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Lea99

Hello - I am so gratefull to have found this site. Your postings have been so informative and helpful. -- A recent problem just happened yesterday, and I really need some advice.

My father had mitral valve replacement surgery about 3 months ago. It went well and he was getting his strength back more and more as the weeks went on. Post-op visit to the doc showed all is good. Then he wore the Holter monitor for 24 hours, and the results were fine. And he got clearance to start cardiac rehab.

Then all of a sudden, last week, there were a few days where he felt so incredibly weak and fatigued. Something wasn't right. - And then just yesterday he was feeling okay, and went to his first day of cardiac rehab. When they took his pulse it was 133. Doctor sent him to the hospital, and tests showed he was in A-flutter. IV Cardizem brought the pulse rate down, they kept him overnight.

This morning his pulse rate is normal, but there's still some "flutter" so they're keeping him in the hospital. --- My question is, what treatment options are usually considered for something like this? --- Any advice or information would be greatly appreciated. I'm so worried.

Lisa
 
Lisa, welcome to the VR community. Glad you found us. I'm no expert on a-flutter since I haven't had any problems that way since my OHS. Did you do a search on "a-flutter" using the search function? As I recall, there have been many threads on it. Hopefully somebody more knowledgeable on this will come by shorty. I really just wanted to welcome you.
 
Regarding A-fib and/or A-flutter

Regarding A-fib and/or A-flutter

Hi Lisa and welcome - I was rehospitalized about two weeks post-op for A-fib (and possible A-flutter also) to be put on a medication called Sotalol, which I had to take for about three months. It quickly stopped my rhythm problem. I was also given magnesium IVs while in the hospital. I was also on Coumadin for three months post-op. Depending on what valve your dad received, he may already be on Coumadin.

Lots of members here have had occurences of this issue and hopefully others will post their experiences also. Hope things go well for your dad. Take care.
 
I had similar experiences in cardiac rehab, somewhat with a high heart rate, somewhat with irregularities. The nurses got all upset, and got the cardiologist to order various tests. I was prescribed amiodarone, which worked well for a short time only. I take magnesium regularly, but still have some irregular beats during stress -- that can't be avoided.
 
Welcome Lisa,

I'm glad they didn't just give him Amiodarone (the Sledge Hammer of anti-arrhythmics) which is recommended as the medication of Last Resort because it can have some NASTY side effects to the Eyes and Lungs, not to mention it's long half life (i.e. it stays in your body for at least 6 months AFTER it is discontinued).

Beta Blockers are typically used for irregular heart beats such as PVC's and PAC's. BetaPace (Sotalol is the generic equivalent) targets Atrial Fibrilation and has worked well for me in a very low dose (40 mg 2X / day). I'm not sure if / how well it would work for Atrial Flutter. You could get a quick answer from any Pharmacist. It wouldn't hurt for your father to ask his cardiologist about Sotalol. Note that it is recommended that the patient be hospitalized for the first few days to ensure that no dangerous arrhythmias are triggered at the onset. Not all doctors do this.

Given his history of fast heartbeats, it would be wise for your father to purchase his own stethoscope so that he (or someone with him) can listen to his heart which is a much better way of assessing heart rate and rhythm than simply feeling for a pulse.

'AL Capshaw'
 
ditto what Al said about Amiodarone (also called cordarone). There are lots of meds that can help and I expect they will find the right one for control.

Welcome to VR. Our purpose every day is support and information - along with friendship. We are glad you joined us.
 
Does this recent treatment plan make any sense?

Does this recent treatment plan make any sense?

Now the doctors are talking about catheter ablation and electrical cardioversion. -- My dad has only been in the hospital for 24 hours, and the heart rate has been stabilized. - But there's still "flutter".

They want to make sure there's no blood clot. And mentioned doing a TEE. Is that the only way to check for a blood clot?

I just think that jumping into these procedures at this point is premature. Am I wrong?
 
I don't know if they are being premature or not. However, I do know from my own experience with A-Fib (not sure about A-Flutter) that it can cause clots around the valve and that the best way to check for clots is with a TEE. They have to check if they plan to do a cardioversion because once the heart starts pumping the way it should pump, there is that much more chance that the clot (if there is one) will be sent to the brain and cause a stroke.

I had a cardioversion (a couple of months before my surgery), and it worked like a charm. I don't know if doing an ablation is being a bit premature though. Maybe other people will have opinions about that.
 
Lea99 said:
Now the doctors are talking about catheter ablation and electrical cardioversion. -- My dad has only been in the hospital for 24 hours, and the heart rate has been stabilized. - But there's still "flutter".

They want to make sure there's no blood clot. And mentioned doing a TEE. Is that the only way to check for a blood clot?

I just think that jumping into these procedures at this point is premature. Am I wrong?
Click to expand...
He is in danger so long as he's in Afib of developing a clot, which makes it pretty much a priority to get these tests done and the cardioversion. I'd much rather hear about them wanting to do cardioversion then putting him on Amiodarone. This drug is to be used as a last resort, but many physicians use it as a first.
 
There has been at least one other member here, Ruth is her name, who recently had cardioversion only a few weeks after her valve repair surgery. Perhaps she will see this and post, or maybe you could send her a PM and ask her about her experience. It was apparently a great relief to her after weeks of a post-op rhythm problem.

Be sure and ask the doctors to explain all of the potential options and the pros and cons of each, Lisa. Hope all goes well for your dad. Post again.
 
my brother had cardioversion. I was there across the room. They sedated him and put the paddles to his check, then shocked him. He said he could feel it but didn't complain of any pain. He had a 'sunburn' on his chest afterward. The cardioversion worked for him for awhile. It eventually didn't do the job, but it is a good first step and might remain stable for your dad. They talked about ablation for Richard but nevwr did it.
 
Hi Lea,

Just thought I would chime in:D I had a problem with a-fib/flutter prior to my AVR so I had the ablation when I had my valve replaced. They said it would take several months before we would know if the ablation would work. Sure enough about three weeks after surgery I went into a-fib. Off to the hospital I went to be cardioconverted:eek: It was a piece of cake. They gave me a little joy juice and gave me a little jolt;) There was nothing to it, realy. The a-fib was gone and has never returned (over a year later).

It is not uncommon to have this type of hickup after valve replacement. I am sure all will be well with your dad.

Cooker
 
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