Atrial Fibrilation

[Ward]

I had a tough day today, need some comradarie. I am 41 years old and recovering very well from surgery on 08-01-01. I went in for my first cadiac rehab excercise today, got all wired up and before I could start the physiologist came over and told me that I was in Atrial Fibrilation and that she would take me to the emergency room! Well I spent about 3 hours there before the ER doctor could even get in touch with a cardiac surgeon, not my surgeon even, but any surgeon. They added Amioderone to my meds and sent me home. As far as I know I still am in Atrial Fibrilation. Next appointment is next Tuesday. Did anybody else have post-op Atrial Fib? What's a guy to do? Thanks.
Ward

 

[Nancy]

Hi Ward-

I think you'll find many people here who have afib. It's quite common after heart surgery. Some people get better after amiodarone (spelling?) and/or other meds., some have cardioversion, some live with it. I guess it affects people quite differently.

My husband had it for many years. He had a fast heart rate and he also had a very slow rate which caused several faints. After he nearly hurt himself very badly during the faints (took out the television set and just missed knocking the pole lamp into the plate glass window one time, fell out in the yard on top of the large intermittent sprinkler another time, and missed by an inch, the corner of the dining room table while falling face down like a tree, partially dislocating his jaw another time), they installed a pacemaker. He still has afib, but the pacemaker keeps his heart rate from falling precipitously and keeps it in regular sinus rhythm. He was also put on Tiazac to keep his heart rate from going too fast. At present time, he's off that and doesn't seem to need it.

No more fainting, I'm very happy to say, because I witnessed all of those. Scary, scary!

When they do the readout during the pacemaker check, it shows that this little gadget is working very, very hard. So it's apparently saved him a lot of grief.

Don't mean to frighten you, but take it seriously and follow up with your cardio.

Best wishes

 

[Perrster]

Hey, Ward

Hey, Ward

Not sure if I can help much with the A-FIB, but I'll tell you about a couple of emergency post-op experiences I had and hopefully this will make ya feel a bit better.

I am 16 months post-op just as of yesterday. I had both Mitral and Aortic valves replaced at the same time with St. Jude's titaniums. (My story is on the VR.com site).

Last summer I was experiencing weird sensations on the left side of my chest that felt like a "lady-wrestler-with-huge-finger-nails" was grabbing me there! This is exactly what I told the emergency room docs, and I saw them TWO TIMES! These pains would come and go intermittently and sometimes not happen for days or weeks. I believe they happened like 3 or 4 months post-op and again about 8 or 9 months. Weird, huh?

Both visits to emergency turned out to be non-threatening and I'd feel very bad having spent valuable time (both times were a 3 hour visit!) of emergency personnel. Although they'd run a battery of tests (heck of a way to get an unscheduled Protime test!) they'd send me home with the conclusion that my problem was "nerve endings."

It's been awhile since I've experienced anything close to these pains, so I "believe" it is over. Man, you're only 3 weeks post-op! Hang in there! It will take time. I was told in re-hab to expect at least 6 months for a "full" recovery. Surgeons and doctors aren't going to give you too much information unless you have specific questions that they have to answer. It just takes time! Perhaps some of your a-fibs are due to impatience and anxiety?

If I had to do it over again (oh sure, I'd love to!), I'd set some solid goals and stick to them. I wasted stupid time after surgery and really regret it!
#1 GOAL: get through re-hab then IMMEDIATELY join a health club and continue the re-hab routines and add to them as you progress. (I'm walking about 2 to 3 miles a day now and it feels pretty good). GOAL 2: your lifestyle HAS changed and you have to submit to it. Seminars and cardiac informational meetings have helped me a lot. Go to as many of these meetings as you can. GOAL #3: Concentrate on your DIET. See a dietician. Learn about food and vitamins and herbal supplements. If you're on Coumadin you have to watch what you eat anyway so you might as well change it now for the better! One of the VR.COM members says his A-FIB's are virtually history due to Magnesium. Sorry I can't think at this time who that is, but I'll re-direct you to his string another time. I found a wonderful physical therapist in Libertyville (after re-hab) and her treatments were very helpful. GOAL 4: keep Coumadin therapy under control. My anxiety over the routine blood draw was terrible. I went numb one time when I was poked by a part-time intern. I thought I was going to have a heart attack right there in the lab! While I still don't like it, I tolerate it! My thoughts and test anxiety is focussed now on the "positive" aspect of getting off of work a few hours early at least once a month to go for my PT!

