Question Title: ATRIAL BIGEMINY

Hello! I am a 41 yr old female, diagnosed with viral dilated cardiomyopathy
in Sept 96 with an EF of 31% last week. I was told the other day that I was
in 'atrial bigeminy' and monitored in ICU overnight in case they developed
into 'atrial fibrillation'. The atrial bigeminy lasted for 27 hours and
then reverted to my 'abnormal' norm (I have a right bundle branch block)!
I was told that they preferred leaving me as the meds given to stop the
bigeminies could have put me into heart failure! What are the usual meds?
WHY could they put me into heart failure? I am presently on 20mg Prinivil,
25mg hydrazide, 325mg coated ASA and .15mg synthroid and not experiencing
any swelling, congestion or shortness of breath and I do take it easy!
Another question is IF meds are needed to stop atrial fibrillation, should
it develop, could these meds throw me into heart failure as well? IF yes,
a complicated question is, would the meds required to get me OUT of heart
failure, possibly throw me back into atrial fib again? Is it a vicious
circle trying to treat them IF the person is already on meds for CHF/DCM ?? I don't quite understand! ALso, my synthroid has been decreased in case it is suddenly acting as too much of a stimulant for my damaged heart muscle to handle).
Thank you for this wonderful forum!

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Dear Dallas:

The medicine your doctors wanted to use to treat your abnormal heart rhythm was probably a beta-blocker, a class of medicines that decrease heart rate, but can also worsen heart failure. Beta-blockers decrease the vigorous contraction of the heart muscle; therefore, they must be used carefully in people that already have weak heart muscles.

Atrial fibrillation in patients with heart failure can be tricky to manage; however, it is not that uncommon a situation for experienced cardiologists. Many of the medicines [though not all] that treat atrial fibrillation do worsen heart failure. Medicines to treat heart failure do not cause atrial fibrillation, so you don’t have to worry about that possibility.

I hope these are the answers that you were looking for. Write back if you have any further concerns.

Information provided here is of a general nature. Specific diagnoses and treatments can only be made by your doctor. If you would like to be seen at the Cleveland Clinic, please call 1-800-CCF-CARE for an appointment with a heart failure cardiologist at Desk F25.

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