Re: Atrial Fibrillation

Posted By CCF CARDIO MD - DLB on June 24, 1998 at 12:18:46:

In Reply to:  Atrial Fibrillation posted by Anita on June 22, 1998 at 19:05:26:






My brother-in-law, 34 y.o. healthy male, has had 2 recent episodes of Atrial Fibrillation requiring cardioconversion as he was non-responsive to medication during his hospitals stays. This last cardioconversion required 2 tries with the final one consisting of maximum voltage of 300. After this last episode his cardiologist prescribed Rythmol  with the advice to avoid caffeine but otherwise resume his normal routine. He was released from the hospital a couple of days ago on his medication.  He still feels "unwell",  and is fatigued easily.
My question is, should he get a second opinion? And is he on appropriate medication?
If he should get another opinion, what exactly should he look for?
We are in the metropolitan NY area.
Thanks so much for your time.
---------------------------------------------------------------------------------------------------
Dear Anita:
A small percentage of the population is unable to properly metabolize Rythmol [propafenone].  These people are prone to side effects such as fatigue.  There are many other medications for atrial fibrillation.  Before seeking a second opinion, I would suggest talking to your present cardiologist.  Let him know about the side effects your brother-in-law is experiencing.  Perhaps he would be able to change to a different medicine.  If you do wish to obtain a second opinion in the NYC area, I would suggest one of the university medical centers in Manhattan.
I would also make sure that your brothers heart is structurally normal [I suspect your cardiologist has already done an echocardiogram to check this].  Thyroid gland function should also be measured with a blood test.
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 cardiac electrophysiologist at Desk F15.