A-Fib and MAC

Posted by dbug7857 @dbug7857, Feb 15 6:35pm

I have had bronchiectasis for several years and recently diagnosed with NTM/MAC disease. I was also just diagnosed with A-Fib. Both doctors said there are very few medications that can be used to treat both conditions at the same time and I am wondering if anyone else is in this situation and what medications they are taking?

How did you get rid of your bronchiectasis ?

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I have not gotten rid of bronchiectasis and it is my understanding that once it develops you will always have it. It is a physical condition not an infection. But the doctor said that is probably why I got the MAC disease however because I also have A-Fib I am hesitant to start the treatment for MAC because the combination of antibiotics and A-Fib medication is contraindicated.

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Hello dbug. I’ve had a catheter ablation procedure to deal with AFIB. The only med I use is Eliquis, a blood thinner which, I’m told, reduces the likelihood of post-op stroke from 4% to 1%.

Re: MAC, the only meds have been antibiotics for acute bronchitis “flare-ups.” Happily since moving from 0.09% saline to 7% strength nebulizer inhalation I’ve had zero acute episodes. Bye bye antibiotics.

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dbug7857 I have both afib and bronchiectasis and Mac. I take Arikace for the Mac and xarelto and metoprolol for the afib. They seem to be conflicting conditions as far as medications and treatments go. The Arikace is an inhaled liposomal form of the antibiotic Amicacin and as such it is not systemic and does not interfere with the heart’s rhythm. It has helped to keep the Mac under control. I was told by a cardiac surgeon that I could not have an ablation until I got rid of the Mac because the mucus would interfere with the intubation and there would be no way to clear it. I still cough and bring up mucus when I lay flat for a while. If you have any more recent or different information please share your experience and what your docs have told you about treatments. Thanks, Candy

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@sounder27

dbug7857 I have both afib and bronchiectasis and Mac. I take Arikace for the Mac and xarelto and metoprolol for the afib. They seem to be conflicting conditions as far as medications and treatments go. The Arikace is an inhaled liposomal form of the antibiotic Amicacin and as such it is not systemic and does not interfere with the heart’s rhythm. It has helped to keep the Mac under control. I was told by a cardiac surgeon that I could not have an ablation until I got rid of the Mac because the mucus would interfere with the intubation and there would be no way to clear it. I still cough and bring up mucus when I lay flat for a while. If you have any more recent or different information please share your experience and what your docs have told you about treatments. Thanks, Candy

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Dear Sounder27, You Just imparted some great knowledge my way!!! Thank-you. I will surely pass along any information too. My Infectious Disease doctor was not in today, so will know tomorrow why I was never tested for MAC. As for the Pulmonologist, after the Bronchoscopy, he never answers calls. It is really weird, like what happened? It is always an answering machine, so I left a message kindly asking if he could test me for MAC. No response. Guess it is time to find a human-being for a Pulmonologist!

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@thumperguy

Hello dbug. I’ve had a catheter ablation procedure to deal with AFIB. The only med I use is Eliquis, a blood thinner which, I’m told, reduces the likelihood of post-op stroke from 4% to 1%.

Re: MAC, the only meds have been antibiotics for acute bronchitis “flare-ups.” Happily since moving from 0.09% saline to 7% strength nebulizer inhalation I’ve had zero acute episodes. Bye bye antibiotics.

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Thumperguy did you have the Mac when you had your ablation???? Has it stopped your afib attacks of tachycardia??? Are you able to lay flat without collecting mucus to set you to coughing?? I am wondering why they sent me home and would not perform my ablation. The anesthesiologist said if I went forward with the ablation that I would risk being on a ventilator!!

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@sounder27

Thumperguy did you have the Mac when you had your ablation???? Has it stopped your afib attacks of tachycardia??? Are you able to lay flat without collecting mucus to set you to coughing?? I am wondering why they sent me home and would not perform my ablation. The anesthesiologist said if I went forward with the ablation that I would risk being on a ventilator!!

