Arrhythmia and weakness

[Bigglesworth]

My husband was diagnoised with an irregular heart beat in 2000  for which he took xanax for symptoms and a beta blocker.   His condition so worsened that we sought a second opinion, and then he had a 3 way by-pass and left corrodid artery fixed in 2004.  Before the surgery he had increased his xanax to 6mg a day to cope with symptoms.  The Drs. wanted him to come off xanax because he was taking too much and had become addicted to them. So in 2004 he did that too.  This was harder than the open heart surgery in terms of recovery. He is taking 150mg of atenol and a catapress patch ( for xanax withdrawal), He is also on cardura for prostate. But his heart beat isn't too low and his blood pressure is quite normal.  He is 71, still works hard work half day and tries to swim 3-4 times a week. But it seems the arrhythymia is still there and at times causes him to feel so weak he has to go to bed. He usually recovers and for a day he might feel what he calls "normal".  I have listened to his heart when he is really weak and it is out of sync totally.  Drs. say that there is nothing they can do, he will just have to live with it.  Sorry but I don't have all the Drs. technical terminology for his conditions but Drs. say pacemakers, oblation etc won't help. Are there any .

Bigglesworth.

[CCF-M.D.-MJM]

Hello,

An irregular heart beat usually means either atrial fibrillation or premature ventricular complexes or premature atrial complexes.  If he has PVCs or PACs, there are not many great options.  This condition is not helped by pacemakers and only a few specific types are helped by ablations.

If he has atrial fibrillation and significant symptoms, there may be some options like amiodarone or dofetilide -- but this is fairly standard.  I think they would have told you he had atrial fibrillation and put him on coumadin.

The best advice I can give you is to make sure you see an electrophysiologist.  This is a subspecialty of cardiology that deals specifically with heart rhythm disorders.  If there is an option, this is your best bet on finding it.

I hope this helps.  Thanks for posting.

[dquenzer]

I was not in atrial fib all the time.  But when I was in AFIB I did feel a kind of energy drain.  It was the main thing that led me to getting an ablation.  

I do agree with the doctor that you should see a specialist in arrythmias for a second opinion.  It may well be this is going to be something he will have to live with or adapt to, but at least you will know for sure.

It may be that some of the weakness in AFIB is due to a low level of anxiety.  I know that when I went into AFIB I had it, and I believe it was the reason I felt the energy drain; especialy early on. As I became more comfortable with the AFIB I didn't feel as much energy drain; although it was still there to some degree.

[masud]

Dear This is my Medical History. I need some suggestions what to do and how to get out of this problem. I have been advised to get Combination ICD implanted,but it is too expensive and out of my reach. Can any one advice or help.

MEDICAL HISTORY & TREATMENTS DETAIL
BLOOD GROUP A Positive

13th August 1975 Suffered ANTERIOR WALL MI in Muscat Sultanate of Oman at the age of 32years.

(Use to smoke 10–15 Cigarettes a day, Height 5’ – 8”, Weight 59kg, Very active life with Athletic body structure)
Gave up smoking and on regular low fat diet with added vegetables, fruits, juices, milk, white meat etc

March 1980 Coronary Angiography in Karachi NICVD Severe LV dysfunction with Normal Coronaries
Aspirin 100mg Alt day + Isordil 10mg TDS

June 1985 ETT with Negative for Ischemia
September 1986 Reviewed and Medicine adjusted to Isordil 10mg TDS + Persentine 75mg BD + Aspirin 150mg OD
November 1986 Due to Ectopics added Rythmodyn 100mgBD – In February increased to TDS
June 1985 ETT with Negative for Ischemia
July 1987 ETT with Negative for Ischemia, done before Angiography

July 1987 2nd Coronary Angiography in Karachi NICVD Anteroseptal MI of 1975 &Severe LV Dysfunction with Normal Coronaries

February 1988 Started TAMBOCOR 100mg BD Replacing Rythmodyn + Isordil10Mg TDS+ Persentine 75Mg BD + Aspirin 150Mg OD

24th March 1989 Suffered SVT (treated Isoptin 7.5mg + Valium 6mg IV + Xylocaine IV + Disopyramide 10mg IV +
Morphine 5mg IM + Phenorgan 25mg IM (Occurred at 01.15 and reverted back by 02.25)
Continue with Tambocor 100mg BD + Isordil10Mg TDS + Persentine 75Mg BD + Aspirin 150Mg OD till August 89

07th August 1989 Tried Mexitil 200mg to replace Tambocor due to notorious reports of sudden death in US. Mexitil did not
Worked & reacted, hence stopped in a weeks time
August 1989 Back to Rythmodyn 100mg TDS
January 1990 again started Tambocor 100 till November 1990
November 1990 Tried Inderal 10mg, increased to 20mg till January 91& then 40mg till May 1991. Stopped due to low HR
May 1991 again started Tambocor 100 till December 1993
December 1993 Started Amiodarone 800, 600, 400 & then maintenance dose 200mg OD + Added Lisnopril 5mg OD
July 1994 Reduced Amiodarone to 100mg OD
April 1995 Stopped Amiodarone due to Thyroids & back to Tambocor 100mg BD

