Re: Atrial Fibrillation

Posted By CCF CARDIO MD-APS on January 24, 1999 at 16:03:38:

In Reply to: Atrial Fibrillation posted by Gwen on January 23, 1999 at 13:29:24:






Hi,
I have been experiencing atrial fibrillations for about 3 years.  I am taking betapace.  Just when I think they have disappeared they return, sometimes for 5 hours.  My chest was heavy and I had a headache while this occurred. I have seen a cardiologist who says it is a typical a-fib. I was on a heart monitor which gave immediate feedback.  Recorded like an EKG which told him it wasn't the kind that could be cured by operating.  I must live with this and it may get worse.  I am not on coumadin yet. I am very scared.  I am 66 years young.

Questions:
1.  How do I know when to go to the hospital.  He says after three hours or if I pass out.  Please comment.
2.  Should I be on coumadin?  I am super sensitive to meds.
3.  Should I get a second opinion? I am in the Detroit, Mi. area.
4.  Should I be concerned about the heavy chest and headache? I have not felt that before.



____


Dear Gwen,
1. You should go to the hospital whenever you feel anything other than just palpitations, i.e. heart or chest pain, any dizziness or lightheadedness,  headache, shortness of breath, weakness, change in vision. And of course if the episode is lasting longer than it's usual time course or more than three hours whichever is appropriate and follows the plan that you and your physician are comfortable with.  Since not everyone feels it when they are in atrial fibrillation, it is important to have holter monitor done every so often and sooner of there are new symptoms just to make sure the majority of the time you are in sinus rhythm and not a. fib (the treatment of intermittent a.fib and continuous or chronic a.fib are quite different.  Of course it is not entirely clear which one you have.
2. Patients with chronic a.fib should be on coumadin so long as there is no contraindication, however there is no proven benefit for those who intermittently get bursts of a.fib.
3. Always get a second opinion, preferably at a major heart center which is usually found at university hospitals in the major cities.
4. The answer to this is YES you should be concerned about any new symptoms, for chest pain, go immediately to an ER (have someone take you), and for headache, at least call your physician  to relate to him your new symptoms.

I hope this information is useful. Information provided in the heart forum is for
general purposes only.  Only your physician can provided specific diagnoses and therapies.
Feel free to write back with further questions. Good luck!
If you would like to make an appointment at the Cleveland Clinic Heart Center, please
call 1-800-CCF-CARE or inquire online by using the Heart Center website at
www.ccf.org/heartcenter. The Heart Center website contains a directory of the
cardiology staff that can be used to select the physician best suited to address your
cardiac problem.