Rheumatic heart/ sinus rythym

    A family member of mine had rheumatic fever as a child which went unnoticed for years.  She is now 54, mitral valve replaced 10 years ago (titanium).  She is now having episodes of afib/tachycardia runnning about 160.  After 7 trips to the ER (unable to convert it on own) they have tried a barrage of meds  none which seem to prevent it.  They are now going to try a drug called amiodarene (I think thats the name) which has bad side effects. They say she will eventually go afib again.  Q:  what can we xpect in the future from this rheumatic heart, is there any treatments short of a transplant?

[CCF CARDIO MD APS]

Dear John,
Rheumatic heart disease (RHD) usually causes early valve degeneration and dysfunction, thereby requiring heart valve replacements.  If the heart's main pumping chamber suffers from years of a dysfunctional valve and or other cardiac disease then the diagnosis is heart failure and this requires medications, surgery if indicated, and when all else fails, transplant.
  
It is likely that the dysfunctional mitral valve in your family member caused dilation of the left and or right atria (upper collecting chambers) that caused the atrial fibrillation (a.fib).  Difficult to treat a.fib is not a reason to transplant, and amiodarone does not have bad side effects in all patients on it, not even in most patients taking it.
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!
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cardiac problem.