Peggy

[Peggy72]

I am 53 years old, and had a very mild stroke (CVA) 8-30-07.  After lots of tests, the neurologist found I had a hole in my heart.  I then had the PFO closure procedure done 12-5-07.  I thought this would limit my chances for future strokes, plus got me off the coumadin I was taking.  However, about 2 weeks after the PFO closure, I had to run a short distance and I noticed my heart beating irregularly.  I laid down and it went away in about 3 hours.  but after many more tests and wearing heart monitors, the doctors determined I have atrial fibrillation, and put me back on Coumaden to thin my blood and atenenol to slow my heart rate. I have an appointment to folllow up with an electrophysist next month, at which time he will decide what is best for me to control the a-fib.  My cardiologist and PCP say it is possible I had a-fib all along, and that could have caused my stroke and not the hole in my heart.

I had the PFO closure done at Shawnee Mission Medical Center and was told that 20% of patients do get a-fib after this procedure.  I know a lady who had the same thing as me, but she said her heart started beating regularly again in a few months, and she is only taking an asprin a day now.

I am wondering your thoughts on my a-fib.  I have had 3 surgeries in past years, always have my yearly checkups and give blood regularly.  No one has ever told me I had a-fib.  And I have never felt like I felt when I felt this first started 2 weeks after the procedure.  I was told by my friend that the heart has a foreign object on it that it's not used to and it will take awhile to get to beating regular again.

I am hoping this a-fib goes away.  After 6 months, tissue is supposed to grow completly over the closure device and I hope the heart accepts it and I have no further problems.  what do you think?

Thank you, I appreciate your help!

[Mukesh Garg, MD]

Many of us have PFOs and and may never have a CVA. So it is hard to say that it was the reason for you to have CVA. You could have had Atrial fibrillation in the past which could be an explanation for your CVA. It is possible that your Afib could be due to the procedure in which case it is likely to go away, but if you have had it in the past, you may remain at risk to get it again.  

[Peggy72]

A related discussion, Could my A-fib be back? was started.

[cabkrun]

Hi Peggy
ASD is an Atrial Septum Defect.  Similar to a PFO, but really a true "hole" in the heart.  I know I have one, not sure about the other.  The surgical route means closure of the defect thru standard heart surgery vs. cathertization of the implant.  Not everyone can have the implants but it's much less common to have the surgery now it seems.  I have heard/read of many people having problems with a-fib after a closure of the defect (in your case PFO), but in most cases it resolves.  I don't think it's because the device hasn't had the tissue grown over it yet, it just seems to be a relatively common but temporary event after heart surgery.  I would say go back to your cardio if it doesn't resolve soon.  Good luck, hope I helped.

[Peggy72]

Thanks for the reply.  I didn't understand all your comments.  I don't know what ASD is.  Also, you said were going the surgical route; so what surgery are you going to have?  The closure device I have is almost all fabric with just a few specs of metal around the edges and maybe in the middle. It is placed on both sides of the hole.   Do you have any thoughts about if my a-fib could be temporary and go away once the tissue grows over the closure device? That's what I'm hoping.  I never wore a holter before the procedure, but I don't think I ever felt the way I have since it either.  

Any comments from you or anyone else will be welcome.  thanks and good luck to you also.

[cabkrun]

Hi Peggy,
your situation is very interesting to me, because I am 42 years old, very athletic, and had two small TIA's.  I too have a PFO with significant continuous right-to-left shunting.  They are also going to make sure I don't have a small ASD ... as the TEE I had done was not that thorough.  We / I have actually decided to go the surgical route for many reasons, so I won't have the metal device placed inside my heart.

In terms of the a-fib, it could have very well be caused by the device. It's not uncommon after such "procedures" I would think it would have been picked up before now if it were an issue, unless it's such a rare occurrence.  Have you ever been on a holter, before the PFO was found?  It is also seen after surgery if the heart is started up in a dis-rhythm.  I am not telling you all this to scare you, nor tell you that you did the wrong thing for your hole :). Good luck, I hope you resolve your issues and can get on with your life.