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!

@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.
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.
I think that it might be helpful to find a Dr. that is not a surgeon? 

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Good afternoon @grandmajan, it’s great to hear that your angina-like pains have stopped. I hope you can talk soon to the doctor that put you on Prednisone; she may want you to scale it down rather than stop it abruptly. As others have told us here, Prednisone can be a big problem, and you would benefit from a good talk about it with her — why it was prescribed and what alternative medications might be considered. Has one of your doctors suggested surgery for your conditions? If so, what was suggested for you to consider? Do you still have an appointment with a doctor in about two weeks?

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@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.
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.
I think that it might be helpful to find a Dr. that is not a surgeon? 

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Hello Grandmajan,
It seems to me that you need a cardiac electrophysiologist. That type of cardiologist specializes in heart rhythm problems, the electrical system in your heart. My cardiologist (general- health of the heart), diseases of the heart) referred me to one for that reason. A cardiothoracic surgeon specializes in surgical procedures of the heart, lungs and other organs in the chest cavity. If you’re experiencing aFib I think you need to see a cardiac electrophysiologist. Seems to be the best person for the job!
Good luck,
Martishka

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@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.
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.
I think that it might be helpful to find a Dr. that is not a surgeon? 

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Thank You, I would never have found that specialty. I will look one up and then ask my Dr for a referral.

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@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.
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.
I think that it might be helpful to find a Dr. that is not a surgeon? 

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Hello, Yes, I still have the appointment with the Cardio Dr, a week from tomorrow. Need to see the Rheumatologist that put me on the Prednisone.  I was getting gel injections, instead of the usual Cortisone, in my knees. We opted to do 5 small injections, one a week. instead of one big injection in each knee.  After 4 weeks, I suddenly was in pain, couldn’t walk or hardly get out of bed. I even had to get a walker to get to the Dr. She put me on 40mg  Prednisone
By the end of the week I was getting better really fast. She told me I had an inflammation of my blood. Anyway, that’s why the pred.
No one even discussed what might be next. 

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I’m 42 years old in great shape (not running shape, but overall); 2 young boys, active, etc.. Recently diagnosed with Premature Ventricular Contractions (PVC), thus still learning about it. Had 7,500 PVC’s in 24 hours. Now trying to decide between meds or catheter ablation (burn or freeze). I’ve probably had it for awhile, but symptoms (light headed, shortness of breath, tired, short-term memory loss at times, etc.) have gotten worse over the past 6 months. I stopped alcohol, caffeine, and trying to reduce stress. Seems to help, but something will have to be done.

I have an appointment with an electrophysiologist in a couple of weeks, but may fly out to MN or FL to Mayo.
Any advice/suggestions appreciated. I’ve read through many comments on Afib (couldn’t find much on ventrical issues) meds, the ablation procedure, etc., but that just made things more confusing.

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@texas7777

I’m 42 years old in great shape (not running shape, but overall); 2 young boys, active, etc.. Recently diagnosed with Premature Ventricular Contractions (PVC), thus still learning about it. Had 7,500 PVC’s in 24 hours. Now trying to decide between meds or catheter ablation (burn or freeze). I’ve probably had it for awhile, but symptoms (light headed, shortness of breath, tired, short-term memory loss at times, etc.) have gotten worse over the past 6 months. I stopped alcohol, caffeine, and trying to reduce stress. Seems to help, but something will have to be done.

I have an appointment with an electrophysiologist in a couple of weeks, but may fly out to MN or FL to Mayo.
Any advice/suggestions appreciated. I’ve read through many comments on Afib (couldn’t find much on ventrical issues) meds, the ablation procedure, etc., but that just made things more confusing.

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Hello Texas 7777,
I was also diagnosed with PVC’s , however it was accompanied with SVT (very rapid heart rate- up to 220BPM), AF and atrial flutter. I am fine now! I was told that the
PVC’s were benign and there had to be a lot of them to warrant any concern. I am sure that with symptoms they need to be addressed. After my final ablation- a Pulmonary Vein Ablation, all the rhythm problems were gone and I am now off all my heart meds except for xarelto (blood thinner) and lipton. Apparently the cocktail of blood thinner and lipitor is the protocol for patients who have had PVA. After the ablation I wore a heart monitor every two weeks and sometimes for up to 7 days. I experienced a lot of PVC’s at that time and I felt very uncomfortable about them. MY electrophysiologist explained that it was a natural occurrence after an ablation and that it was benign. I am wondering if you have any other rhythm disturbances as well. I am not aware of the meds for PVC’s but if an ablation is a possibility I can answer some questions.
Good luck. martishka

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@texas7777

I’m 42 years old in great shape (not running shape, but overall); 2 young boys, active, etc.. Recently diagnosed with Premature Ventricular Contractions (PVC), thus still learning about it. Had 7,500 PVC’s in 24 hours. Now trying to decide between meds or catheter ablation (burn or freeze). I’ve probably had it for awhile, but symptoms (light headed, shortness of breath, tired, short-term memory loss at times, etc.) have gotten worse over the past 6 months. I stopped alcohol, caffeine, and trying to reduce stress. Seems to help, but something will have to be done.

I have an appointment with an electrophysiologist in a couple of weeks, but may fly out to MN or FL to Mayo.
Any advice/suggestions appreciated. I’ve read through many comments on Afib (couldn’t find much on ventrical issues) meds, the ablation procedure, etc., but that just made things more confusing.

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Hi Texas777
On this webpage you’ll find the contact information for all 3 Mayo Clinic campuses http://mayocl.in/1mtmR63

@cynaburst @predictable @lynnkay1956 and others can share their Mayo experinces with you.

You can also read more discussions in Visiting Mayo Clinic group https://connect.mayoclinic.org/group/traveling-to-mayo-clinic-minnesota/

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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 @frank4848. I moved your question over to an existing thread “AFib questions.” Here you’ll find several members who are discussing various conditions, procedures, recoveries, etc. Specifically, I’d like to introduce you to @cynaburst, @HeartPatches, @predictable and @mlemieux, who are all active mentors in the Heart & Blood group.

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

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@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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@patinhou

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

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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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@patinhou

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

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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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@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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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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@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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