Elongated QTs, A-fib and dizziness

[roann]

My husband was diagnosed with elongated QTs and arrhythmia 5 years ago. He took Norpace for years until it started having a negative effect on his bladder.  A year ago he had a pacemaker implanted and started taking Atenelol. His heart went into atrial fibrilation in April 2005 and he spent 3 days in the hospital and now takes 8mg coumadin.  This was his second confirmed Afib.  The first was when he was first diagnosed with arrhythmia. He gets blood tests often to confirm the coumadin dosage is correct.  He had a blood clot in his arm soon after the April afib.  It dissolved. He is 51 years old and taking the following medication.
Atenelol - 50mg - once a day
Coumadin - 8mg - once a day
Protonix - 40 mg - once a day for stomach acid
FlowMax - 0.4mg - once a day to improve urinay flow
Midodrine - 2.5 mg -3 times a day for dizziness and low blood pressure.
Saw Palmetto - 320mg - once a day (just started this within the last couple of weeks)
His doctor told him to drink lots of water or gator aid and salt his food heavily or take salt pills to decrease dehydration.  He takes a salt pill and drinks gator aide but not daily.  The doctor said dehydration can worsen his problems.
My husband is frequently dizzy.  He cannot bend over without feeling dizzy and many times feeling like he will faint.  He has no energy. His pacemaker fires in his top chamber 99% of the time.  Is there anything he can do to improve his situation ? Are any of these medications contributing to his dizziness ?  He is at his wits end dealing with this problem and will try anything to feel better.

[CCF-M.D.-MJM]

Hi Roann,

Is there anything he can do to improve his situation ?

These can be very difficult problems to solve.  One question that I have is out of the atrial fibrillation?  If he isn't, the upper chamber should not be firing.  I assume he is back in sinus rhythm.

The current treatment is what we usually start with in addition to knee high stockings to improve blood return.

Are any of these medications contributing to his dizziness ?

Has he had a tilt table test?  For people that get tachycardic on a tilt table before passing out or getting dizzy, a beta blocker like atenolol will sometimes help.  If he gets bradycardic first, the beta blocker may make it worse.

I recognize this is a very frustrating problem and hope that he finds some relief soon.

Good luck.

[roann]

He is not in Afib at this time.   When he left the hospital he was back in sinus rhythm.  When he went for a pacemaker check last week they told him the upper chamber was firing 99% of the time.

How does he tell if he is in AFib?  Other than going to the hospital and finding out while there.  He has many days when he feels pretty bad and gets dizzy.  Is that a symptom ?

He said sometimes he feels like his heart is jumping but then at his pacemaker check they told him heart was beating irregular on a specific date and he does not recall feeling any symptoms on that date.  So seems like he cannot really tell when he is in afib.

He had a tilt table test when he was first diagnosed with arrhythmia but I don't know if he had tachycardic or bradycardic
first.  What is the difference ?

After his recent afib the doctor put him on beta pace but he could not tolerate the pressure it caused in his chest so he went back to the atenolol.

I appreciate any information you can give us to help us research and try to find a better way for him to cope with this problem.

[ernests]

A related discussion, a fib was started.