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Heart Disease (Expert Forum)
Re: thallium stress testing as a test for atrial fibrillation
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: thallium stress testing as a test for atrial fibrillation
by CCF Cardio MD - MTR, Jan 01, 1995 12:00AM
Posted By CCF CARDIO MD - MTR on July 11, 1998 at 18:28:36:
In Reply to: thallium stress testing as a test for atrial fibrillation posted by zander on July 10, 1998 at 22:44:26:
I had one episode of diagnosed paroxysmal atrial fibrillation last week at age 42 with no structural heart problem (echocardiogram) and moderate hypertension (now on cozaar 50 mg/day), the af laste 24 hours, ended with pronestyl after ibutilide didn't work twice. A thallium stress test one week later showed no coronary artery disease, and was unusual I was old only in that it showed a modestly decreased uptake of thallium after rest as compared with the uptake of thallium after exercise. Is this a positive thallium stress test, will I get this condition again, is flecamide safe to interrupt it, does stress cause this condition, do I need a second opinion from somebody who is an expert only in AF? I'm told by my cardiologist that my AF is no big deal in a younger person like myself, but I am planning to get older and also wondering how much to worry and what to do in the long run. Thanks much.
Dear Zander, thank you for your question. Atrial fibrillation (AF) is a disordered
electrical rhythm of the heart that originates in the atria. There are multiple
causes of AF including valvular heart disease, coronary artery disease, hyperthyroidism,
alcohol, a lot of caffeine, hypertension, and sometimes stress. Your thallium
stress test was indeed negative for coronary disease and the decreased uptake
at rest can be seen sometimes due to the way that different people handle the
thallium that is injected for the test. The medications that have been used
to treat your AF are appropriate and flecainide shouldn't pose a risk for you
since you appear to have a normal heart. However, I wonder if you had an
echocardiogram done to image the cardiac chambers and valves to exclude vavular
heart disease. When the mitral valve leaks, the left atrium dilates due to the
increased amount of blood it receives. Left atrial dilation is thought to cause
AF by stretching the conduction fibers that run through its walls. Left atrial
dilation can also be caused by chronic hypertension, so it would be important
to determine the size of your left atrium with an echo. Your long term prognosis
could be better predicted with this information. Another test that should be done
is a blood test called a TSH which looks for hyperthyroidism. Overall, AF should
not cause too many problems in a young person like yourself if you truly have a
normal heart but I can't comment on what will happen in the future because each
person must be assessed individually and predictions are often inaccurate. In
addition to flecainide, one full-strength, coated aspirin per day should be used
to help keep your blood thin to prevent clots from forming as a result of the AF.
A general cardiologist should be capable of treating your AF and it doesn't appear
that you need to see an AF specialist at this point. I hope you find this
information useful.
Information provided in the heart forum is for general purposes only. Specific
diagnoses and therapies can only be provided by your physician.
In Reply to: thallium stress testing as a test for atrial fibrillation posted by zander on July 10, 1998 at 22:44:26:
I had one episode of diagnosed paroxysmal atrial fibrillation last week at age 42 with no structural heart problem (echocardiogram) and moderate hypertension (now on cozaar 50 mg/day), the af laste 24 hours, ended with pronestyl after ibutilide didn't work twice. A thallium stress test one week later showed no coronary artery disease, and was unusual I was old only in that it showed a modestly decreased uptake of thallium after rest as compared with the uptake of thallium after exercise. Is this a positive thallium stress test, will I get this condition again, is flecamide safe to interrupt it, does stress cause this condition, do I need a second opinion from somebody who is an expert only in AF? I'm told by my cardiologist that my AF is no big deal in a younger person like myself, but I am planning to get older and also wondering how much to worry and what to do in the long run. Thanks much.
Dear Zander, thank you for your question. Atrial fibrillation (AF) is a disordered
electrical rhythm of the heart that originates in the atria. There are multiple
causes of AF including valvular heart disease, coronary artery disease, hyperthyroidism,
alcohol, a lot of caffeine, hypertension, and sometimes stress. Your thallium
stress test was indeed negative for coronary disease and the decreased uptake
at rest can be seen sometimes due to the way that different people handle the
thallium that is injected for the test. The medications that have been used
to treat your AF are appropriate and flecainide shouldn't pose a risk for you
since you appear to have a normal heart. However, I wonder if you had an
echocardiogram done to image the cardiac chambers and valves to exclude vavular
heart disease. When the mitral valve leaks, the left atrium dilates due to the
increased amount of blood it receives. Left atrial dilation is thought to cause
AF by stretching the conduction fibers that run through its walls. Left atrial
dilation can also be caused by chronic hypertension, so it would be important
to determine the size of your left atrium with an echo. Your long term prognosis
could be better predicted with this information. Another test that should be done
is a blood test called a TSH which looks for hyperthyroidism. Overall, AF should
not cause too many problems in a young person like yourself if you truly have a
normal heart but I can't comment on what will happen in the future because each
person must be assessed individually and predictions are often inaccurate. In
addition to flecainide, one full-strength, coated aspirin per day should be used
to help keep your blood thin to prevent clots from forming as a result of the AF.
A general cardiologist should be capable of treating your AF and it doesn't appear
that you need to see an AF specialist at this point. I hope you find this
information useful.
Information provided in the heart forum is for general purposes only. Specific
diagnoses and therapies can only be provided by your physician.
