                            AVR May 19, 2008
                            Edwards LifeScience Bovine Pericardial

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                            • #15
                              I had afib twice during the weeks that followed AVR. First time I was cardioverted successfully, but it returned a few days later and I was put on Multaq for 6 months. Off it now for 4 months and my heart has been very steady with no afib.
                              Doug, Bi-cuspid Aortic Valve
                              AVR Jul 27, 2010
                              Mayo Clinic, Dr Daly

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