Arrythmia after surgery - temporary or permanent

[hook]

I have one cardio telling me my post surgery a-fib will be permanent, and that I will have to be on cardiac chemo (amioderone) permanently. Another cardio tells me this is common in about 45% for all open heart patients, and in most cases it will go away; he went on to say he would like to get me off the amioderone after 3 months.

I have seen much information that agrees the post surgery arrythmias are common, but they do not go into detail as to how many of those affected get past the problem, and how many need further interbention. Do these guys ever agree on anything?

Anyone out there had a bad arrythmia after surgery that went away with healing time?

 

[neil]

hi, yea af is very common after ohs, i had it bad was admitted to hospital 3 times with it, i was put on amioderone for 3 months and bingo it sorted it out, your heart has been through the mill and it just likes to kick arse for a time, it should calm down in time

 

[Ross]

Most everyone gets over it, though not all do. I can't really say a percentage type statement on this one. I can simply say that for most, it's only a short term issue.

 

[ARGreenMN]

I had a similar experience to Neil. And my cardiologist (and surgeon and two GPs) agree with your second cardiologist - it's pretty common after OHS and it's usually temporary. I had bad arrythmias and afib starting about 2 wks after surgery, went to ER twice with it (see links below). Went on Amiodarone for 3 months. After I'd been on Amiodarone for a couple weeks (it takes a while to get in your system), the bad arrythmias and afib went away for the most part. Who knows how much the Amiodarone helped, vs. just normal healing, but things were noticeably better, although I still had a few relatively minor episodes after that, but they might have been at least partially self inflicted by dehydration and/or over-tiredness.

I just came off Amiodarone last weekend, so I'm still cautiously optimistic, but so far so good. I think it takes a while to actually leave your system, just like it takes a while to get into your system, so I'm still watching things closely. I was happy to go off it as there are some potentially bad side effects if you stay on it longer than 3-6 months. And my cardiologist said if the arrythmias come back, he'll put me on something less toxic for the long-term (there are milder options that apparently work pretty good now that I'm healed more). Also, not sure if you went tissue or mechancial, but if the latter, remember that Amiodarone affects your INR (it raises your INR).

Good luck, I suspect you'll be fine. I asked the same question a couple months ago (what percentage of people found it to be temporary vs. permanent). I got a lot of responses saying it was temporary. Only a few (as I recall) saying it was permanent. Here's a few of my related threads with lots of replies (they’re not necessarily in chronological order, but all from about 2-4 wks post op).

http://www.valvereplacement.org/forums/showthread.php?35142-Anyone-have-a-fib-palpitations-after-surgery-that-went-away&highlight=

http://www.valvereplacement.org/forums/showthread.php?35072-Question-for-you-old-pros-episodes-of-noticably-slower-heart-rate&highlight=

http://www.valvereplacement.org/forums/showthread.php?35112-Anyone-else-notice-this-Laying-down-makes-irregular-beats-worse&highlight=

 

[ALCapshaw2]

I would RUN away from any Cardio who suggested LIFETIME maintenance on Amiodarone.
It might even be worth reporting such a recommendation to the State Medical Board.

WHY, you ask?

Do a VR Search for Amiodarone, or Google, or read the Information Sheet that comes with the original packaging (start with information sheet your pharmacy should have provided). Be sure to look for the Half-Life of Amiodarone. You might also want to read the FDA WARNING on Amiodarone. It can take MONTHS to leave your body completely.

Bottom Line: Amiodarone has a Laundry List of NASTY side effects to the Eyes and Lungs that can show up with too High of a dose or being on it for TOO LONG (i.e. LIFETIME).

Why do Doctor's prescribe Amiodarone?
In my NON-professional opinion, it is a combination of "It Works" and being Lazy.
Even the manufacturer recommends that Amiodarone should be the medication of Last Resort.
How many OTHER medications did your Doctor try *before* putting you on Amiodarone?
Yeah, that's what I thought.

FWIW, several of our members have had Good Results using SOTALOL (generic form of BetaPace) to prevent/control A-Fib. Note that it is recommended that you be Hospitalized for a few days when starting Sotalol "just in case" one of the dangerous arrhythmias is triggered while your body 'adjusts' to the medications. Mild dizzyness can be an early side effect but typically goes away after a few weeks.

'AL Capshaw'

 

[sherry8484]

Hello Andy,

My 18yr old son Tyler had his aortic valve replaced with a 21mm St.Jude mechanical valve on July 23rd and he just got out of the hospital yesterday 8/3/2010. His valve is working great. He is on 3 mg of coumadin daily. He says he can hear the ticking sound really loud when he lays down. The surgeon also repaired his aorta some. (rescected it)??? Anyway, he is having bad arrythmias and has been on a holter monitor and the doctors added Atenolol 50mg daily to stop or slow down the arrythmias. Question, do or did they stop after surgery? Or when do they slow down? They were hesitant about him going home yesterday but knew Tyler was really wanting to get out of the hospital. After almost 2 weeks.. I just wanted some input on your experience since you had a St.Jude valve yourself. I really enjoy reading your informative post. Thank you, Sherry .. (Mother of Tyler)

