I had a bovine aortic valve replacement in March 2018. Recovered pretty quickly and was back paddling an outrigger by late July. I did have an a-fib occurrence in July but recovered quickly. Doc put me on diltiazem. Did the full race season in 2019, and then the next two seasons were essentially cancelled because of covid, but I did train and coach novice and paddled a one-man. Then in 2021, I started racing again. But in August, a-fib came back and Doc put me on Xeralto. That December I had ablation for a-fib and a-flutter. Stayed on Xeralto for 6 more months, but no a-fib or a-flutter (I go to cardiologist every 3 months). Then last month they found a-fib and a-flutter again in a different part of my heart. Back on Xeralto and two ablations scheduled for this summer after race season. I am totally non-symptomatic and can race 12 miles on the open ocean. Anyone else have these occurrences after aortic heart valve replacement? I was pretty damned depressed when the a-fib and a-flutter came back. It probably means I will be on Xeralto for the rest of my life. (I am 74.)
A-Fib after Aortic Valve Replacement
- Thread starter Jerry D
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Hi Jerry
sorry to read of your AF onset ...
However its not an uncommon occurrence AFAIK
I have had (12 years post surgery) an onset of Tacycardia, which I attribute to COVID. While it was "intermittent" I didn't worry to much about it (as I was already on warfarin due to picking a mech valve in my 3rd OHS). However were I not I'd likely have sought something out quickly because IMO this will (if not treated with medication) be an increase in morbidity for me.
jamanetwork.com
thus my advice is to always consider this when making a decision towards a bio-prosthetic if it is based on a dislike of being on anticoagulation therapy (ACT) rather than an actual medical "contra-indication" ... because you may just wind up on ACT and then that may make it all the more a regretful decision.
But at least you don't have to check INR ...
Best Wishes
sorry to read of your AF onset ...
However its not an uncommon occurrence AFAIK
I have had (12 years post surgery) an onset of Tacycardia, which I attribute to COVID. While it was "intermittent" I didn't worry to much about it (as I was already on warfarin due to picking a mech valve in my 3rd OHS). However were I not I'd likely have sought something out quickly because IMO this will (if not treated with medication) be an increase in morbidity for me.
New-Onset Atrial Fibrillation After Aortic Valve Replacement
This population-based study evaluates the incidence of new-onset atrial fibrillation and assesses the incidence of in-hospital mortality associated with new-onset atrial fibrillation after transcatheter aortic valve implantation and surgical aortic valve replacement.
jamanetwork.com
Atrial fibrillation is a common arrhythmia with a lifetime risk of 37% in individuals older than 55 years. Atrial fibrillation is also associated with significant cardiovascular morbidity and mortality. New-onset atrial fibrillation has been recognized as a common occurrence after noncardiac and cardiac surgery, such as aortic valve replacement (AVR).3-5
Several investigations have attempted to elucidate the incidence of atrial fibrillation after AVR. The incidence estimates of atrial fibrillation after transcatheter aortic valve implantation (TAVI) and surgical AVR have varied widely, ranging from 8% to 100%.6-9 New-onset atrial fibrillation after TAVI and AVR has also been associated with increased morbidity and mortality.10 Most investigations detailing new-onset atrial fibrillation after TAVI and AVR, however, are single-center series or post hoc analyses of clinical trials.
thus my advice is to always consider this when making a decision towards a bio-prosthetic if it is based on a dislike of being on anticoagulation therapy (ACT) rather than an actual medical "contra-indication" ... because you may just wind up on ACT and then that may make it all the more a regretful decision.
But at least you don't have to check INR ...
Best Wishes
Last edited:
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- Oct 25, 2020
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- 39
Hi Jerry. I'm a lifelong endurance runner and have had 2 valve (mitral) surgeries and 2 ablations (technically 3 as an ablation was also done during my first valve surgery.
- I routinely recommend older endurance athletes read "The Haywire Heart" by Case, Mandrola, & Zinn. As much as it still bothers me to acknowledge it, there's quite a bit of data indicating that longtime endurance athletes have an increased risk of arrhythmias. Unfortunately it is also (essentially) impossible to run a double blind, randomized, verification/refutation of this for the obvious (to the endurance athletes anyway!) reason. The reference book does have lots of easy to read information on arrythmias and what can be done about them.
