A-fib following OHS

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Hello all.

 I had OHS pm 30th June, to replace my aortic valve and repair a 5.1 cm TAA. I was released after 6 days and I was OK for a few weeks. Then, I started having a-fib. First time was 190 BPM, that lasted over 6 hours. They diagnosed me with Narrow Complex Tach, and they were going to shock me, but it reset itself and they let me go the next morning.

   A few hours after I was released, I went back into a-fib, this time it was 205 BPM and lasted about 5 hours.  They put me on Beta Blockers and kept me in for 4 days. The moring I was released, I had 4 episodes, that only lasted about 5 mintues, then reset. 

   Within hours of release, I went back into a-fib again, and this time, I called the hospital that I had the surgery in, and they admitted me. My heart reset itself on the way there. But they changed my meds to Amiodarone. That seemd to do the trick, and I had no episodes for a week. Then, on the way to a 24 halter monitor appointment, it started up again. Lasted for about 2 hours, and reset itself. That was 30th July and I've had no episodes since.

   My concern is this...I am down to one pill a day for another 2 weeks and then they are going to put me back on a low dose beta blocker. 

   Has anyone else had a similar experience...did the a-fib come back? I know I can't stay on Amiodarone forever (bad side effects), but I don't want to go though that again on beta blockers. 

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5 Replies

  • Posted

    Hi Kristi,

     The doctors could decide to put you on Multaq which does not have bad side effects. Beta blockers like (meta)Toprol are not bad as they simply prevent excessive heart rates and I have taken one every day for years with no side effects. Do not be afraid of beta blockers. If you do not have a good result from Multaq (65% success rate) after say 6 months then they will need to do an ablation which is a safe non surgical procedure to freeze off the arteries causing the afib.That normally has a 94% sucess rate. Next time you visit your doctor ask about Multaq and ablation and you will see that there are protocols today that work well for afib.

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    • Posted

      From RXLIST, is it a good idea?

      In patients with symptomatic heart failure and recent decompensation requiring hospitalization or NYHA Class IV heart failure; MULTAQ doubles the risk of death. MULTAQ is contraindicated in patients with symptomatic heart failure with recent decompensation requiring hospitalization or NYHA Class IV heart failure.

      In patients with permanent atrial fibrillation, MULTAQ doubles the risk of death, stroke and hospitalization for heart failure. MULTAQ is contraindicated in patients in atrial fibrillation (AF) who will not or cannot be cardioverted into normal sinus rhythm.

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    • Posted

      I'm not afraid of beta blockers...they just didn't seem to work for me. I was still having short episodes on them, whereas I have only had one two hour episode in nearly month on amiodarone. 
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  • Posted

    Thanks Deric for the correction, you re correct as it applies here to patients with symptomatic heart failure.
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    • Posted

      RXlist and drugs dot com always give a lot more information than BNF that our doctors and hospitals use. It always seems the more effective the drug the more harm it causes in other parts of the body.

      BNF said.

      Hepatic disorders:  Liver injury, including life-threatening acute liver failure reported rarely; monitor liver function before treatment, 1 week and 1 month after initiation of treatment, then monthly for 6 months, then every 3 months for 6 months and periodically thereafter—discontinue treatment if 2 consecutive alanine aminotransferase concentrations exceed 3 times upper limit of normal. Patients or their carers should be told how to recognise signs of liver disorder and advised to seek prompt medical attention if symptoms such as abdominal pain, anorexia, nausea, vomiting, fever, malaise, itching, dark urine, or jaundice develop

      Heart failure New-onset or worsening heart failure reported; patients or their carers should be told how to recognise signs of heart failure and advised to seek prompt medical attention if symptoms such as weight gain, dependent oedema, or dyspnoea develop or worsen; if heart failure or left ventricular systolic dysfunction develops, discontinue treatment

      contra indications, liver or lung toxicity associated with previous amiodarone use; second- or third-degree AV block, complete bundle branch block, distal block, sinus node dysfunction, atrial conduction defects, or sick sinus syndrome (unless pacemaker fitted); permanent atrial fibrillation; bradycardia; prolonged QT interval; existing or previous heart failure or left ventricular systolic dysfunction (see also Heart Failure above); haemodynamically unstable patients

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