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!

@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?

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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@audree, welcome to our convocation on sharing medical experiences and hopes for speedy help in making the best of them. I’m sure everyone here is glad that you signed in and contributed so much to alleviating our concerns.

The heavy doses of Cardizem and Lasix you received in the emergency room make it clear that you were facing severe conditions, and it’s encouraging that you did not get rushed prematurely into surgical procedures of consequence, largely because of your own insistence.

I was motivated to do some research by the comments you made about Coumadin, and would like to share 2 findings: First, the antidote for Pradaxa (which replaced your Coumadin) is Praxbind, given conditional approval last October by the FDA, but still in regulated studies and with limited use for only emergency surgery “in life threatening or uncontrolled bleeding.” As such, it may be misleading to call it “an excellent antidote” yet, since its excellence is still to be demonstrated.

Second, Coumadin is not being abandoned because it takes “up to 72 hours to stop bleeding,” but for other reasons of personal convenience of doctors and patients. In fact, “rapid reversal” in 10-15 minutes is expected with a combination of Vitamin K and the standard antidote or with frozen plasma injections, 4-6 hours with intravenous Vitamin K alone; it takes up to 72 hours only when Coumadin is omitted and wears off without any antidote added. Against that background, Coumadin remains a positive option for needed anticoagulants to prevent blood clots in cases of A-fib.

Your experience with an A-fib emergency and hip-replacement is heart-rending to hear, and it is reassuring to see your strength of character and the insights you developed and shared with us.

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Thank you, @martishka! I’m among “some of the people” interested in this technological therapy and will track down more information — for myself and for others. I doubt I’ll employ the therapy, because my hypertension is not so bad with my current meds, but that’s been somewhat unreliable, so I’ll welcome a solid fallback if needed.

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Thank you @predictable. When I was dealing with my heart rhythm problems I also did a lot of research trying to stay one step ahead
so that I always had a plan when the “what ifs” presented themselves to me!

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Is part of the Afib what feels like what I think is Angina.  Happens rarely and was always short lived pain. Last time on Mon, it lasted 1/2hr. usually in one side and or arm. This time it was center chest. I didn’t think to tell the cardio Dr about it when I saw him last week. It has been such a rare occurrence, and I felt overwhelmed with all of the new info.  So Is this going to make a difference in the outcome, plus someone said I also have a leaky valve.
Thank you so much for answering my questions as much as you can. I’m getting nowhere trying to get info from the Dr. 
Jan

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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@grandmajan, however rare is the pain in your chest, it is a serious symptom that the doctor should know about at the time. I’d call the doctor to talk about it now. If he/she can’t be reached when the pain occurs again, you should consider going to an emergency room. I’m neither informed enough or qualified to distinguish a transitional angina from a more serious heart problem. Only a doctor can do that. Can you make that call and, if necessary, get to the hospital?

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@grandmajan

I had the cardioverson attempt, it didn’t work. I will now be wearing a monitor. We are weaning me off of prednisone, that should take several weeks. I started on 40mg because I had polymyalgia rheumatica. I’ve been cautioned to be aware of the return of any symptoms I had before. I also have a leaky Mitral valve. Will that need to be dealt with before any further attempts to correct the AFib? I have found an Echocardiographic Dr, just need to get that arranged. Also looking at an Integrative medicine Dr. Your thoughts. I’m feeling much better. Have spurts of energy. Am more careful to not over due. Hopefully the monitor will give more clues as to what is going on. Thanks for your help.

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Hi @grandmajan, It can be overwhelming at a doctor’s appointment to remember your concerns when you’re also getting so much new information. Are you feeling this angina-like pain right now?

Like @predictable, I strongly urge you to call your doctor. Call him today. Is that possible?