Ward, I hope this is helping? I believe you are on the right track by at least talking about your situation. This website is a great tool with people of all walks, some with more details than others, nevertheless, all of us are here today because of valve replacement.

I live just over the Wisconsin border in Vernon Hills, IL. Please feel free to e-mail or call.

Take care and please keep in touch.

Perry Anderson
847-377-0825-direct line at work (I work in Waukegan)
[email protected]

 

[Gillian (in UK)]

Hi Ward - I was fine until I had AFib 10 days after my surgery and it lasted on and off for another ten days. I also had a urinary infection at the time and just wanted to lie in bed. I felt really ill. I was put on Amiodarone which is what presumably stopped the AFib. And I came off the Amiodarone after approx three months.

I didn't realise setbacks were common. I thought I would sail through. But now I see that people do have setbacks. And they are dealt with. And it is SO SOON after your surgery.

What a good thing it was discovered and can be sorted - and presumably without you having to put up with any symptoms.

Good luck.

Gillian
(AVR 13.Mar.01)

 

[ken]

Amiodarone

Amiodarone

Hi Ward:

Arrhythmias involving the atria (upper receiving chambers of the heart) are the most common and unfortunate complication post cardiac surgery, occurring in up to 60% of patients having heart valve surgeries, with atrial fibrillation (AF) being the most frequent occurrence.

One of the problems of being on a regimen of Amiodarone is that if you have a serious side effect the extremely long half life of this compound makes it almost impossible for other treatment to be given. The effects of Amiodarone lasts for months, It will vary with individuals with a half life as much as 180 days, this means that 180 days after being taken off it (6 mo.), you will still have one half of it still in your body. It also interacts with many other drugs causing difficulty in proceeding with alternate treatment. This helps to explain why the manufacturer designates it for a last resort use only.

Amiodarone is a dangerous drug that is being prescribed for mild atrial fib when it has only been approved as a last resort drug for life threatening arrhythmias. Read its history and wonder how it is being used as it is today. Patients are not being properly warned or monitored before or during using of this drug.

Here is the link to a thread on about.com on Amiodarone with Dr. Richard Fogoros ( Dr. Rich) as well as the link for his Bio. In my opinion you will not get any better input online than that of Dr. Rich - he is an expert in the field of cardiac electrophysiology.
http://heartdisease.about.com/mbiopage.htm
The below referenced thread consists of 27 messages. which include 5 from Dr. Rich himself.
http://forums.about.com/n/mb/message.asp?webtag=ab-heartdisease&msg=864.

Here are some additional links to web sites that you might find useful in your research on this drug.

http://www.westsubcardiology.com/pages/ep/drugs/amiodarone.htm
http://www.wholehealthmd.com/refshelf/drugs_view/0,1524,22,00.html
http://www.intelihealth.com/IH/ihtIH/WSIHW000/19689/11225/213698.html?rbrand=Pacerone

Ward, may I also suggest you contact your Cardiologist as soon as possible to discuss this drug with him.

Ken

 

[ken]

Amiodarone

Amiodarone

Hi again Ward:

Here is another article I have found in my files but am unable to locate the URL:

Last Revision 5/29/01
LINKS TO WEB SITES
AMIODARONE

FDA AND ETC.
Warnings

FDA Problem
Reporting Site

Side Effects

Medical Terms

FDA Warning Letter

FDA MEDWATCH

FDA MEDWATCH FORM 3500
You Can Report Your Adverse Effects On The Above Form!



