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Buckwheat

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Jan 31, 2024
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11
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North Dakota
Hi there! I'm just shy of 3 weeks post op. In the hospital I went into AFIB and was given amiodarone along with magnesium, potassium, and metoprolol. Boom, AFIB gone (ish). Back home, PACs (in the form of bigeminy mainly) like to haunt me along with maybe just a few short episodes of AFIB. My "smart" watch has shown my heart rate to go as low as 47 BPM, but upon reading up, not very accurate if you're having PACs so likely higher than that 47. I came out with a left bundle branch block and 1st degree heart block. All of the doctors at Mayo have reassured me that this is all extremely common after heart surgery and that in general, the vast majority (I believe 94%) of people experience this as a temporary set back as the inflammation around the heart goes down and the heart heals.

My question is, for those that have experienced this, how did you handle all these annoying and anxiety provoking beats? And was the AFIB and ectopic beats a temporary hindrance for you or did it stick around?
 
Welcome to the other side!

I had a few episodes of afib in the hospital in the days following surgery. It is very common. Mine resolved and was not present for the final 48 hours in the hospital and no sign that it has returned since. It's been almost 3 years.

You'll probably want to wean off of the amiodarone as soon as you can. I was also on it and it's nasty stuff. It wreaks havok with your INR management, so as they wean you, be aware that you will most likely need to gradually increase your warfarin dose to stay in range. It has a really long half life of 25 to 100 days, so the need to increase warfarin will be very gradual- just be sure your INR is checked frequently during the weaning.

Best of luck with your continued recovery.
 
My question is, for those that have experienced this, how did you handle all these annoying and anxiety provoking beats?
I never felt anxious, and I just said to myself that I'm on ACT and so it'll settle down eventually. Actually I can't really ever recall feeling anxious. Worried about things (but nothing in hospital). Dunno ... perhaps being prone to anxiety is a case by case thing.

Longest single bout was around 8 hours

I sorta look at it like when I was a kid, I soon learned it was better to not ask "are we there yet" and just look out the window.

In hospital I played Angry Birds till my phone got hot.
 
Welcome to the other side! I had Afib's after my surgery (Dec 2020) too. They kept me in the hospital a few extra days because of them. I was put on amiodarone and metoprolol for thirty days (it was a process of weaning me off slowly). I had a few Afib's at home and talked to the surgeon and his nurse and they reassured me it was normal. Talking to each of them, reassured me it was okay. Then they stopped and I was off the meds after 30 days! Yay! The meds gave me nightmares and beat me down. I don't like them. My heart rate went low to the 40's a couple of times during that first month too. I haven't had any Afibs since the first month after my surgery. I had a few episodes of Tachycardia the 2nd year but we think it was because my thyroid levels were off. I don't have them much anymore. The first time was scary and I did call the nurse at my cardiologist office. Now, I know when to call the doctor and/or go to ER. But I haven't had to do either. Take care and good luck with your recovery!
 
hey, @Buckwheat
it just occured to me, perhaps (well aside from afib) what's wrong is that your whole heart beat feels wrong because of the whole post surgery thing with the new alien valve.

I'm sure the neurbiology of the heart is not adapted (evolutionarilly) to have new parts stuck in to it and that exacerbates the whole thing.

I mean as humans we are very much pattern matchers, and all you need is a not out of place in a piece of music to cause it to feel jarring ... you're brain hasn't yet adapted to it. Also for what its worth most of us (certainly me) feel each beat far more than before. For instance I felt like I was rocking back and forwards for a bit, till I realised it was the hydraulic pressure of my pumps new valve.

Hope it gets straightened out soon.

Best Wishes
 
My question is, for those that have experienced this, how did you handle all these annoying and anxiety provoking beats? And was the AFIB and ectopic beats a temporary hindrance for you or did it stick around?
Buckwheat - I'm glad you're home and doing well! Have you told your cardiologist about these issues, and are they concerned? My approach is to consider if something seems serious, or if it is within the normal range of behavior for a heart with a mechanical valve. If it is serious, then I need to talk with my doctors. If it is within the normal range of behavior, then I need to continue living my normal life, while also continuing to monitor my health.

I had an On-X aortic valve installed at Mayo last Sep. I have had some Afib events since then. As Pellicle said, we all need to adjust our perceptions and expectations to our new reality. For example, several times after exercise my Kardiacare 6L monitor has told me I am in Afib. Once I expected it because of how I felt while on the exercise bike. Several other times I was surprised because I felt fine. In all cases, a few minutes later the monitor said I was out of Afib. My cardiologist and electrophysiologist had me wear a monitor for 2 weeks 24/7, and it showed nothing of concern. I'll follow up with them in May. Meanwhile, I monitor my health and watch for any issue worth reporting to my doctors.

I think sometimes the home monitors (Kardiacare and smart watches) can give us so much data that we worry unnecessarily. These devices can give false positives. Also, occasional Afib is within the normal range of heart behavior.

The Afib that did scare me was in early January. I had a bad cold that eventually turned into pneumonia. For a couple nights I took Robitussin DM to control coughing while I slept. Twice I woke up in the morning with a VERY obvious FAST heartbeat that my Kardiacare 6L monitor reported as Afib. I was still able to perform my normal daily tasks, so I decided to wait before going to the ER. After a few hours my system recovered when the Robitussin DM passed out of my system. I will read labels carefully in the future!

I hope this helps!
 
Amiodarone IS nasty stuff. I was stuck on it for a week - and it completely shut down my digestive system. Never again. (And the iod in amiodarone is IODINE - not the healthiest material).

As far as the pulse of 47 goes, I have a pacemaker that keeps my heart at a MINIMUM of 85 bpm. When monitors (watch, BP testers, pulse/ox meters) show an odd result like 47, it usually means that my arrhythmias are confusing its sensors. I've even had the arrhythmias confuse the meters in the hospital -- they eventually had to turn their alarm off because of all the erroneous values.

A few weeks ago, I had a few weeks of Aortic Fibrillation - heartrate at 135 or higher when I did very little activity. An in-office defibrillation took care of this. (My electrocardiologist did it while I was sitting in a chair in an examining room - he told me that hospitals charge way too much for things like this, and he was able to do the same thing in his office. Of course, if there WAS a problem, I'm sure he could have handled it).
 
My a-fib started 3 years after my 3rd surgery. I was cardioverted back to rhythm. Two years later, back into a-fib but cardio version didn’t work. I’ve been in chronic a-fib since ‘14. It took some getting used to , but now it just beats whenever it wants and I don’t much think about it. Not usually too fast.
I take 75mg bid of metoprolol and 100mg
of Losartan qd. I was already on warfarin.
 
And was the AFIB and ectopic beats a temporary hindrance for you or did it stick around?
Had 2 episodes. One was in the hospital, on the 2nd day after surgery. Got amiodarone as well, that was in total about 5 weeks (low dose after discharge). 2nd time was about 4 weeks out, while still on amiodarone. That time, it self-converted to sinus rhythm. Hasn't happened since (1.5 years later).
 

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