 

[Bill B]

Hello Andy,

My 18yr old son Tyler had his aortic valve replaced with a 21mm St.Jude mechanical valve on July 23rd and he just got out of the hospital yesterday 8/3/2010. His valve is working great. He is on 3 mg of coumadin daily. He says he can hear the ticking sound really loud when he lays down. The surgeon also repaired his aorta some. (rescected it)??? Anyway, he is having bad arrythmias and has been on a holter monitor and the doctors added Atenolol 50mg daily to stop or slow down the arrythmias. Question, do or did they stop after surgery? Or when do they slow down? They were hesitant about him going home yesterday but knew Tyler was really wanting to get out of the hospital. After almost 2 weeks.. I just wanted some input on your experience since you had a St.Jude valve yourself. I really enjoy reading your informative post. Thank you, Sherry .. (Mother of Tyler)

Do you know what they are calling his arrhythmia? He might just have a fast heart rate (tachycardia) or he could be having some PVCs or something else. Regardless, the valve noise can be quite annoying when the heart rate is fast. I had the same experience after surgery. My heart rate was high post-op and gradually fell over the next 2 weeks and now is quite slow. Initially my valve was quite noticeable when lying down but now isn't at all. Like you, I wondered if it would get better - it did. I'm sure this is quite worrisome to your young son. He will have some other concerns as well as he recovers. Things will not be fully normal for a couple of months perhaps. Talk to the doctors about it. If he is getting around OK and only has a fast heart rate it may not do him any good to stay in the hospital any longer. In that case, he needs reassurance and a follow-up appointment to monitor his progress.

Bill

 

[Cris N]

Run, do not pass go, from any doctor who tells you you'll be facing a lifetime of amiodarone. Even if you were to continue with irregular heartbeats, it can be dealt with (for most people) with other medication or procedures. Amiodarone is not designed for lifetime use - it should only be used as a temporary fix.

I was on it for only a month.

 

[buncle]

I also had afib after surgery. I couldnt stand up without getting dizzy.I went back to the hospital for a few days.They treated it and never came back.Hopefully that will your case.

 

[Penny]

I had some a-fib too that ended up in a trip to the emerg room... they just increased my metoprolol which seems to have done the trick. It is beating pretty normal now with just a few skipped beats here and there. The only issue now is getting used to the side effects of the medication. A little lightheaded and dizzy plus low blood pressure but hoping they can tweak the dose a bit to lessen the side effect... we will see I am off to the doc tomorrow. I must say though, a little lightheaded is better than feeling like your heart is going to bounce right out of your chest... good luck

 

[hook]

Thanks all, I feel the same amount the amioderone, so this is great confirmation. When I go see my primary I am going to suggest a new electo guy.

 

[ARGreenMN]

Hello Andy,

My 18yr old son Tyler had his aortic valve replaced with a 21mm St.Jude mechanical valve on July 23rd and he just got out of the hospital yesterday 8/3/2010. His valve is working great. He is on 3 mg of coumadin daily. He says he can hear the ticking sound really loud when he lays down. The surgeon also repaired his aorta some. (rescected it)??? Anyway, he is having bad arrythmias and has been on a holter monitor and the doctors added Atenolol 50mg daily to stop or slow down the arrythmias. Question, do or did they stop after surgery? Or when do they slow down? They were hesitant about him going home yesterday but knew Tyler was really wanting to get out of the hospital. After almost 2 weeks.. I just wanted some input on your experience since you had a St.Jude valve yourself. I really enjoy reading your informative post. Thank you, Sherry .. (Mother of Tyler)

Hi Sherry, I missed this the other day but someone else just replied, bringing it to the to of my "What's New" page My experience was the arrytmia's (sp?) stopped a couple wks after I started having them (started having them about 2 wks post op, they went away about 4 wks post op). I'm not sure whether the Amiodarone helped, or whether it went away just because I was getting more and more healed. I've recently gone off Amiodarone (a week ago) and so far am cautiously optimistic because the arrythmias haven't come back. But it takes a while for Amiodarone to get out of your system, so I'm still keeping a close eye on it. I do know that a lot of medical professionals have told me that most likely, it was a temporary thing, due to the cutting into they heart they do when they replace a valve. But of course, there's always a chance (hopefully remote) it could become chronic - which is why I'm still keeping an eye out for it. I don't think the brand of valve has much to do with it, I think it's more just because they cut into your heart, which causes scar tissue, which interferes with electrical signals to your heart until the wound heals. That's my understanding anyway. Keep us posted how Tyler's doing!

 

[Michelle D]

I'm so paranoid about afib. I've been having some string PVCs, I've had them for many years but now I have them and since my ejection fraction is way higher they feel so much stronger. Today I over did the fluids and sodium so my heart is taking a PVC fit. How does afib feel in comparison to pvcs?

 

[Julieaka]

THANKS all - once again I got on here depressed from the doc visit today and prepared to search this topic - when lo and behold...... here it is!

I have the SA Node not firiing quite right and lots of "I don't know what".... skipped beats, added beats, vibrating - not really the high heart rate....... sigh - was told it was likely a side effect of the surgery - but I wanted to know if it might go away as I heal????
Mine has been between weeks 3 - 6 so far.....