--------------------------------------------------------------------------------
UPSHER-SMITH
Pacerone Warnings
Pacerone Package Insert



--------------------------------------------------------------------------------
BLINDNESS
Oregon Live: 1-25-00 $22 Million Damage Award To Blind Man Will Stand!
Oregon Judicial Department - Publications


--------------------------------------------------------------------------------
PERSONAL WEB SITES WITH ADDITIONAL INFORMATION OR REPORTS
Cecil's Page
(Adverse Reactions)

Cindy's Page
(Post Your Story)
URL Revised
05'29'01


--------------------------------------------------------------------------------
SEARCH RESULTS FOR AMIODARONE
Search Yahoo


--------------------------------------------------------------------------------
SEARCH RESULTS FOR ATRIAL FIBRILLATION
Search Excite
ALMOST 100% SCARING OF CORNEA 75%+ HAVE SERIOUS SIDE EFFECTS
PROLONG USE INCREASES DANGER CONSTANT TESTING ESSENTIAL

One of the problems of being on a regimen of Amiodarone is that if you have a serious side effect the extremely long half life of this compound makes it almost impossible for other treatment to be given. The effects of Amiodarone lasts for months, It will vary with individuals with a half life as much as 180 days, this means that 180 days after being taken off it (6 mo.), you will still have one half of it still in your body. It also interacts with many other drugs causing difficulty in proceeding with alternate treatment. This helps to explain why the manufacturer designates it for a last resort use only.

The effects of Amiodarone are not well understood with the elderly patient often reacting
differently and the taking of food with it can also effect its absorption. It is also well known
that other drugs interact with it for instance Warfarin (coumadin) requiring very close
monitoring of the pro-tine (clotting time) of the blood. You may check the links on the left
for more information about the many drugs that should not be used in conjunction with it.

The before mentioning of the extremely long half life of Amiodarone causes another serious
problem in persons who develop a serious side effect, There is nothing that can be done to
get rid of it before it has it's way with what ever organ it is attacking, leading to the death
of the person in many cases. The FDA has on file many such instances where it has caused
the death of individuals being treated with it. These records are available to you thru the
Freedom Of Information Act (FOIA) there is a link to the left that will take you to the web
page of the FDA where this information is available.

You will also find many links to other sites that have vital information you need to be aware of if you are on or will be on Amiodarone (cordarone®) (pacerone®).

Amiodarone affects every part of the body the loading dose of it is quite strong because
it must reach a level thru out the body in order to work which means that it is in all the organs
it also has an affinity or certain organs making them targets over and above the others
which means they are at greater risk, The lungs are quite vulnerable and once attacked
often cause the death of the person, the Thyroid, Liver etc. are all subject to such damage.

The other organs of the body not vital to life are at risk also, for instance the eyes. Almost
all people suffer scarring of the cornea which takes a very long time to heal, Others have
the Optical Nerves damaged so that they become blind permanently, This is a side effect
that the manufactures have been reluctant to reveal, But they have had to findlay admit to.
(see the links on left) The fingers and toes are affected, loss of sensitivity, soreness tingling
etc. Constipation, fatigue, nightmares, the list goes on and on. (more information in the
links column)

 

[ken]

Links for the above article

Links for the above article

Here are the links referred to in the above article:

Warnings
http://www.rxlist.com/cgi/generic/amiodarone_wcp.htm

Side Effects
http://www.nursespdr.com/members/database/ndrhtml/amiodaronehydrochloride.html

FDA Warning Letter
http://www.fda.gov/medwatch/safety/1997/cordar.htm

FDA MEDWATCH
http://www.fda.gov/medwatch/safety/1998/jun98.htm#cordar

Oregon Live: 1-25-00 $22 Million Damage Award To Blind Man Will Stand!
http://oregonlive.advance.net/news/00/01/st012504.html


--------------------------------------------------------------------------------

PERSONAL WEB SITES WITH ADDITIONAL INFORMATION OR REPORTS - Cindy's Page
http://www.geocities.com/cindyj2283/index.html

 

[BillC]

Hi Ward ... hope you're feeling better by now. I too have had the experience of ending up in the ER with Afib. It happened to me in the middle of the nite 4 weeks post-op. (I also had Afib in the hospital on my 3rd day post-op.)

In both cases I was treated with an IV of Cardizem. As soon as they got the drip regulated, it stopped the Afib very quickly. That took 1-2 hours the second time, but nevertheless it worked. I personally can't imagine not knowing you were in Afib. It woke me up in the middle of the nite and I could easily tell that my heart was racing.

The result of the 30-day post-op episode is that the cardio put me on Amiodorone for one month. I didn't know too much about this drug when I first started taking it; but then I read about it and was only too glad to finish it. It seems to be the most effective med for regulating afib and a-flutter.