May 1995 3rd Coronary Angiography in Royal Hospital Muscat Severe LV Dysfunction with Normal Coronaries & no major irregularity

During various Echo’s observation was impaired LV function and EF remained between 40 – 45%

January 1996 Added Thyroxin 25mcg OD due to T4-4.3, TSH 14, Cholesterol 194, Triglasrides 82 and Glucose 102
May 1996 Tambocor 100mg BD started instead of Amiodarone
August 1998 Echo showed 38% EF
August 1998 Stopped Tambocor and back to Amiodarone

September 1997 Modified Bruce TM was done, cleared 5th Stage & achieved desired HR

March 1999 Thyroxin increased to 50mcg
December 1999 Due to Chest Pain Admitted to hospital for observation, NO new changes and was released on same Medication.

September 2000 Tambocor 100mg BD started again instead of Amiodarone

January 2001 Suffered VT & was treated at AIFC Rawalpindi Pakistan, One Shock was given to regulate HR of 150 BPM
Dropped BP etc. Under observation for four days and discharged with advise to implant ICD (Mini Jewel II) to
Protect form any future VT’s or any other complication. It was suggested to have EPS if felt necessary before
Implantation of ICD

January 2001 Echo showed LV EF 35-40%. Medication adjusted and advised Tambocor not to be used in future

August 2002 Amiodarone 200mg OD + Zestril 5mg OD + Aspirin 75mg OD + Thyroxin 50mcg OD, Thyroxin to be adjusted
According to the results of Thyroid Function Test (TFT) every 3 Months
Weight 65kg. T4-17.8, T3 3.6, TSH 0.2, Cholesterol 198, Triglasrides 1.9 and Glucose 95

January 2003 Echo Measurements - AO Root-3.2, LA-3.6, IVS (D)-0.9, AOV opening-1.9, LVEF-35.3%
Valve Morphologies - LVID (D)-5.9, LVID (S)-5, LVPW (D)-1.0, FS-16%, Mitral Valve-Normal,
Aortic valve-Sclerotic, Tricuspid valve-Normal, Pulmonary valve-Normal, Left Atrium-Normal, Left ventricle-Dilated, Impaired, Right atrium-Normal, Right Ventricle-Normal
Septae - IVS-Thinned & Hypokinetic, IAS-Intact
Greta Vessels – Aorta-Normal, Pulmonary Artery-Normal
Wall Motion analysis – Septum & anterolateral hypokineisa distal septum & apex akinetic  
Pericardium – Normal
Doppler Data

PRESSURE GRADIENT mmhg
VALVE Diastolic Systolic Regurg Grade Valve Area Sq cm
PPG MPG PPG MPG
Mitral 2
Aortic Vel-1.4 1+
Tricuspid
Pulm

FINAL IMPRESSION Dilated Left Venticle, Markedly reduced Iv Systolic function, Lv EF-35% by simpson”s method, Mild mr, Normal arch of aorta

January 2003 Amiodarone 200mg OD + Zestril 5mg OD + Aspirin 75mg OD + Thyroxin 25mcg OD
Weight 67kg. T4-18.8, T3 3.6, TSH 0.2 Cholesterol 224, LDL 157, HDL 37, Triglasrides 1.8 and Glucose 95

February 2003 ONTARGET Telmisartan 80mg or Placebo, Ramipril 10mg or Placebo, Amiodarone 200mg OD, Aspirin, Isordil 10mg
February 2004 Weight 68kg, Treadmill at 3.5 – 4.0 kmp for 15-20munits on average of 5days a week
March 2004 Weight 68.2kg, FT4-13.2, FT3-5.0, TSH-5.4, Cholesterol - 235, Triglasrides-145, HDL C2-44, LDL C-162, CRE-1.0, UA-3.8
August 18 2004 ONTARGET Telmisartan 80mg or Placebo, Ramipril 5mg or Placebo, Amiodarone 100mg, Aspirin, Isordil 10mg tds
Thyroxin 50mcg OD CRESTOR 10mg
May 2005 ONTARGET Telmisartan 80mg or Placebo, Ramipril 5mg or Placebo, Amiodarone 100mg, Aspirin, Isordil 10mg tds
Thyroxin 50mcg OD, CRESTOR 10mg – Thyroid Cholesterol & other Blood Test OK Weight 66Kg
June 9, 2005 Getting miss beats Amiodarone 200mg, visited hospital on 10 & 13th June
August, 2005 Ectopics continue and July August Amiodarone 200mg added Valium2mg Morning Evening
Dec 10, 2005 since November Amiodarone 100mg TDC (300mg) plus Valium2mg Morning Evening
Still getting Ectopics after every 4-6-10-15 beats. Some time it is OK but most of the time getting Ectopics