need A-FIb info and help

[susiesknight]

I am now 9 weeks post op(AVR/ aneurysm repair surgery 3/11). Had A-Fib 2x on 3/17 and was put on warfarin (5mg)and betapace(Sotalol) 80mg 2x a day. All has been good until I had a 24 hour halter monitor 2 weeks ago. Last night my heart was really pounding and then had some irregular beats so I went to the cardio today. Saw the nurse: ekg was good but the halter monitor indicated that I was still having A-Fib, so must continue warfarin and sotalol plus go back for another 24 hr monitor in 2 weeks. Meanwhile my bp has gone up but the cardio didn't tell me to take anything. Said the sotalol has bp lowering properties. Well then I went to have my INR checked at Gp and it was 1.8, but bp was high..pulse is ok. So he wants me to be on bp meds and then have blood work to make sure that the dyes from my cardiac tests aren't messing up my one and only kidney. Apparently sotalol can mess with the creatin. Find it strange that the cardio didn't say anything about my bp. Any ideas. I have also been sceduled to see an electrocardio doc also and am supposed to start cardiac rehab tomorrow. I am hoping beyond hope that this is all just post op things and will correct itself within the next 2 months. Any ideas and/or words of wisdom greatly appreciated.Am taking Xanax to cope!

 

[Ross]

I think at this point, he doesn't want to give you any other drugs to mess with your system until he gets the problems straightened out that are current. If I were in his shoes, that would be what I'd do.

They do need to get your INR up though. How long have you been on the Coumadin now? Thing is, starting rehab is going to cause your INR to fall further.

 

[terodac]

Hang in there! Had a heart meeting last night the subject was Afib, he said it was very normal after open heart surgery to have this. It is because the heart has been worked on and is in the wounded healing stage. I had it a month after my valve replacement and had to stay in the hospital on a drip for about three days. I haven't had any trouble sense then. Rehab is a great thing to do, you feel safe they monitor you and start you out slow. Xanax will help the panic you feel for sure! mine also was a adjustment of some meds! God Bless!

 

[ALCapshaw2]

YEP, A-Fib is a common 'after-effect' of OHS. Usually it will go away after a few months.

Hopefully that will be the case for you, especially if your A-Fib is intermittent rather than constant.

It sounds like your Doctor is being conservative and trying to use only enough medication to control your symptoms (for the most part). To my mind, that is a Good Thing.

If your A-Fib becomes constant, there are other techniques and/or more powerful medications they can try such as Ablation and Amiodarone. Hopefully the Sotalol will work for you but you may need a higher dose, at least temporarily or when events show their ugly head.

Caffeine (coffee, tea, Chocolate, Cola drinks, etc.), Stress, and Alcohol? are known 'triggers' for A-Fib so be sure to reduce or eliminate them from your life.

Did anyone tell you to increase your weekly Coumadin dose by a few percent (say 5 to 10%)? That would be a typical recommendation to raise your INR above 2.0

Best Wishes,

'AL Capshaw'

 

[susiesknight]

They upted my warfarin 2.5 mg per week so I should be in my range then. It's the pounding that has me worried, comes and goes and happened just recently. I am taking 3 multi/calcium vitamins daily and wait the 2 hrs after taking the sotalol. ..maybe I am not getting enough rest since I seem to wake up too much at night. Anyway, I'm going to focus on my husband's vision that I would be healed and better than ever plus be patient. Thanks for your encouraging words.

 

[ALCapshaw2]

Mention the "pounding" to your Cardiologist.

Do you have a stethoscope? If not, buy an inexpensive one so that you can listen to your heart when you feel weak or pounding or irregular heartbeat so that you can give a better description of the symptoms. You may also be having Premature Contractions of either the Left Atruim (PAC's) or Ventricle (PVC's), both of which are generally considered to be benign (but still a Nuisance!)

There are other Beta Blockers that do a better job of quieting PAC/PVC's.

Getting proper Rest helps also (and I KNOW that sleep patterns for Post-Op OHS patients is eratic! NAPS are GREAT

'AL Capshaw'

 

[tcopel]

As mentioned, atrial fib is fairly common after heart procedures. I developed atrial fib on 3 separate occasions after my surgery. The first episode occured 3 days after my procedure and resolved after a few hours of a cardizem drip. The cardizem is a medication that slows the rate down ( it was beating about 130 beats per minute, normal being about 70 to 90 or so). The second occurence developed about 3 weeks later. This responded to electrical cardioversion, where I am put in a light sleep via sedation and "shocked" with immediate results of going back into normal sinus rhythm. This is not as dangerous as it may sound and I did very well. However, I went back into atrial fib about a week later and it was at that time that I was put on a new medication called Tikosyn, a medication with simliar effects of Amioderone but with less potential side effects. I did well with this medication for 9 months and now do not take it. No recurrence of atrial fib for 2 years. My heart finally healed. That is not to say that I do not have palpitations still periodically, but this is attributed to PVC's which are a nuisance but not dangerous.
Just thought I would throw all that at you to let you know that there are other options out there. Sotalol is a medication that slows your heart rate down to normal given your atrial fib. It can also help with elevated blood pressure but if it is still high despite this regiement, I wonder why additional medications or dosage adjustments are not being considered. Having had an aneursym, blood pressure control is important.
Lastly, I just want to encourage you. I am hoping with you that you will recover completely. It may take several months to get you body back to where it was before the surgery so hang tough. If can be discouraging when stuff keeps happening after the biggest surgery of our lives. but this is not totally unexpected. God bless.

 

[susiesknight]

I am now on anantidepressant to help anixety go down to help bp. Then probably will have to be hospitalized according to doc to change meds but am encouraged by your results and know the surgery was the biggie and these A-fib and PVC'S lord willing will go away.

 

[johnfreeman62]

Me Too

Me Too

I too had racing heart and A-fib about 3 weeks post AVR - nobody warned me that was common post surgery and I freaked - but it all went away just like they said it would.