They assured me in the ER that my afib was only a very minor set-back, and in my case, nothing to be worried about. The good news is that it's now 13 months later, and I have not had another episode.

I agree that you should discuss this med with your cardio. If it happened to me again I would request another drug if at all possible. But for now I'd just try and relax and not worry. It really is not uncommon to have afib/flutter post-op. My cardio told me it happens with 35-40% of the patients.

All the Best to you and keep in touch ~

 

[hensylee]

Ken, thank you, thank you for posting so much info on amiodorone. My brother was put on it 11/99 thru 4/01 w/o any lab testing followup and what a nightmare my brother has become. Even the reported side effects we gave to his dr, did not light the bulb in the dr's head!! He should have picked right up on it. My bro no doubt has permanent damage in many ways. I am taking him to a neurologist Tuesday to get him checked for whatever. Amiodarone can be devastating if not properly watched.

Nancy, I found your private message a couple days ago, and this is also a reply to you.

God bless.

 

[Nancy]

Amiodarone and Vioxx--

Amiodarone and Vioxx--

Hi Hensylee-

Since amiodarone stays in the system for so long after treatment, I'm hoping that your brother's symptoms gradually improve with time.

What problems this drug has caused! It cures one problem and leaves several in its wake. Like the the proverbial Hydra. Cut off one of its heads and two replace it!

To everyone who is taking Vioxx--

And speaking of prescription drugs, Joe just found out the hard way that Vioxx interacts with both Lasix and Coumadin. He had some residual foot pain from his bout with Serum Sickness, so the Primary prescribed Vioxx in a limited prescription. All of a sudden he started putting on fluid just like before surgery. I thought the two might be related and so did my research, there it was in black and white. Vioxx "blunts" the effects of Lasix and in addition also causes edema and worsens CHF, plus it interacts with Coumadin. Celebrex does the same. It's a relatively new drug and so not too much is known about all of the side effects, but it is on the Net. He's off it as of today. So you arthritic "guys", be careful.

 

[Mike in Florida]

A-fib

A-fib

Ward,
Glad to hear you're recovery is going well,
but sorry you got a-fib going on, I'm even more
concerned the docs put you on amiodarone. This
is a heavy duty drug and can certainly cause
many nasty side effects. I'm 40 and have been in
chronic a-fib for 6 mths. I've decided to not try
amiodarone as this is what my cardio and e.p.
want me to do. I've talked to many people and
done plenty of research on this drug, and yes it
is good at controlling a-fib, but in most cases
should be used as a last option. What dose did
they send you home on? Normally you are put on
a loading dose and then the dose is lowered.
There are many drugs available to control a-fib,
and help you to convert back to sinus rythum,
with a lot fewer side effects. A-fib is common
after valve replacement, as your heart kind of
gets beat up a little. Keep yourself informed,
and please find out why they chose amiodarone,
when there are so many other options. Hang in
there! Godspeed to normal sinus rythum.
Mike in Florida

 

[hensylee]

A dr on another site said that he used amiodarone as a final resort. It can be dangerous, if not followed by dr very carefully. I hear of folks that do well on it, tho - in this site.

As Nancy said, she searched the internet for interactions. Glad you are on top of things Nancy. It is important for US to do our own checking, because drs often go by what the 'detail man' tells them and don't do their own studying, so that's why WE MUST.

 

[Bill Hall]

Ward - I was afib for a month after surgery. They put me on amiodarone after trying cardiovert. The medication worked with no side effects. My cardiologist kept me on for an additional month. I am now off the stuff for 4 months. Hope all goes as well with you.

 

[Perrster]

Hey, Janie...

Hey, Janie...

I haven't heard of an Electrophysiologist before. What does he (or she) do? I suspect the job has something to do with EKG's?

Tonto say amiodarone sound like bad medicine.

I'm doing 250mgs of Magnesium per day. Do you think I'd notice any significant change or problems if I upped it to 400? Did you gradually increase or start at 400?

I am convinced the vitamins and minerals are helping my heart maintenance program. Darned prescription meds probably count for something, but I would much rather believe the natural stuff is doing the most good.

