Confused

[C.N.]

I had written previously and asked a question that was not phrased correctly, but I believe I know it now, so I'll try again.  A little background.  I'm 33 yr. old female, with a rate responsive pacer.  Since it was placed I have developed worse rhythm problems, A-Fib with fast venticular rate (300bpm), a-flutter, other atrial ectopic sights.  My medications are, amiodarone 400mg.,coumadin,lasix,cartia xt,midodrine(my blood pressure drops dramatically),calcitonin (osteoporosis).  Well on to my questions:
1)My EP doctor told me about doing an AVnode ablation, but has decided he doesn't want to do it because I have very high reflex sympathetic tone (I hope I got that right).  I do not have any idea what that means, or how it has anything to do with having an AV node ablation, please explain?  He thinks I may end up having decompensation as a result of this procedure.

2)I had my INR level checked yesterday for the coumadin, and they told me it was a little over 7.  Is this dangerous, and should they have informed my cardiologist?  

3) I often get chest pain.  There is one particular type of pain that I get on/off.  When I breath, the pain is worse.  Many times when I'm sleeping I wake up with horrible pain on the left side of my chest, when I roll over it feels a little better. I also have trouble with breathing.  I just feel like I am suffocating at times, and I produce alot of phlegm.  Do you have any ideas what those pains could be?

4) They put me on lasix because of pitting edema that comes on quickly.  But my cardio. doc. sent me to my reg. doc, who sent me to a kidney doc., but no one seems to be able to come up the a reason. Can the meds I'm taking cause this?

I also have mild to moderate regurg. in my tricuspid valve and mild regurg. in mitral valve.  Thankyou so much for any insights or information you may be able to provide.

[In regards to question #3]

Get checked for asthma for #3 question in your post.

[CCF CARDIO MD - DLB]

1. The problem with AV node ablation is that it is a permanent step. Furthermore, it does not stop the atrial fibrillation, it just keeps your ventricle from tracking the atrial fibrillation.
2. This level of INR increases your risk of major bleeding complications; the doctor who regulates your coumadin level should be notified immediately.
3. NOt really. It could be from the atrial arrhythmias or unrelated to the heart.
4. It could be a side effect of the medications, though I would not really expect that degree of edema.

[jennifer]

I know very little about most of yuor questions but i might be able to help with two of them. Your INR level at 7 is not real good if you are having pain in your belly, red in the whites of the eyes. You need to get in touch with your doctor or a ER room. INR at 7 in some can cause you to bleed inside. Your questing on lasix you can call your drug store and get them to give you a list of all the problem you meds can cause. I hope I have helped you some.