Low pulse rate after cardioversion

My wife had an op. for a mitral valve repair and AF (maze) some ten weeks ago. After the op. she was put on amiodarone, digoxin and furosemide. While the MVR appeared successful the maze did not kick in, and she experienced irregular heartbeats, cica 90 p.m. She then had cardioversion a few days ago after which her heart rhythm appears to have regularised but her pulse rate has dropped to 42-46 p.m. She is now quite weak and she has lost a lot ef energy. We are concerned about the low heartbeat. She has been taken off all medication except warfarin (5 mg pd) Where should we go from here?

[Michael J. McWilliams, M.D.]

Stay in touch with your doctors.
As the digoxin washes out of her system, her heart rate is likely to increase -- this should take a few days.  The amiodarone will take longer -- months --- but also should allow for increased heart.
Deciding when and if to proceed with a pacemaker can be hard and is a decision better left between you and your doctor.  Hopefully she will feel better as the medication washes out.