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@sounder27 @cdee @dbug7857 – I don't have AFIB, so it wasn't a concern in treating my MAC. That said, I wonder if any of you have access to/have considered being treated by a facility with a multi-disciplinary approach, like Mayo, or a specialty in treating MAC like National Jewish Health? I am fortunate that my primary, Pulmonologist & ID docs are all in a clinical practice where they communicate with each other, and are not shy about consulting with experts when they are stumped. It made a huge difference in the treatment I received.
Sue

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@sounder27

Thumperguy did you have the Mac when you had your ablation???? Has it stopped your afib attacks of tachycardia??? Are you able to lay flat without collecting mucus to set you to coughing?? I am wondering why they sent me home and would not perform my ablation. The anesthesiologist said if I went forward with the ablation that I would risk being on a ventilator!!

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@sounder27 I also have bronchiectasis, MAC/MAI and aFib. I had the ablation surgery in Oct 2016, I had a lung surgery Dec 2016 (to remove a nodule), and just had gall bladder surgery this past Aug. I have received anesthesia and been intubated during the first two surgeries. I’m not sure about the last one, but I think that is standard procedure during any surgery. I do not take any antibiotics for the MAC. I use an Atrovent pump inhaler once a day, nebulize 7% saline once per day and lung clearance twice a day.
The ablation did stop the palpitations. I don’t take any blood thinners. When I was first Dx with the AFib, I was on Elloquis. After one month, I started “gurgling” up blood. I wasn’t coughing, it would just bubble up. Dr took me off blood thinner and that’s when I had the ablation. The hemoptysis continued until the lung surgery. Then it dwindled off. I’ve only had it happen a couple of times again since then but it doesn’t last very long and usually happens during allergy season. Obviously, we are all different, and our treatments are different, but I hope this gives you some comfort if you do decide to have the ablation.
Gina

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@thumperguy

Hello dbug. I’ve had a catheter ablation procedure to deal with AFIB. The only med I use is Eliquis, a blood thinner which, I’m told, reduces the likelihood of post-op stroke from 4% to 1%.

Re: MAC, the only meds have been antibiotics for acute bronchitis “flare-ups.” Happily since moving from 0.09% saline to 7% strength nebulizer inhalation I’ve had zero acute episodes. Bye bye antibiotics.

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Hi debug. Welcome to the world of bronchietasis, MAC, and Afib. As others have replied, also received pulmonary vein ablation, had mastectomy and most recently pneumonia, was ventilated nine days. The only antibiotic treatment was for the pneumonia. MAC has not be treated, was diagnosed in 2017. Take warfarin, sotalol for Afib, nebulize atrovent and use compression vest for bronchietasis. Have never had anesthesiologist comment on mucus congestion, and there’s plenty of it. Tussin Mucus & Chest Congestion liquid is excellent for thinning congestion. Wishing you well on your journey. Good health.

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@ginak

@sounder27 I also have bronchiectasis, MAC/MAI and aFib. I had the ablation surgery in Oct 2016, I had a lung surgery Dec 2016 (to remove a nodule), and just had gall bladder surgery this past Aug. I have received anesthesia and been intubated during the first two surgeries. I’m not sure about the last one, but I think that is standard procedure during any surgery. I do not take any antibiotics for the MAC. I use an Atrovent pump inhaler once a day, nebulize 7% saline once per day and lung clearance twice a day.
The ablation did stop the palpitations. I don’t take any blood thinners. When I was first Dx with the AFib, I was on Elloquis. After one month, I started “gurgling” up blood. I wasn’t coughing, it would just bubble up. Dr took me off blood thinner and that’s when I had the ablation. The hemoptysis continued until the lung surgery. Then it dwindled off. I’ve only had it happen a couple of times again since then but it doesn’t last very long and usually happens during allergy season. Obviously, we are all different, and our treatments are different, but I hope this gives you some comfort if you do decide to have the ablation.
Gina

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Ginak hi Gina, these posts have been eyeing opening for me. I feel like there are more options available now. I’m so grateful to dbug for posting and having all this information revealed as a result. Thank you all for sharing your experience.

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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.

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@anonymous217382

Dear Sounder27, You Just imparted some great knowledge my way!!! Thank-you. I will surely pass along any information too. My Infectious Disease doctor was not in today, so will know tomorrow why I was never tested for MAC. As for the Pulmonologist, after the Bronchoscopy, he never answers calls. It is really weird, like what happened? It is always an answering machine, so I left a message kindly asking if he could test me for MAC. No response. Guess it is time to find a human-being for a Pulmonologist!

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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

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