1. < Heart Rhythm Conditions

AFib questions

Posted by peggyd @peggyd, Mar 23, 2016

Good morning! I'm almost 66 years old, with infrequent AFib and on Eliquis. Sunday evening I had a spectacular nosebleed and went to the ER, where the attending physician inserted an epistaxis nasal pack (the kind with the inflatable balloon). I'm getting it removed tomorrow. What can I expect when it comes out--besides my own reaction of dancing gleefully around the office? Blood? Clots? Scabs? A genie? Thanks for your help!

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Martin Jensen, Volunteer Mentor | @predictable | Aug 1, 2016
In reply to @patinhou "My cardiologist tells me not all clots are stopped with blood thinners. He suggested the mini..." + (show)
@patinhou

My cardiologist tells me not all clots are stopped with blood thinners. He suggested the mini Maze procedure.

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Welcome to Mayo Connect @patinhou. Thanks for adding the mini-Maze procedure to our conversation. Are we talking about two different problems -- clots and a-fib cures? Coumadin and similar blood "thinners" prevent clots from forming in the heart, but they don't cure a-fib. The mini-Maze procedure does; it is a surgical procedure that stops heart tissue from issuing the spurious electrical impulses to the atrium (upper chamber). Through small incisions, the surgeon cuts heart tissue slightly, causing scars that block the faulty beats. The cuts are called "ablations."

There are other ablations as well -- heat, cold, radio energy, for example -- that are administered by catheter through a blood vessel. They too stop the faulty beats most of the time. Here are some links to more info; view them in this order:
http://www.stopafib.org/maze-surgery.cfm
http://www.stopafib.org/mini-maze.cfm
The choice of ablation in general -- and the type of ablation -- must be tailored to the individual patient. Thus, mini-Maze is not always appropriate. @patinhou, would you favor us with some of the points your cardiologist made in recommending mini-Maze for you? Do you think ablation is essential or elective for you? And why mini-Maze is better than other ablations? Thanks for anything you can add to help other members who are interested.

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Patricia | @patinhou | Aug 1, 2016
In reply to @patinhou "My cardiologist tells me not all clots are stopped with blood thinners. He suggested the mini..." + (show)
@patinhou

My cardiologist tells me not all clots are stopped with blood thinners. He suggested the mini Maze procedure.

Jump to this post

I saw Dr Wolf here in Houston.  He does the mini Maze procedure.  We have not decided absolutely that I am a candidate for this procedure.  However, I really don't want to take blood thinners,  and I have a past history of thrombi shower.  I know this procedure is not for everyone,  but the lecture I went to made me realize there are options.  I have paroxysmal a fib.  I get fast, pounding heart rate with it, but recently found out I also have silent episodes.

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Martin Jensen, Volunteer Mentor | @predictable | Aug 1, 2016
In reply to @patinhou "My cardiologist tells me not all clots are stopped with blood thinners. He suggested the mini..." + (show)
@patinhou

My cardiologist tells me not all clots are stopped with blood thinners. He suggested the mini Maze procedure.

Jump to this post

Patricia, thanks for your candid offering of information on your circumstances. We all can understand how important your decisions are at this crucial time, and we hope you can sense our concern for your efforts to bring your a-fib under control. I usually suggest that a person get a second opinion from the best health care professional they can find. Your relationship with Dr. Wolf clearly has equipped you with very sophisticated information and moved you toward making vital decisions. As you know, paroxysmal a-fib, being unpredictable, heightens the need for a highly expert medical team with a lot of experience in dealing with variants in symptoms and functions. Do you feel that you're about ready to decide on your series of steps in treatment?

Most of us here are not so well-informed as you on your challenges, so for our benefit, I'd like to insert a link to a general article on a-fib to make it more convenient for us to understand better what you're dealing with:
http://www.mayoclinic.org/diseases-conditions/atrial-fibrillation/diagnosis-treatment/mayo-clinic-experience-patient-stories/orc-20164957.
We'd like to stay in touch with you to learn from your experience, but more to cheer you on and offer our support as you move forward. Please keep us posted and tell us if you need anything that we can provide.

