AF and anaesthetics

[Mrspat]

Just looking to compare notes with anyone who has AF and has undergone routine surgery under GA.

I have permanent AF which is well rate-controlled with Bisoprolol and Digoxin. I have also had an aortic valve replacement due to a congenital condition.

I am scheduled to have a procedure on my tear duct (DCR) in a couple of weeks, carried out by endoscopy. Today I went for a pre-op assessment, which included an ECG. The technician, who incidentally was grossly overweight and had a smoker’s cough, looked worried throughout and asked me if I was feeling poorly. I could feel my heart bumping but it was only measuring 76 bpm and I felt fine. Failing to notice either the information on the ECG request form or the large scar on my chest, she asked if I had previous heart problems. She then said that she needed to go and discuss the result with her seniors. When she came back she said that they said it was OK but that she had thought I had experienced two episodes of block. I can’t read ECGs. I am hoping a doctor will.

I already lack confidence in this hospital - the nurse in the department didn’t know about the endoscopy procedure.

Has anyone here been refused surgery due to AF and a dodgy ECG? Or has anyone had a bad reaction under GA? Feeling very nervous. My tear duct problems are not serious but I’ve already postponed surgery once as the symptoms cleared up, only to return.

Thank you for reading this far.

[10gingercats]

Not sure how helpful this might be.I had a total hip replace last year following an accident......had Perm AF for several years and 'quite elderly'. No Gen. anastet. problems .I was 'out' for nearly 2 hours.All went well.I have tricuspid leak but I am generally quite well and only take Verapamil to control AF.It sounds as though you are lacking info. which can be worrying even for a minor op. Can your GP advise?

[pottypete1]

I can only tell you that I have had a 3 hour microsurgery operation under GA with no ill effects.

I have also had 4 AF ablations under GA where they had to induce and stop the AF regularly to enable the ablation procedure to be possible.

Again no problems.

Obviously I cannot comment on your particular condition I therefore suggest you insist on talking directly to the surgeon who is going to operate on your tear duct.

In addition it is customary for the anaesthetist to talk to you prior to an operation to ensure you will be safe as in the truest sense of the phrase “your life is in their hands”.

Pete

[PatWalsh010]

Hi Mrspat - when I had paroxysmal AF I had a GA and made sure to tell the anaesthetist when he came to see me before the procedure. He made a note of it and didn't seem concerned. The GA seemed to take ages to work and there was lots of chat and activity in the room. I seemed to be talking for ages and I even said will It ever work! We were all having a chuckle waiting and obviously it did work but whenever I have had a GA in the past it's been like bang, lights out so I think the anaesthetist intended to administer it slowly to prevent any sudden shocks that might trigger my AF.

i have had other things done since it has become permanent - approx 18 months now - and no problems. I have had sedation which very nearly knocks you out and no harm done. I always speak up and make sure they know about my AF but all anybody is ever bothered about is making sure INR levels are ok for anything slightly surgical.

Hope this is helpful and reassuring. Patx

[BobD Volunteer]

MrsPat I think the only person who can agree or not to the surgery will be the anaesthetist as it is he or she who is going to be looking after you during the operation/procedure. I do know of a lady refused a knee replacement op due to AF but she was over 80 I seem to remember. As I say really not up to the surgeon. When I had my prostatectomy they did indicate that they may have refused had I still had AF at the time but that was a five hour operation.

[Mrspat]

Thank you all. I think my anxieties boil down to:

What did the technician think she spotted, perhaps mistakenly, on the ECG? Does everyone realise that I’m having an endoscopic procedure and not an external tear duct procedure (which I realise is not as serious a problem as, say, having the wrong leg cut off!). Overall, I worry that not everyone involved has read all the relevant bits of paper....

[BobD Volunteer in reply to Mrspat]

Such a common problem I'm afraid. Not much joined up thinking anywhere these days.

[Oldcarol in reply to Mrspat]

Technicians sometimes are little more than the only person available to do a procedure. Don’t take much stock in he/she. U have a right to call your doctor and ask exactly what your ecg read.

[cassie46]

I have permanent AF and had breast cancer op in 2015. The anaesthetist at the time of the op said he would take extra care of me as I had AF. All went well, in fact I was up and about 3 hours after the op and had no side effects.

Cassie

[resqme1065]

I had an ablation in February and a t test in March. General Anesthesia. No problem. I am scheduled for a mitral valve repair/replace end of this month and no problems mentioned.

Curious about your tear duct issue I have had a blocked tear duct since July and I've read to unblock it you need lite sedation, maybe twilight which is how they performed a cath earlier this month. Is this what you have? Thanks

[Mrspat in reply to resqme1065]

No, I am having an endoscopic procedure under GA. They have to make a new tear duct rather than unblock the existing one. The surgeon told me it is a “very bloody” operation so I have to stop anticoagulation for 3 days beforehand.

[Thomas45]

I had an appendix out 10 days ago under General anaesthetic. The appendicitis came on 2 days before the op, when I was fully antocoagulated. I have persistent AF, permanent really. I went to an out of hours doctor on the Saturday lunch-time, and admitted to hospital at 3pm Saturday, straight on nil by mouth while they recoagulated me with loads of intravenous Vitamen K and another drug I didn't catch the name of. I had the op 2.30am Sunday morning by keyhole surgery. Towards the end of it my heart rate increased rapidly and I was sent to Intensive Care. I was woken up after 4 hours, my heart rate then at 170bpm. I was transferred to a general ward. After a few hours they realised that the machines I was linked to would keep everyone awake all night, so was transfered back to intensive care where they had quieter machines. Once my heart rate had fallen to below my previous 'normal' (88bpm) I was discharged. During my 3 day stay I had intravenous and oral antibiotics, and put on bisoprolol 2.5mg (no side effects so far).

I had superb care throughout. One doctor did remark that it was odd to have a patient who understood what AF is and how it's treated. I had said that I was concerned about the higher risk of stroke being coagulated and they were genuinely concerned.

[Jollies]

Had surgery 6 days ago under ga. Glad to report no problems and I am in permanent af x