Re: Atrial flutter

Posted By CCF CARDIO MD - DLB on April 08, 1998 at 10:34:35:

In Reply to: Atrial flutter posted by Henry on April 01, 1998 at 12:47:59:






I am 61-year old male who had bypass surgery in June 1995. This caused AF
which was successfully treated with cardioversion and 200 mg/day tambocor.
Later, that dose was reduced to 100 mg/day which I tolerated fine.
Since I had done fine for so long, I stopped tambocor last December. Then
vigorous exertion on Feb. 27 caused strong chest pains and recurrence of
AF and flutter which refused to respond to increased doses up to 200 mg/day.
Cardioversion of Mar. 13 was successful and I was in SR at least till
Mar. 18 (strip confirmed at cardiologist's office) with 100 mg/day.
Then the dose was increased to 150 mg/day. Physical exertion on 3/27 caused
AF (which I can feel). Despite an increase in tambocor to 200 mg/day, an
office visit on Mar. 31 confirmed that I was stuck in atrial flutter again
(which I cannot detect in my pulse). The increased dose makes me sicker and
does not undo the arrythmia. What are my options now? (Tambocor is taken
twice a day, along with aspirin (81 mg) and accupril (5mg))
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Dear Henry:
Tambocor is only one of several medications that can be used for atrial arrhythmias.  Since it no longer seems to be effective, and since you have side effects at the higher doses, it seems reasonable to try a different class of medications.  It may still be necessary to perform an electrical cardioversion, but hopefully the medication can prevent a recurrence.  If after several trials of medications, the atrial arrhythmias persist or recur, you may be a candidate for a procedure to "ablate" or remove the abnormal heart tissue causing the atrial flutter.  This procedure does not involve open-heart surgery, but is similar to a cardiac catheterization.  It is performed by a cardiac electrophysiologist, a cardiologist who specializes in treating problems with the heart's electrical conduction system.
Information provided in this forum is of a general nature.  Specific diagnoses and treatments can only be made by your doctor.  If you would like to see a cardiologist who specializes in heart rate problems, please call 1-800-CCF-CARE for an appointment at desk F15 with a cardiac electrophysiologist.