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Heart Disease (Expert Forum)
Re: A-Fib
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Re: A-Fib
by CCF Cardio MD sc, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD sc on March 09, 1998 at 09:59:19:
In Reply to: A-Fib posted by Dave on February 28, 1998 at 19:07:55:
: My father fell from his bike during a ride last summer. He only suffered from some cuts and bruises. Interestingly, right after doctors said he was in A-Fib. He never had any heart disease prior to this accident. It was in a higher elevated area and I am sure it stressed his heart. He is 70 years old and said he felt fine. Was he about to go into A-Fib anyway? Or did the accident "throw" him into it? Doctors now say he needs to be converted with paddles because the meds have not worked. Is this procedure life threatening? Seems very coincidental that the heart rhythm problem came immediately after the accident. Thank you.
_
Dear Dave,
Atrial fibrillation is a very common condition in somebody your fathers age. Although in most cases it is associated with some kind of underlying heart disease there are a good percentage of patients in whom it is the only abnormality, the so called "Lone atrial fibrillation". The presentation of a. fib. May be different in many patients from worsening of heart failure and anginal attacks, syncope and near syncopal spells if the rate is to high, to no symptoms whatsoever. If fact afib is frequently incidentally found in patients undergoing routine physical. In your fathers case it is difficult to determine whether the afib predated his accident, played a part in it, or was just an incidental occurrence during or after it. What I can say is that it would be very unlikely that the actual fall caused it.
The problem with a afib is that although it does not cause many significant symptoms in some patients like your father it is still associated with an increased incidence of strokes. This happens because blood clots tend to form in the top chambers of the heart called the atria as the contraction there is not organized because of the rhythm problems. Because of this increased risk of stroke every effort should be made to return the patient to a regular rhythm and if this cannot be done the patient will need to placed on lifelong anticoagulation therapy combined with medications that control the heart rate in the bottom chambers of the heart the ventricles.
Cardioversion or the attempt at returning the heart rhythm to a regular rhythm may be attempted via medicines or via the so called electrical cardioversion whereby a direct current is applied to the chest wall through special paddles. This procedure is done under light sedation and if done correctly the patients should have no memory of it. Although there might be a slight risk of degeneration into a worse rhythm this should easily be taken care of in the setting of the lab where the cardioversion is attempted. If this is successful the patient may be taken off the anticoagulation after a period of 3-6 weeks.
I hope this has helped clarify some of your questions, if you have any further questions or would like your father to be seen by one of our electrophysiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE to set this up.
Information in this forum is intended for general purposes only. Specific diagnosis and treatment should be reserved for physicians directly involved in patient care.
In Reply to: A-Fib posted by Dave on February 28, 1998 at 19:07:55:
: My father fell from his bike during a ride last summer. He only suffered from some cuts and bruises. Interestingly, right after doctors said he was in A-Fib. He never had any heart disease prior to this accident. It was in a higher elevated area and I am sure it stressed his heart. He is 70 years old and said he felt fine. Was he about to go into A-Fib anyway? Or did the accident "throw" him into it? Doctors now say he needs to be converted with paddles because the meds have not worked. Is this procedure life threatening? Seems very coincidental that the heart rhythm problem came immediately after the accident. Thank you.
_
Dear Dave,
Atrial fibrillation is a very common condition in somebody your fathers age. Although in most cases it is associated with some kind of underlying heart disease there are a good percentage of patients in whom it is the only abnormality, the so called "Lone atrial fibrillation". The presentation of a. fib. May be different in many patients from worsening of heart failure and anginal attacks, syncope and near syncopal spells if the rate is to high, to no symptoms whatsoever. If fact afib is frequently incidentally found in patients undergoing routine physical. In your fathers case it is difficult to determine whether the afib predated his accident, played a part in it, or was just an incidental occurrence during or after it. What I can say is that it would be very unlikely that the actual fall caused it.
The problem with a afib is that although it does not cause many significant symptoms in some patients like your father it is still associated with an increased incidence of strokes. This happens because blood clots tend to form in the top chambers of the heart called the atria as the contraction there is not organized because of the rhythm problems. Because of this increased risk of stroke every effort should be made to return the patient to a regular rhythm and if this cannot be done the patient will need to placed on lifelong anticoagulation therapy combined with medications that control the heart rate in the bottom chambers of the heart the ventricles.
Cardioversion or the attempt at returning the heart rhythm to a regular rhythm may be attempted via medicines or via the so called electrical cardioversion whereby a direct current is applied to the chest wall through special paddles. This procedure is done under light sedation and if done correctly the patients should have no memory of it. Although there might be a slight risk of degeneration into a worse rhythm this should easily be taken care of in the setting of the lab where the cardioversion is attempted. If this is successful the patient may be taken off the anticoagulation after a period of 3-6 weeks.
I hope this has helped clarify some of your questions, if you have any further questions or would like your father to be seen by one of our electrophysiologists here at the Cleveland Clinic please feel free to call 1-800-CCF-CARE to set this up.
Information in this forum is intended for general purposes only. Specific diagnosis and treatment should be reserved for physicians directly involved in patient care.