Right now they are just increasing the Metropolol - let's hope - at least you all give me hope!!!

 

[Luana]

I'm so paranoid about afib. I've been having some string PVCs, I've had them for many years but now I have them and since my ejection fraction is way higher they feel so much stronger. Today I over did the fluids and sodium so my heart is taking a PVC fit. How does afib feel in comparison to pvcs?

When I had a-fib, my heart rate didn't go below 130, so if you're running 130 - 150, it's probably not PVCs and you should get seen right away. A-fib made me SOB and made me feel totally exhausted; once when I was in the shower, I had it and had to sit down as I didn't feel like I had the strength to stand.

I've had a lot of PVCs, but since surgery, I can barely tell when I'm having them. Last day in the hospital, I was really bored and watched the monitor a lot and saw I was having PVCs when I hardly felt them.

I think you feel a whole lot worse with a-fib than with PVCs; however, this close to being out of surgery if you're feeling like something is not right, call your doc and/or get yourself to an ER.

 

[Luana]

I have one cardio telling me my post surgery a-fib will be permanent, and that I will have to be on cardiac chemo (amioderone) permanently. Another cardio tells me this is common in about 45% for all open heart patients, and in most cases it will go away; he went on to say he would like to get me off the amioderone after 3 months.

I have seen much information that agrees the post surgery arrythmias are common, but they do not go into detail as to how many of those affected get past the problem, and how many need further interbention. Do these guys ever agree on anything?

Anyone out there had a bad arrythmia after surgery that went away with healing time?

Todd,
I had a bad arrythmia in the hospital. I took amiodarone for about 6 weeks and it's gone.

I don't know how your doctor can predict your a-fib will be permanent. For most of us, it goes away with some kind of treatment. If you read about amiodarone, you'll see it's maybe not such a good idea for long-term management and I would not stay with a doctor who told me I have to do that unless every other avenue of treatment had been tried.

 

[Michelle D]

I think they were PVCs my heart rate wasn't up at all, I think I just ate too much and had too much fluids. I gained 3 lbs in two days so I took an extra lasix. I guess I still have to be careful even though I had surgery and no longer have heart failure. I need to be mindful that my heart is healing. I'm pretty sure they were PVCs, it's just different because I can actually feel my heartbeat now even when I'm not trying. My valve was repaired not replaced but it's beating so much stronger now. The doctors say it's great but I'm just not used to it. You can even see my pulse. I can get my heart rate just by looking in the mirror.

 

[ARGreenMN]

t. You can even see my pulse. I can get my heart rate just by looking in the mirror.

I can get my heart rate just by listening to my ticking valve Which makes it very easy for me to tell exactly what's going on with my beats, regular or otherwise. As far as what afib feels like, it's pretty noticeable, and distinctly different than PVCs. There have been quite a few people describe the difference on here, but in a nutshell, PVCs are pretty regular irregular beats. I'll describe it as a skipped beat, because that's how it feels to most people, even though they say it's actually an extra beat. It might be just one or two skipped beats, or might be a pattern like beat.. beat.. skip.. beat.. beat.. skip..). But afib is like a muscle spasm in your heart - more like bea...t skipbeatbeat...skip.beatskipskipbe...at.

I don't know if you're mechanical or tissue, but if mechanical, as scary as afib feels, you really don't need to be overly concerned about it because you're already anti-coagulated. In fact, worrying about it makes it worse (they often give you an anti-anxiety med to help you calm down and that often helps the afib). Several professionals have told me there's really no danger from afib other than having it 'throw a clot'. But if you're anti-coagulated, that's not even a risk, so there really is no risk. At least that's what they say - even thought is sure feels risky, lol. I'm not sure what happens if you have a tissue valve and get afib - I assume they might put you on coumadin temporarily, or maybe do something like Lovenex (sp?) to make sure clots aren't an issue while going through it, but I'm not sure.

 

[Country]

just like mentioned above.... amazing how all the threads that i need to know about are already started!!

at any rate ...no pun intended. i have been noticing a skipped beat over the last few weeks. i thought that it was just my ears playing tricks on me but this morning it has been happening more frequently and i can feel the "missed" beat with my hand on my chest.

i am just over 5 weeks post op and have been doing great besides this. it seems that my tele monitor at rehab doesnt pick up on missed beats or maybe i just dont have any issues there? i dunno. and of coarse i havnt mentioned it to my docs becasue i just thought i was crazy and they havent said anything to me....

i am already on 100mg of metropol a day, 2 50mg dose, and my coumadin of coarse.

i think that ,unless it gets worse this weekend, i will just wait till i get my protime done and ask the nurse and see what the doc thinks about it all!

 

[ARGreenMN]

I agree it's probably ok to wait 'till Monday, unless it gets a lot worse, but if it does get a lot worse, don't be shy about heading to the ER. I had to do that a couple times and I'm glad I did (they don't call you a baby or anything for coming in, lol). I don't know why this kind of stuff always seems to happen late at night or on weekends, but it sure seems to