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Atrial fibrillation
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MedHelp Member's Question

Atrial fibrillation

by Veronica, Sep 16, 2000 12:00AM
When I was eleven years old  (1985) I was diagnosed with complete heart block. My condition was treated with a pacemaker.  Over the years my condition has remained stable, although I am pacemaker dependent. The only treatment I required was the replacement of pacemaker because of battery life.



When I became pregnant in March 1999, I began to experience problems.  In my eighth month (Nov 1999), I began to have symptoms of cardiac myopathy.   My heart muscle was weakened and enlarged.  The doctors proceeded to deliver my child. Soon after I developed atrial fibrillation and was cardioverted. Artial fibrillation was gone and I was on the following medications: univasc, lanoxin, lasix, and procainamid.

After EEG I learned that both upper chambers of my heart remained enlarged, but my cardiac output had returned to normal. The doctors slowly removed me from the medicines.   I seemed to return to normal, but in early August 2000 the atrial fibrillation returned, and I began to take lanoxin and coumadin to treat the symptoms I was experiencing. My atrial sensor function in my dual chamber pacemaker was turned off.



The doctor says I have two choices:



1. allow my heart to stay in atrial fibrillation and take the lanoxin and coumadin for the rest of my life or

2. be cardioverted again and take anti-arrhythmia drugs for the rest of my life.



Are there any other options?

Doctor's Answer

by CCF CARDIO MD - DLB, Sep 17, 2000 12:00AM
Those are the two usual options that patients are presented with and you will probably have to go with one of those options. Other possibiliites include an ablation procedure to try and eliminate the atrial fibrillation all together, though this only works with certain types of atrial fibrillation and would require an invasive electrophysiological study to determine whether you are a candidate. A cardiac electrophysiologist could help steer you in the right direction in this regard.
Member Comments (11)

by Michelle, Sep 18, 2000 12:00AM
Veronica,

My husband to was told the same two alternatives.  He began taking Amiodorane/Cordarone about 1.5 months ago and was very successful at converting actually in two days.  Unfortunately this weekend he went back into Atrial Fibrillation.  We too now must go to the Doctors next week to find out what the next step is.  The Doctor warned us that he may go back into it once he was put on a lower dosage.  We would then need to evaluate whether or not he would want to take the higher dosages of this drug since it has many side effects especially at a higher dosage.  I am interested in seeing an EP Doctor to see if there is anything else that we can do.  My husband unfortunately has much worse matters because he has Cardiomyopathy also which could have caused the Atrial Fibrillation or the Atrial Fibrillation could have caused the Cardiomyopathy.



All of this is so confusing and it seems like there are no easy answers.  I would sure be interested in hearind about others that are going through this and what their successes have been.



As far as the ablation goes, our Cardiologist says that my husband is not a candidate for it since he does not have the very fast paced Atrial Fibrillation but again I do think I want to get an opinion for an EP Doctor before we finalize that one.



I would be interested in hearing what you find out and I will share with you what happens to my husband.  I only hope that we get some good news since my husband is deeply depressed since he went back into Afib.



by C.N., Sep 18, 2000 12:00AM
I also have a-fib on/off all day.  Like Veronica I have a pacemaker. Mine is a dual chamber.  They have done all kinds of reprogramming to no avail.  The choices my Dr. gave me sound slightly different than yours.  Apparently there are alot of options, the only problem is not one is guaranteed to be successful, so they cant just give you the one that will do the trick, because there isn't one.  My options were a brand new catheter ablation they are only doing in selected large hospitals.  It is similar to the maze procedure, if you've ever heard of that, but it is not open heart.  The other option was an AV node ablation.  This ablates the node in between the atrium and the ventricles so your not able to feel the fast-paced atrium during afib.  With that one you still have to remain on coumadin.  It also means a pacemaker if your husband doesn't already have one.  From what I've been told that procedure is a last resort. I know how difficult it is to have no easy answers. I have been on various antiarrythmisc as well.  Some have effected me worse than others.  It is difficult to be forced to make all these decisions, but it does help to understand your options.  Veronica or Michelle if you'd like to talk further, my email is tim-***@****