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2880 | @2880 | Aug 10, 2016
In reply to @audree "Did your cardiologist explain the cardioversion procedure? I was an emergency Afib patient on July 24,..." + (show)
@audree

Did your cardiologist explain the cardioversion procedure? I was an emergency Afib patient on July 24, 2015 and was cared for by an emergency doctor. He had me on cardizem 360 and lasix 160 and coumadin. I was miserable with hugely swollen legs (plus 3) and still in Afib. That doctor told me to go through the scheduled hip replacement surgery in Afib and then get a cardioversion later. When I saw my own cardiologist one month later (August 27th) in a different hospital and city he told me no surgeon would perform on a patient in Afib and I’d have the cardioversion immediately (September 11, 2015.) It was successful, heart back in rhythm, and I then had surgery October 19, 2015. I was 86 years old then and did not flip back into Afib during the surgery. You may want to ask your cardiologist if you are a candidate for cardioversion. If not, why not? <br><br>I got off the coumadin after 10 months because it was not compatible with my food requirements and I now take Pradaxa since May 10, 2016. Pradaxa has an excellent antidote and I have seen no side effects from taking it except it costs much more than coumadin. Report is that they are backing off of coumadin now because it can take up to 72 hours to stop bleeding. Much too long for safety.

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I had a Cardioversion a week ago and am in normal sinus rhythm now .i still take Elequis 5 mg 2 x d Diltiazem 180 2 x dand Flecainide 100 2 x d .All these make me very tired !

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2880 | @2880 | Aug 10, 2016
In reply to @grandmajan "I'm ok. Sorry to upset. I was looking for answers. If the pain returns I'll get..." + (show)
@grandmajan

I'm ok. Sorry to upset. I was looking for answers. If the pain returns I'll get help. I see the dr on Mon and will get more of my questions answered. I'm not sure that the Cardio-version is right for me. I used to drive mental health clients to appointments for shock therapy for bipolar and depression. Sounds similar. I will also start checking my mail everyday. Thank you for being concerned. Jan

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Cardioversion is a great first step ! It is easy and could just work !Had one last week and am quite pleased .

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Moderator
Colleen Young, Connect Director | @colleenyoung | Aug 10, 2016
In reply to @frank4848 "I wanted to find if anyone had Watchman implant done. If so, what are your thoughts..." + (show)
@frank4848

I wanted to find if anyone had Watchman implant done. If so, what are your thoughts about the procedure and how it affects you personally.

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Hi all, @frank4848 asks about the WATCHMAN implant (Left Atrial Appendage Closure Device). It was FDA approved in March 2015 as an alternative to long-term warfarin therapy http://www.fda.gov/MedicalDevices/ProductsandMedicalProcedures/DeviceApprovalsandClearances/Recently-ApprovedDevices/ucm440621.htm

Anyone had it done?

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Moderator
Colleen Young, Connect Director | @colleenyoung | Aug 10, 2016
In reply to @audree "Did your cardiologist explain the cardioversion procedure? I was an emergency Afib patient on July 24,..." + (show)
@audree

Did your cardiologist explain the cardioversion procedure? I was an emergency Afib patient on July 24, 2015 and was cared for by an emergency doctor. He had me on cardizem 360 and lasix 160 and coumadin. I was miserable with hugely swollen legs (plus 3) and still in Afib. That doctor told me to go through the scheduled hip replacement surgery in Afib and then get a cardioversion later. When I saw my own cardiologist one month later (August 27th) in a different hospital and city he told me no surgeon would perform on a patient in Afib and I’d have the cardioversion immediately (September 11, 2015.) It was successful, heart back in rhythm, and I then had surgery October 19, 2015. I was 86 years old then and did not flip back into Afib during the surgery. You may want to ask your cardiologist if you are a candidate for cardioversion. If not, why not? <br><br>I got off the coumadin after 10 months because it was not compatible with my food requirements and I now take Pradaxa since May 10, 2016. Pradaxa has an excellent antidote and I have seen no side effects from taking it except it costs much more than coumadin. Report is that they are backing off of coumadin now because it can take up to 72 hours to stop bleeding. Much too long for safety.