Looking forward to meeting y'all in Nashville.

PerryA

 

[hensylee]

An electrophysiologist cardiologist is a specialty section of cardiology and guess it has to do with the electrical impulse parts of the heart. My bro was in a-fib and his electrophysiologist found it immediately, knew my bro needed cardioversion, did it and now bro is better in that part of his heart. Along with meds, he now is out of a-fib.

The amiodarone is another story. Took him today to neurologist that found the horrid side effects, back in April. My bro didn't even recognize the man, but the dr knew/remembered Richard's case very well and commented about what an improvement since then. Some improvement, in my opinion, but not great. Anyway, he found symptoms of Parkinson's but doesn't know if it's real or remains of amiodarone and we will continue to wait to see if further improvement in next months. Went over carefully the visit with my brother again once we were home, so he'd remember so he could tell our sister. He called me from her house and couldn't recall anydetails about the visit, except that he had been there. Wish I had never heard of amiodarone; it has caused us such grief.

 

[Shari]

Wow! You guys are all wonderful...I learn something new every time I read these message boards. I never knew how dangerous amioderone (sp) could be. If you remember, it was my husband who had emergency heart surgery on 5/25 and 6/1 (he had an aortic dissection repair and a St. Jude heart valve put in). He went into a-fib about three days after his first surgery. Scared me half to death. It happened while he was still intubated. I was talking to him and all of a sudden his heart rate went up to 178!! Anyhow, they put him on amioderone. He has been on it ever since. His cardiologist cut his dose in half in July. We went back to see him on August 7th and he didn't take him off it yet. We go back in early October. I'm going to bring this up. Thanks for the tip on the magnesium. Oh, and Nancy...thanks for the Vioxx information. My husband also suffers from gout (can you believe this guy is only 38!!! LOL!!). He was taking vioxx before his emergency surgery, and his internist did tell him that he can't take it because of the coumadin. He takes allopurinol to control it, although he still has some pain. Basically his doctor says he'll have to put up with the slight pain because coumadin is so tricky. If it gets really painful, he takes tylenol.

This has been a great thread. Thank you all for the great information.

 

[hensylee]

Shari, don't be too afraid of amiodarone as long as your husband's dr is on top of things. What happened with my bro is that he was put on it 11/99 and kept on it til 4/09 without any regular lab testing to be sure no damage was being done - unfortunately it became a poison for my brother and even with our reports of side effects it didn't ring a bell with the dr!! Amiodarone should be a medicine of last resort because it is so powerful and potential for side effects is so great. I think most folks are put on it as a short term thing. Is that right Janie? God bless

 

[Shari]

Henyslee,

I know that my husband will be coming off it. If I remember correctly, the cardiologist said that they would put my husband on one of those all day heart monitor things (I forget what it's called) to make sure he's not going into a-fib and then they'll take him off it. I wonder how long is "too long" to be on it? Is it the type of drug that can will just build up in your system and then BAM - do something to you? Gosh, it seems like it's always something to worry about!

 

[hensylee]

The monitor will be a good thing for followup on your husband's afib. And yes, amiodarone builds up - its half-life is a very long time and since my bro was on it from 11/99 to 4/01 the buildup was great and is slow leaving his system. It's been 4 mos now since he was taken off and the neurologist is watching for more improvement - while he's doing the watching, I am doing the hoping. God bless.

 

[Guest]

I am a pharmacist who monitors warfarin, not a valve patient. I also run the website www.warfarinfo.com. Amiodarone is a potent drug with a long half-life and many toxic effects. However, many cardiologists consider it to be the most effective treatment for atrial fibrillation. You must consider too that it has a very potent interaction with warfarin and needs diligent monitoring. Two other factors need to be considered. The package insert from the manufacturer of the drug is a legal document approved by the FDA. They take a very conservative view. It costs millions of dollars to run studies to get the package insert changed. There is no profit in this for the drug companies, so they tend to not change them. The other is that bad news makes a better website. How many comments have you seen about good results with amiodarone? Few people bother to write them. So you have to consider that bias. It is not an easy choice to go on amiodarone. However, if you have a good doctor who is willing to do the proper monitoring and keep you on the lowest effective dose, your chances of a good experience are increased.