A-Fib and MAC

I am shocked by what the anesthesiologist told you.

I was diagnosed with afib in 2006 and copd and bronchiectasis in 2010. I had minimaze surgery which removed the appendage which is the part of the heart where afib clots are likely to occur. I take xarelto and diltiazem which is a calcium channel blocker which acts to control the rapid heart rate associated with afib.

The only interaction between drugs for afib and lung disease that I am aware of is metoprolol and other beta blockers which are given to control the rapid heart rate associated with afib. Studies have shown that beta blockers can lead to an enhanced exacerbation in copd patients. I don't think this is true for bronchiectasis which is a different lung disease.

I hope you are seeing an electrophysiologist rather than a cardiologist for treatment of afib. Electrophysiologists are the heart's electricians and treat rhythm issues. Cardiologists are the heart"s plumbers and treat the valves and the flow of blood. It was my Electrophysiologist who took me off metoprolol. My pulmonogist was unaware of the studies.

I had surgery for colon cancer as well as a bronchoscopy and a multitude of other tests over the years. I have always reminded the anesthesiologist about my lungs and have always been reassured that they will take care of me. I was on the big 3 for 14 months and am currently (and hopefully forever) MAC free.

I don't know where your anesthesiologist got his information about afib and sedation.

Connie, your experience with a response-phobic Pulmo reminds me of my experience with two Pulmos. Although I like them both the first one arranged for me to get a percussion vest, and concurrently started me nebulizing 0.09% saline. At that time I hadn't discovered the Mayo Connect Treasure Trove of useful treatment info for our maladies. The Pulmo didn't mention that 0.09 is but one of multiple saline concentrations and I was too dumb to question his choice.
After he bailed out of his practice I transferred to his office colleague who continued on the same regimen for months and months, up until the time I mentioned to him that I had learned of the availability of a 7% solution which was reputed to kill or at least make life miserable for MAC infections. He gave no indication that he had ever heard that good news, but happily complied with my request to amp up my saline Rx to 7%. And I've lived happily ever after...sorta. Don

Dear Thumperguy,

Thank-you for that! It is so true that we must be our own advocate...but it sure is a hard road to travel! So glad you are better!

Yes Sounder, lying flat isn’t noticeably associated with coughing episodes, which isn’t to say they don’t occur. Not spontaneously every day, but a few times weekly and fairly reliably during and following my evening neb/thumper session. Don

I had a discussion about this with my doctor as there was a concern that I might have Afib around the time I was starting MAC meds. The issue is that Rifampin changes the metabolism of the newer anticoagulant drugs, making it hard to dose correctly (i.e. risk of bleeding). You could be treated with azithromycin, ethambutol plus either clofazimine or Arikayce to avoid taking Rifampin. Or your Afib could be managed with Coumadin(warfarin) which can be monitored with blood tests to make sure your dosing is correct and then you could take the Rifampin. Good luck- with sorting this out- you don't say whether your MAC needs treatment yet- many people are able to delay if it is not progressing too fast and some never need treatment. Maybe there are other options to resolve the Afib before you start MAC treatment if not needed soon

My husband has been in a fib for over a year. His cardiologist just kept giving him different medication’s. When we asked if he could do an ablation or shock treatment, which our friends have had done in the same situation, he said no you’re good, go live your life ? So we went to an electrophysiologist and had a shock treatment done yesterday. He instantly went into rhythm. His electrophysiologist said because his cardiologist was not on the ball and waited too long, that he now has more heart damage. And his a fib has a 40% chance of coming back in the next year. Very disappointed!!

I solely have MAC plus Afib of the heart and QT Prolongation(whatever that is). I have to take Eliquis which thins my blood and Sotalol(Betapace) to control my heart rate. Both my Pulmonologist and Infectious Disease Doctors say I cannot take some of the Antibiotics to treat MAC because of the QT Prolongation. Am doing really well for now; but, will probably go to Jewish Health to determine treatment. I am 83 and don't expect to be cured. Just want to be able to manage my disease.

Has anyone suggested daily airway clearance and nebulized 7% saline? That may knock down the MAC well enough to keep you going.

I had to quit the meds because the regimen was wiping me out even though I still have MAC. As of Saturday, I will have stayed healthy on the saline plus airway clearance for 2 years!
Might this be worth a try for you?
Sue

Don the book I thought u would be intrested in was The Secret to Health and the truth about Disease by Ron Garner it is based on the practise and teaching of Dr Robert Morse, ND. It is available at amazon. It is so true about the food we eat has made us sick and un healthy.I have been reluctant to get off my antibiotics but after what u said about the saline I am going to give it a try. I do the7% saline every day but still do the antibiotics every 3 day. thanks Don Garry

Afib can be symptomatic causing those that have it to feel their hearts racing and palpitations. This can be horrible. However, afib episodes are not dangerous in themselves. The dangers come from clots forming and causing a stroke and a very high heart rate. Your afib issues are being managed with an anticoagulant (blood thinner) to prevent clots and a beta blocker to keep the heart rate from going too high.

Your other heart problem is qt prolongation which can be much more serious than afib and is detected through an ekg. On an ekg read out, heart beats appear as long vertical lines. There are much shorter lines between the beats that look like waves. One of those waves is the qt and yours is abnormal. Some drugs including some antibiotics may affect the qt
prolongation making it worse.

Your doctors need to balance the risk of antibiotics for MAC affecting your heart. If you don't have severe MAC symptoms or a lot of MAC and especially if you don't have cavities, the decision may be to keep your MAC levels stable or even reduce it through nebulizing 7% saline and doing airway clearance and not doing antibiotics.

I hope this helps and I hope you hear your doctors' recommendation soon.