Stopping Amiodarone treatment for AFIB after AV replacement

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My 3-wk post-op A-fib (& V-tach then A-flutter) was treated with a shot of a Calcium Channel Blocker and a prescription for Metoprolol alone. Those drugs, and/or time and healing, seem to have dismissed the arrhythmias. BD, did you declare "no sign of AFIB" based on your being able to recognize it by the feeling, or did you have a Holter Monitor done? I think most of the "funny heart-beat feelings" I experienced were PVCs, not A-fib. When I had my A-fib & V-tach then A-flutter episode, I just felt miserable all over (then finally collapsed slowly and gently to the floor!).
 
Hi Norm

I had 3 episodes of AFIB in 2 days. I was connected wirelessly to my monitor in the ward. The first was at night, 3 days post-op. I felt my heart begin to race. Looked at the monitor and observed beats of 140 > to 170 bpm and then dropped back to normal. The nurse immediately came out and checked my BP which was normal. The next two episodes of AFIB occurred 36 hrs later. The first at 07:00 and the second 1 hr later. This after my first night out of the step down ward.

I was moved back to the step down ward for replacement of magnesium by IV and potassium by tablet. This is when they started the Amiodione loading phase. From my research, Amiodione is the last line of defense for AFIB only if the episodes are prolonged. Mine only lasted < minute. I think they overreacted and over treated a temp condition of AFIB.

I had the three chest tubes in for 7 days, as the majority of the fluid from surgery pooled my chest cavity. Several of the nurses said prolonged insertion of the chest tubes can cause AFIB. I wish they had waited until after the chest tubes were removed before starting the Amiodarone.

I responded immediately to the oral administration of the Amiodarone plus replacement of electrolytes and was able to avoid the IV loading procedure. [thank God]. As an aircraft tech when trouble shooting a fault that is not obvious, or revealed by the BITE, you accomplish one procedure and test the outcome starting with the basics. I wish my medical staff would have done this starting with the replacement of the electrolytes followed by removing the tubes. Like I stated previously, from my research Amiodarone is the last line of defense for AFIB.

At least the treatment with Amiodarone was stopped after 20 days. I was on a 200 mg maintenance dose. From what I have found, this was a light dose. It's the long 1/2 life that bugs me. This chemical penetrates every cell in your body and is not excreted. Rather we must wait for our cells to die and rebuild, this is how the chemical is removed.

I searched what a definition of a pharmacology 1/2 life is. Get this, after 100 days 50% of the chemical remains. After another 100 days, 25 % remains and so on. This means it can take a year to fully get rid of the Amiodarone. I called my pharmacist and asked him what the 1/2 life would be after a 20 day course of Amiodarone. He consulted his pharmacology manual and said 14 days is the 1/2 life. I was told to defiantly avoid a glass over this period to protect the liver.
 
hi bruce,
i'm afraid to tell you that joey was on amiodarone for almost 9 years! ofcourse, he wasn't on the full loading dose most of that time. a few months post surgery they lowered his dose and thereafter lowered it even more. for years he was taking about 100mg each day and whenever he's try to wean off the amio (even take it down to 50mg a day), he'd be fine for a few months and then go into afib.
this went on for years and all the doctors told us that he was on a scant dose and not to worry. joey was tested and monitored every year. his lung capacity did diminish but not significantly. he developed retinal deposits in his eyes, but they have since gone away. he takes synthroid and his med had to be monitored closely. in addition, no matter how much sunblock he'd use, he's get burned.
last year he decided to try multaq_ did not work. he had been on betapace (sotalol) presurgery and when he initially went into afib post surgery, they gave him that, but it did not work. therefore, they decided not to retry it.
finally he started taking tikosyn. it was not 100% fool proof and he decided to have an ablation done this past winter. so far so good. he is taking less of the tikosyn and will no longer be taking bloodthinners (first coumadin, then pradaxa), just aspirin.
we are keeping our fingers crossed.
bottom line is that amiodarone is probably the most effective med in preventing afib, despite its dreadful side effects. i imagine if the patient is watched very closely (and the dose is the least amount that can be effective), it can be very appealing.
i'm glad joey is no longer taking it. i was more worried over the years and urged him to come off the stuff.
hope you are well and that the metropolol is doing the trick.
please keep us posted as to how you are doing.
be well,
sylvia
 
