A-flutter Question

[MaryC]

Well I was moving along on a smooth recovery after my MV repair on 02/21 until I went to my cardiologist last Monday. He determined I was in a-flutter, put me on 5 mg coumadin, 25 mg toprol-xl and 50 mg/2 times a day of flecainide. He also referred me to a specialist in his group dealing with electrical issues. When I went to see the specialist on Thursday he increased the dosage of the flecainide to 100 mg/2 times a day. On Friday at cardiac rehab they noticed my resting HR was 126 BPM. It stood out to them because the other 2 sessions in the week I was at 90 BPM (& at the orientation before any of the medicine I was at 70 BPM!) Although it didn't increase during the exercise it did stay up in the 120's. I called the specialist on Friday afternoon and went around with them about the flecainide. I was told the increased dosage of medicine was not causing the increased HR - it was just part of a-flutter. On Saturday and then this morning I had 2 incidents where I felt myself getting lightheaded, everything turning white...basically I felt I was passing out. The 1st time I was doing light house work...picking up etc and the 2nd time going for a walk. It was pretty scary stuff.

Has anyone had this type of experience with a-flutter or the drugs to treat it? I have an appointment with the specialist tomorrow - but I also have a call into my surgeon.

 

[GeorgeM]

Mary

I'd be interested to hear what your surgeon says.

I had A-Fib several times after my AVR surgery, and was put on a combination of beta blockers and Amiodarone. After 7 weeks I stopped the Amiodarone and haven't had any further A-Fib.

However, I have had some irregular heart beats and am waiting to see what my Cardio says when I see him in two weeks.

Other's here have suggested that these sort of symptoms could be the result of the heart remodelling itself post-surgery, and will stop in due course - but it's always good to check !

Best Wishes

George Montgomery

 

[MaryC]

George,
Did you have any side affects from the Amiodarone? I am being told this increased heart rate and now these other spells are not related to the Flecainide but I was not even aware I was in a-flutter until I went to the cardio.

 

[Kathleen]

Mary
They certainly prescribed alot of meds very quickly for you. Did he diagnose the a flutter with the stethescope or did he do an EKG. A flutter can be caused by being just 7 weeks out of surgery. Sometime waiting a bit and then doing a holter would let them know how often it occurs. Rather scary to go in thinking this will be such a nice appt and hearing this can really upset what you felt was going along very well. Since you did not even realize you had a flutter you can guess how common it is after surgery. The EP should be able to tell you more and what he feels needs to be done. Proceed slowly since you have much healing to do.
Kathleen

 

[MaryC]

Kathleen,
You hit right on what I have been thinking since I left that appointment on Monday with my handful of prescriptions. I keep wondering if my heart would have gone into a normal rhythm without this medicine and now it won't because of the medicine. Prior to starting all of this medicine I was walking 2 miles at my normal pace and riding my recumbent bicycle for 30+ minutes.

 

[GeorgeM]

Mary

I too had quite a lot of meds to take after surgery. Most of these I have now stopped taking (except for the coudamin and beta blocker).

You mentioned you were getting light headed and felt like passing out.

How much exercise are you doing ? - you mentioned walking and riding a bike. I found that I needed too take some rest after my surgery (in the afternoons). I have done some daily walking but that's all. Before surgery I could comfortably run 5 - 10 miles.

So don't forget to factor in some regular rest for yourself !

Best Wishes

George

 

[ruth]

Mary -

So sorry to hear about the aflutter. I know exactly how you feel about the drugs and all, I felt the same way when my a-fib started. What seems different is that you were feeling pretty good and I was feeling awful. If I'd been feeling good I would have felt even more frustrated by the drugs.

I hope you start to feel better, I think rhythm issues are even more prevalent among us mitral valve folks so hang in there.

Take care,
Ruth

 

[MaryC]

Quick update on my a-flutter situation....I am now seeing another specialist (EP). I don't want to go into too much detail about my prior treatment but want to say I wish I had questioned the original treatment right then and there. My gut instinct was not feeling comfortable with being sent home with a boatload of prescriptions. Mostly because it didn't feel right for me and how I had been feeling prior to walking into my cardio's office. The new specialist said I was in normal NSR but could be going in and out of a-flutter. He said this is very normal for someone who recently had OHS. We set up up with some basic tests over next week to see where I am at and I will meet with him the end of next week. Whew! I feel like I am back where I was 2 weeks ago but after almost passing out the 2 times....I'LL TAKE IT!!

 

[ruth]

I'm so happy that you have this new treatment.

Looks like following your instinct really worked.

Take care,
Ruth

 

[Kathleen]

Mary
Don't be to hard on yourself for not trusting your gut instinct. We do seem to be good little patients and do and take whatever cardiologists tell us to without our questioning them. You should be irked at him not yourself. I hope things now go according to your plan. I will be watching for a post saying you get the all clear.
Kathleen

 

[Susan BAV]

Hi Mary -

Scary stuff you've been going through! I thought maybe I had read somewhere that it's best to be hospitalized when being put on the flecainide? Does anyone else know? I know that I had to go back into the hospital to be put on Sotalol for A-fib, which began about a week after AVR, after some other meds I tried at home didn't get rid of it.

I hear you about the prior treatment issue. I had some, I'd have to say dangerously bad, advice from a cardio pre-op. His group specializes in pharmaceutical studies but I've never figured out why he gave me such obviously bad advice, and rudely given. To give him the benefit of the doubt, maybe he wanted me to go elsewhere for treatment and had no other way to communicate that to me?

I was also given IV's of magnesium for the A-fib, while I was re-hospitalized. Maybe you can ask your doctor about magnesium?

Hope all is going better for you now. Take care and post again.

 

[MaryC]

Hi Mary -

I thought maybe I had read somewhere that it's best to be hospitalized when being put on the flecainide? Does anyone else know? I know that I had to go back into the hospital to be put on Sotalol for A-fib, which began about a week after AVR, after some other meds I tried at home didn't get rid of it.

Susan,
The new cardio said just what you are saying - he starts these drugs in the hospital because the side affects can be dangerous. He said usually only 1 in 100 have problems with them and I finished his sentence....'but who wants to be the 1?!!' Through this whole experience that started with my cardio I have been seeing for 13 yrs, I am moving to the new cardio. It's important that I trust the person whose hands I am placing my life. I will be depending on the cardio to monitor my new MV repair and make sure it's holding up over the years.