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Welcome to Connect @2880. Great to hear that your cardioversion was a success. Will you have to continue taking all 3 medications? Have you talked to your cardiologist about your ongoing fatigue?

REPLY
2880 | @2880 | Aug 10, 2016
In reply to @audree "Did your cardiologist explain the cardioversion procedure? I was an emergency Afib patient on July 24,..." + (show)
@audree

Did your cardiologist explain the cardioversion procedure? I was an emergency Afib patient on July 24, 2015 and was cared for by an emergency doctor. He had me on cardizem 360 and lasix 160 and coumadin. I was miserable with hugely swollen legs (plus 3) and still in Afib. That doctor told me to go through the scheduled hip replacement surgery in Afib and then get a cardioversion later. When I saw my own cardiologist one month later (August 27th) in a different hospital and city he told me no surgeon would perform on a patient in Afib and I’d have the cardioversion immediately (September 11, 2015.) It was successful, heart back in rhythm, and I then had surgery October 19, 2015. I was 86 years old then and did not flip back into Afib during the surgery. You may want to ask your cardiologist if you are a candidate for cardioversion. If not, why not? <br><br>I got off the coumadin after 10 months because it was not compatible with my food requirements and I now take Pradaxa since May 10, 2016. Pradaxa has an excellent antidote and I have seen no side effects from taking it except it costs much more than coumadin. Report is that they are backing off of coumadin now because it can take up to 72 hours to stop bleeding. Much too long for safety.

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Hello ! <br>I am still on all drugs but have reduced Cardiazem to 120 mg -2x d .<br>Would love to not take that and the Flecanide - <br>Still in nsr but have a few palpatations in the evening .<br><br>

REPLY
grandmajan | @grandmajan | Aug 10, 2016
In reply to @grandmajan "I'm ok. Sorry to upset. I was looking for answers. If the pain returns I'll get..." + (show)
@grandmajan

I'm ok. Sorry to upset. I was looking for answers. If the pain returns I'll get help. I see the dr on Mon and will get more of my questions answered. I'm not sure that the Cardio-version is right for me. I used to drive mental health clients to appointments for shock therapy for bipolar and depression. Sounds similar. I will also start checking my mail everyday. Thank you for being concerned. Jan

Jump to this post

Was this your first Cardioversion?<br> <br><br>

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2880 | @2880 | Aug 11, 2016
In reply to @grandmajan "Well, no. Not after the Cardioversion attempts. I asked before hand if the reset would fix..." + (show)
@grandmajan

Well, no. Not after the Cardioversion attempts. I asked before hand if the reset would fix the pains. He said they were probably another issue and he could look for a cause after the cardioversion and a stress test. Very odd, since the attempt to reset my heart I have not had any (angina like) pains. Possibly anxiety.  I'm not having any luck with the Dr that has me on Prednisone. No response from her yet. <br> I would hope for a treatment like you are on,  with the least amount of surgical intervention and very controlled use of pills. Yet willing to work with me and  give me guidance.<br>I think that it might be helpful to find a Dr. that is not a surgeon?  <br>

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I had a Cardioversion last week and so far am in nsr but - now I have palpatations especially at bedtime .
I see an electrophisiologist not a cardiologist -
Am still on Eliquis , Flecainide & Cardiazem - which make me extremely tired and listless .
Try the electrophisiologist route - as they specialize in rhythm disorders.
Best of luck!!

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