A Fib disappointment / Setback

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Mike59

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Mar 14, 2012
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Hi All

Had a disappointing day today, I am 3 weeks post surgery and have been doing well since having AVR and ascending aorta repaired

Anyway last Thursday I had what I knew as palpitations which didn't cause too many problems other being a bit scary

But today went for ecg to be told I was in AF

Doctor has now put me on warfarin and increased Bisoprolol to 2.5mg was on 1.25mg

Really scared now as had tissue valve,

Has anyone else experienced this and how was it treated


Please help if you can
 

AgilityDog

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Afib is not uncommon after OHS. It may very well stop after you heal. You will be on warfarin for several months at a minimum. However, if the Afib continues, they may cardiovert you, or do an ablation to stop the Afib. They may also change/add medications.

If your afib is not controlled by medication or otherwise, then you will be on warfarin or other anticoagulation therapy for life. This is just fine. It beats the heck out of a massive stroke.

This is why on this board we tell people who are choosing valve type that there is no guarantee they will be warfarin free if they choose a tissue valve.

But this too will pass. It is early days yet, and you just have to keep tabs on it, follow doctor's orders, and wait and see. This may not be permanent.
 

Roberta

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Sorry to hear of this setback. A friend of mine went into afib. about 2 weeks after AVR and root graft. She was disappointed as she had a tissue valve as well. (Luckily this didn't happen to me.)

Her afib lasted for about 4 more weeks and she eventually went out of afib. During that time they upped her beta blocker and placed her on coumadin. She is no longer on coumadin and only a beta blocker.

The surgeon said that it is apretty common occurence post-op and it is often temporary. I hope this is the case for you as well.
 

karla

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Laurie hit the nail on the head, I think. I was told, as I recall, that around 80% of OHS patients develop afib at some point in time. I did, also, around week 2 or 3. Since i have a mechanical valve I was already on warfarin but my beta blocker (metoprolol)was increased from 12.5 mg twice a day to 25 mg twice a day. That took care of it and I do not think I have had any afib since - I haven't felt the palpitations I felt at the time and none of my EKGs done since have shown it.
Afib is not a life-threatening condition - the problems develop if a clot forms because the blood is "pooling" rather than being pumped around efficiently. That's where the warfarin comes in. You were started on warfarin so chances of that are now quite low.
Relax. All will be well. :)
 
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Lionheart

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Mike,
I too went into A-fib and A- flutter after surgery. I too have a tissue valve and they put me on Warfarin which was not a big deal and was easily managed. The doctor had me on Amiodarone for several months which is a drug to help your body revert to a natural rhythm. They eventually did the cardioversion which solved the problem.
John
 

Scott

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I also had a-flutter twice after surgery. It hasn't been back. I think the odds are with you that this will not be a permanent problem.
 

epstns

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Mike - As the others have said, afib after heart surgery is common. Each of us heals differently, so it can happen to different degrees, at different times in recovery. Even with my pacemaker, I had some bouts of afib about a month after surgery, but the surgeon had me on warfarin for the first 3 months anyway, so we waited it out. In my case, the afib stopped on its own, so we stopped warfarin as well. Give it some time. Very often afib just goes away as you heal more.
 

Mike59

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Thanks guys for the advice as always appreciated

Does anyone else have experience of Bisoprolol in the States or UK

Like I say I'm on 2.5mg once a day

It would be good to know the dosage levels of others if possible

Many thanks

Mike
 

valdab

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I'd also heard that about OHS and AFib.
I know quite a lot about AF as my husband developed it about 7 years ago. He was first put on Bisoprolol but then changed to Flecainide which he tolerated better. He had no blood thinners as his CHADS score was low. He was eventually ablated (twice) and is now AF free, but the condition is pretty volatile I think. After his second ablation, he was recovering well, then out of the blue had his worst ever attack. That lasted a few hours, depressed the hell out of us, but he spontaneously converted back has had nothing since. That was about 4 1/2 years ago
Not particularly relevant to your situation, but I thought I share it if only to demonstrate that AF is an unpredictable condition. Keep positive - I'm sure it's only a temporary glitch.
 

neil

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hi mike, i had af after my op, its very common although unpleasant,after a short spell on amioderone it went,try not to worry about bisoprolol, am on 2.5 twice a day and have been for over 3 yrs and with no problems,was only on wafarin for a short time which was great as cert didnt want to be on it long term, try to stay positive and am sure things will work out fine,
 

Lily

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Like others have said, some post-op A-fib and/or A-flutter isn't uncommon. It does need addressed though. I was put on Sotalol (a beta blocker) for nearly three months (had to be readmitted to the hospital for a few days to start me on it). I was also on 3 mos of ACT post-op. Occasionally since then I've had to take a week or two of beta blockers for other heart rhythm issues.