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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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@grandmajan, you are so fortunate to have a doctor’s appointment so soon, and you have every good wish from us for a productive and reassuring talk. If it were me, I’d press the doctor for a thorough explanation of the difference between cardioversion applied to the heart and shock treatment applied to the nervous system. You can get a start on that discussion by googling “cardioversion” and getting a one-paragraph description right off. Is there anything I can do to turn up some information for you?
Martin

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@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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Hello Jan,
I am happy to hear that you are ok. I just wanted to comment on your thoughts about electrical cardioversion. It is nothing like shock therapy for mental health patients.

It is a procedure in which an electric current is used to reset the heart’s rhythm back to its regular pattern. Its low voltage and you are given meds so that there is no pain or
stress. My sister had it done a few months ago and her heart went right back into a sinus (regular) rhythm.
Its good that you are seeing your doctor on Monday.
All the best,
Martishka

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@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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Thank You for your response. Every one is a relief. I’m so glad that I found this thread for the Mayo Clinic.

Liked by Ali Skahan

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@predictable

@grandmajan, you are so fortunate to have a doctor’s appointment so soon, and you have every good wish from us for a productive and reassuring talk. If it were me, I’d press the doctor for a thorough explanation of the difference between cardioversion applied to the heart and shock treatment applied to the nervous system. You can get a start on that discussion by googling “cardioversion” and getting a one-paragraph description right off. Is there anything I can do to turn up some information for you?
Martin

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Yes, I really know that they are basically different.  I do have to make sure that the Dr knows about the Angina (if that’s what it is) pain and ask about the Mitral valve leaking. How will that effect the outcome.
Everyone has been so helpful and supportive. In my more calm moments It’s all good. I need to keep the fear at bay.  Thank  you for helping me do that.

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@predictable

@grandmajan, you are so fortunate to have a doctor’s appointment so soon, and you have every good wish from us for a productive and reassuring talk. If it were me, I’d press the doctor for a thorough explanation of the difference between cardioversion applied to the heart and shock treatment applied to the nervous system. You can get a start on that discussion by googling “cardioversion” and getting a one-paragraph description right off. Is there anything I can do to turn up some information for you?
Martin

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Hello Grandmajan,
Please let us know the outcome of your visit with the dr on Monday,
All the best,
martishka

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Yes I will. It’s not until 3pm calif time.

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@predictable

@grandmajan, you are so fortunate to have a doctor’s appointment so soon, and you have every good wish from us for a productive and reassuring talk. If it were me, I’d press the doctor for a thorough explanation of the difference between cardioversion applied to the heart and shock treatment applied to the nervous system. You can get a start on that discussion by googling “cardioversion” and getting a one-paragraph description right off. Is there anything I can do to turn up some information for you?
Martin

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Had my Dr appointment. He feels that the best treatment for now is the Cardioversion. He did answer all of my questions. Then if the Angina pains continue, we will look for a clogged artery or other cause. He did tell me when I asked if this is a fix or a patch. It is merely a patch. Most have to be redone. It could be a long time or not. In the meantime I will be exploring ways for it to be a fix. I apologize for not making a timely post. My family all came together yesterday to make sure that I have enough help after the procedure tomorrow afternoon.
So now my question to the community is , How many of you had have the Cardioversion re done and how long in between?

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@predictable

@grandmajan, you are so fortunate to have a doctor’s appointment so soon, and you have every good wish from us for a productive and reassuring talk. If it were me, I’d press the doctor for a thorough explanation of the difference between cardioversion applied to the heart and shock treatment applied to the nervous system. You can get a start on that discussion by googling “cardioversion” and getting a one-paragraph description right off. Is there anything I can do to turn up some information for you?
Martin

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@grandmajan, we are all rooting for success from your cardioversion procedure this week and for the later tests that will find out about the angina-like pain in your chest. I can’t claim any personal experience with cardioversion. My friend with advanced a-fib has had an ablation — more complex and invasive than cardioversion — and he is doing well now. He’s willing to have the procedure again, if his symptoms warrant it; he’s thinking it may be five years or more before he faces that decision again. Family care-givers are a great advantage for you, and your doctor’s forthcoming guidance must help you a lot.

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