by Bob Hill , Sep 23, 2000 12:00AM
Greetings!  I'm new to both the forum and to having heart problems!  In 1988 after running 15 miles while training for a marathon, I collapsed in the shower in Afib.  To make a long story short--had a cather and echo-cards done--nothing!  Structurally ok heart.  Was put on lanoxin and did fine until 1992.  Then another afib bout.  This time was put on lanoxin and quinidex.  Worked well (some PACs and PVCs but no fib) until March 2000.  I began breaking through about 2 times a month--always in my sleep, between 3 - 6 am!  Since I'm very symptomatic, I wake up from it.  In August I went out  and didn't go back on my own--so was hospitalized and after 30 hours sotolol (betapace) put me back in rhythm.  Was discharged on 60 mg twice a day and coumadin.  Two weeks later--afib again.  They raised the betapace dose to 80 mg twice a day.  I went into sinus rhythm again.  Last week I went into afib again--it returned to "normal" by itself.  On Thursday, I went to the docs--he said both the holter and 12 lead electrocariogram showed ventricular problems--proarhthmias FROM the betapace and he took me off of it.  Tonight I start my first dose of rythmol.  He told me we're just beginning the process of trial and error--and that we may have to explore a lot of options before we get the right one.  I plan to try to join the chat as this is really freaking me out!  Thanks!  Bob

by Ramman, Sep 27, 2000 12:00AM
I've had Arrythmias of some sort since age 19 (I'mm now 44). I've been hospitalized 3 times in the last 2 months with A-Fib. Typical drugs like Quinidine, Tambicor, etc cause Torsades & V-Tac so they are out. Atenolol & Lanoxin keep my rate down when I go into A-Fib but don't prevent it anymore. I'm considering an Ablation, although I'm told it's less successful for A-Fib than other forms of SVT. Has anyone out there been "healed" of A-Fib by ablation? I've been told it can take 6-8 hours to perform - is it a nasty procedure?

by chris, Sep 27, 2000 12:00AM
My father has atrial fibulation and has been on coumadin for about 6 years.  It is causing bleeding problems. Has anyone had any success in curing a-fib with accupuncture? It is an avenue we are looking at.

by Penny To All Above, Sep 28, 2000 12:00AM
This abstract is from a highly respected journal, if you go to your local Uni library they will most likely be able to give you the full article, hope it helps anyone out there

: Am J Cardiol 2000 May 1;85(10 Suppl 1):25-35 Related Articles, Books, LinkOut  





Atrial fibrillation: nonpharmacologic approaches.



Cannom DS



Division of Cardiology, Good Samaritan Hospital, Los Angeles, California, USA



[Record supplied by publisher]



Various nonpharmacologic interventions are available for patients with atrial fibrillation (AF) who are refractory to standard drug therapy. Atrioventricular junctional ablation and permanent pacing is a very effective therapy for patients with AF and a poorly controlled ventricular response. The surgical MAZE procedure has been performed on small numbers of patients but is remarkably successful in restoring and maintaining sinus rhythm. The role of permanent pacing as treatment for paroxysmal AF is undergoing evaluation and dual-site atrial pacing appears particularly promising in reducing the number of episodes of paroxysmal AF. Certainly the most exciting frontier in the treatment of AF is radiofrequency catheter ablation procedures. Our understanding of the mechanisms of paroxysmal AF and chronic AF has expanded enormously in the past 5 years. Radiofrequency lesions in pulmonary veins using standard technology will cure many cases of paroxysmal AF. However, catheter systems under development offer a great promise of treating most paroxysmal and chronic AF within the next few years. These developments will revolutionize our approach to this ever more prevalent clinical problem.



PMID: 10874096



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

by Simon, Oct 19, 2000 12:00AM
Hi Randy!.  I've been on Rythmol for four months now to help with AFIB.  One thing I noticed immediately was a jump in the frequencies of my "attacks" (once a week from once a month) but their duration was MUCH shorter and controlled.  Started getting WICKED headaches and wierd pains though.  I'm heading in next week to get a second opinion to the first opinion which was to undergo a RF Ablation.  Want to check all my options first.

by Ramman, Oct 23, 2000 12:00AM
Hi Simon,

Let me know what you decide after your second opinion. I'm in the process of tapering off my Atenolol & going on Verapimil along with my Lanoxin. I've had no A-Fib for 3 weeks and have felt relatively good except I have some PVC's after I eat. I've had this problem in the past when on Lanoxin. I am seeing a Doc on 11/2 about an Ablation. I'll let you know what develops there also. Thanks for writing & good luck.



Randy

by bw, Oct 24, 2000 12:00AM












i have been expierincing pacs and pvcs for about six years now i am 29. after the birth of my son the pacs were constant sometimes thousands a day. the other day i went into a fib with a fast ventricular respose. went to icu and converted on my own in 16 hoursn after being on cardizem. i think the a fib was provoked by cold water weird huh when i drink cold water it triggers it off. does that happen to anyone else now i am on cardizem atenolol