One other thing, FWIW: I was also given magnesium IVs when I was back in the hospital for that post-op A-fib/A-flutter. Search here and the web about magnesium. I think my minerals have always tended to be a little more unstable than in someone with a genetically healthy heart, but this last heart surgery seemed to intensify that problem. And some blood pressure and heart medications can also cause mineral imbalances.

Hoping your recovery is smooth from here on out :)
 
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Mike59

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Thanks lily
Excuse my lack of knowledge but what is ACT

Doctor has increased my Bisoprolol to 2.5mg Twice a day

See the cardiologist on the 22nd May

Will keep you all updated

I will ask about the Magnesium supplement
 

Bina

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Thanks lily
Excuse my lack of knowledge but what is ACT

Doctor has increased my Bisoprolol to 2.5mg Twice a day

See the cardiologist on the 22nd May

Will keep you all updated

I will ask about the Magnesium supplement
ACT=AntiCoagulationTherapy (Coumadin/warfarin)
 

Mike59

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Thanks Bina

Yeah they have just put me on warfarin for a period as well - suspect 3 months
 

epstns

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Mike - 3 months of anticoagulation is common after valve surgery, even absent other issues, even with tissue valves. It depends on the surgeon and what he/she normally prescribes. I was told before surgery that I would be taking warfarin for the first 3 months post-op, just as a precaution. After that, if there are no other issues requiring ACT, they discontinue it.
 

Michelle D

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Sorry to hear that. I went into afib shortly after my surgery too. I never had it before my surgery. They put me on sotalol which helped and it's been two years and since then I've only had atrial flutter a few times for a few minutes, once for a couple hours. They switched me off the sotalol to tambacor because I have soooo many PVCs. around 30,000 a day. I haven't had any atrial flutters since I've been on the tambacor
 

Mike59

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Hi All

It's now been 3 weeks since the AFib started

Been a little bit better I am on Bisoprolol 2.5mg Twice a day

But the afib is very persistent and heart rate is still over 100 bpm

Typically how long does it normally take to get things back under control?

Hopefully they will tweak the meds and if that isn't successful cardiovert

Any help and advice please

Cheers
Mike
 

drivetopless

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HI, MIke-
Same thing happened to me at week 2/3. My afib was so bad, it put me in the hospital for 10 days while they figured out the meds.
They talked about ablation, but my afib seemed to be caused from the surgery (lots of swelling of the heart)., so we waited.

I was taking 3 meds for the afib and it was controlling it pretty well. 4 months later we tried to eliminate the Cartia XT but the afib came right back so I started taking it again.

Then 14 months post surgery we tried again to eliminate the Cartia XT with EXCELLENT results. I've now been off the Cartia for 2 months with no issues or signs of irregular/fast heart beat.
In 2 more months we will try to eliminate the next med -- sotalol.

My point is that your heart is pretty pissed off after surgery. It has suffered a great insult. It will take a while to totally recover, so afib is kind of typical. Don't worry too much. Just give it some time.
 

Mike59

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Hi All

Spoke with the cardiologist last Friday, still in AFib have been for 3 weeks now

Meds 2.5mg of Bisoprolol. Twice a day

But he also put me on 40 mg of Furosemide (dietetic ) daily to help relieve pressure on heart

Heart rate still 100 plus bpm

Hopefully this will start to work over the next couple of weeks

And heart will revert back into normal sinus

See cardiologist again in 3 weeks time

Any advice in helping keeping heart below 90 and staying calm would be very welcome

Thanks all

Mike
 

Mike59

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Quick update

Still in AF been on Bisoprolol now for 6 weeks resting hr about 90

See the cardiologist next Tuesday the 19th

To discuss cardioverion

Quick question to all my friends has anyone use FLECAINIDE to control or eliminate AF

Was it successful and how long did it take to get back into sinus rhythm

Would really appreciate your advice

Thanks
Mike
 
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