Hi Sylvia

Thanks for preparing me that the AFIB may return. I'm glad Joey is now off the drug! Got my fingers crossed that the Metoprolol does it's job. Like my cardiologist told me, if the AFIB returns, up the dose of Metoprolol by 50mg up to double my present dose of 200 mg twice daily. [Note: this direction from my Cardiologist is for me alone. I have stated what the preventative plan is so others with a similar condition can run this by their Cardiologist as defense against AFIB, to hopefully avoid Amiodarone.]

I also have a bundle branch block which I believe to be left sided due to my hypertrophied left ventricle. I really hope that as the heart remodels the condition reverses, but I believe the damage has been done due to the hypertrophy and the nerves are permanently damaged. My cardiologist at present is not to concerned about the bundle branch block.
 
As an aircraft tech when trouble shooting a fault that is not obvious, or revealed by the BITE, you accomplish one procedure and test the outcome starting with the basics. I wish my medical staff would have done this starting with the replacement of the electrolytes followed by removing the tubes. Like I stated previously, from my research Amiodarone is the last line of defense for AFIB.

Bruce I thought you guys ask us to shut everything down and then reboot! I'm glad they didn't try that with you! PSEU fault maybe but not afib......
 
My surgeon put me on Amiodarone two days before surgery and this Tuesday, 2 week post surgery, I go off of it. I have not had afib so I'm scared it will start.

Carol
 
Hi jumpy

PSEU faults are easy to trouble shoot as the BITE is very reliable. Yes, a full system reboot can clear a PSEU anomaly as you are aware. No code blue or system reboot for me, thanks very much!

Robthatsme developed AFIB after replacement of the AV. He posted on another the thread that he questioned the surgeon as to why he was placed on Amiodarone, as it is the last line of defense against AFIB. Apparently the surgeon told him that after heart surgery and a resulting AFIB, they administer the Amiodione to protect the healing heart.
 
Hi Rosebud

Excellent they are taking you off Amiodione! Talk to you surgeon prior to stopping the Amioderone, about a plan for the onset or possible return of AFIB, as appliceable. For example ask him about correcting the AFIB with Multaq which is Amioderone with Iodine, or starting Metoprolol or upping or your present dose. Don't go cold turkey without a plan. If you go into AFIB, you could be in emergency possibly going through the loading phase of Amioderone all over again.
 
Jeff

No getting emotional during the ceremony, OK big guy! Hey lets do this, only in England. We should stay at Neil's place and crash the wedding in his new Jag. Neil seriously, Jag or not, you are going to have to wear a shirt, other wise we will not be able to crash the Royal wedding. You cannot get in if you look like Onslow from "Keeping up appearances". LOL!

Greg a, see if you can conjure up a pic of Onslow driving one of his beaters!

 
Excellent! Well done! That should get us turfed from the Royal wedding!

Thx much
 
Bina

HaHa! Well done!

Look out Royal wedding, the VR boys from Hull England and Alberta Canada are coming to town!


The Queen was recently spotted walking near the palace
and rumour has it GOING to her second job

the-queen-of-england-owns-a-mcdonalds-near-buckingham-palace-as-part-of-her-vast-real-estate-portfolio.jpg



AFTER ALL
SOMEONE HAS TO PAY FOR THE WEDDING


queen-elizabeth-in-a-mcdonalds-uniform2.jpg


SO YES......, NO SHIRT, NO SHOES, NO SERVICE
 
Greg, stop it your are killing me. LOL! By the way..... would you like fries with that?
 
Looks more like the Queen needs to break wind and she can't hold it much longer. Note the body language, hand on abdominal and bulging eyes. Clearly a desperate case!
 

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