- As Pellicle points out, there is plenty of evidence that AFIB incidence increases with age.
- Every surgical incision into the heart muscle is scarring it. Because cardiac tissue (unlike muscle tissue arranged in fibers with a common cell membrane) transmits it's electrical signals multi-directionally, every scar changes the electrical pathways in the heart. This is actually what ablations do as well. An ablation's scarring is intended to correct erroneous pathways but they don't always work and not always permanently. I have one friend who underwent 5 ablations for AFIB over about 36 mos. So - to me anyway - it makes sense that those of us who have undergone valve surgery have a greater chance of developing an arrythmia. Reading about the early Maze procedures on the outside of the heart and on the inside were educational for me.
So you have several factors that could all be playing a role (and of course there are many other factors as well; e.g. alcohol). Some good news is that it need not stop your activity. AFIB and/or preventative drugs may well impact performance but I (eventually) accepted that I was slowing down with age anyway! I still run 5 or 6 days a week and compete regularly.
fyi - my actual "order of operations" was AFIB ablation age 45, mitral repair age 49 (cryogenic ablation also performed), mitral replacement age 50, Aflutter ablation age 56. I went on warfarin in my early 40's after a blood clot so I never considered anything other than mechanical when the repair became problematic.
- I routinely recommend older endurance athletes read "The Haywire Heart" by Case, Mandrola, & Zinn. As much as it still bothers me to acknowledge it, there's quite a bit of data indicating that longtime endurance athletes have an increased risk of arrhythmias. Unfortunately it is also (essentially) impossible to run a double blind, randomized, verification/refutation of this for the obvious (to the endurance athletes anyway!) reason. The reference book does have lots of easy to read information on arrythmias and what can be done about them.
- As Pellicle points out, there is plenty of evidence that AFIB incidence increases with age.
- Every surgical incision into the heart muscle is scarring it. Because cardiac tissue (unlike muscle tissue arranged in fibers with a common cell membrane) transmits it's electrical signals multi-directionally, every scar changes the electrical pathways in the heart. This is actually what ablations do as well. An ablation's scarring is intended to correct erroneous pathways but they don't always work and not always permanently. I have one friend who underwent 5 ablations for AFIB over about 36 mos. So - to me anyway - it makes sense that those of us who have undergone valve surgery have a greater chance of developing an arrythmia. Reading about the early Maze procedures on the outside of the heart and on the inside were educational for me.
So you have several factors that could all be playing a role (and of course there are many other factors as well; e.g. alcohol). Some good news is that it need not stop your activity. AFIB and/or preventative drugs may well impact performance but I (eventually) accepted that I was slowing down with age anyway! I still run 5 or 6 days a week and compete regularly.
fyi - my actual "order of operations" was AFIB ablation age 45, mitral repair age 49 (cryogenic ablation also performed), mitral replacement age 50, Aflutter ablation age 56. I went on warfarin in my early 40's after a blood clot so I never considered anything other than mechanical when the repair became problematic.
Thank you for your responses. Very helpful.
Gail in Ca
Well-known member
My chronic a-fib started 3 yrs after my 3rd surgery. The cardio version worked for 2 yrs. my a-fib came back in 2014, cardio version didn’t work, so I’m in a-fib all the time. Couldn’t have ablation as I have mechanical valve. It’s not bad living with it. I was already on warfarin, so no more drugs needed.
Thanks for your response. Yes, I am on Xeralto and suspect they will keep me on it forever. Fortunately I am asymptomatic. Be well and take care.
Haoming Li
Member
Hello Gail, I am also a member, but didn't post much. Just came across your post now, I also had AFib couple times after valve replacement since June 2016. I had fast heart beat in last 2weeks,
already scheduled to do cardioversion on coming Wed. It will be the 4th time I am having this procedure, cross fingers that it will help. Many people say they could live with AFib, but it bothers me too much!!
Thank you for listening to me.
HaoMing Li
