Surgery and AFIB

[ajaxaf]

I'm due to have an open mesh hernia repair under general anaesthetic soon.

Since organising it with the consultant I have gone back into AFIB. I was 13 months into NSR with ectopics after a previous cardioversion.

My cardiologist gave the all clear but wanted me to increase bisoprolol from 2.5mg to 5mg per day but I really find this drug difficult. Tinitus, zombie head etc, so still only on 2.5mg.

Also wanted me to start on 125ugm of digoxin, but have not started that due to being preoccupied with trying to boost the bisoprolol.

I'm very anxious about the surgery anyway, but being back in AF has really ramped up my state of angst about the general anaesthetic.

Has anyone any experience of surgery under GA with AF and of a hernia repair in particular?

[BobD Volunteer]

Had this done a few yearas ago and it was a total non event. I was onlyy in for about five hours and two of those was waiting for pharmacy to bring pain kilers down. Recovery was very quick. The surgeron told me nothing I could do would undo his work so carry on as normal which i did. Re the AFthis is osmething the anaesthatist needs to deal with not you. so if they are happy to proceed then relax. Presumably they have discuussed anticoagulation with you?

[ajaxaf in reply to BobD]

Thanks for that BobD. That's very encouraging. But I assume then, that u were not on AF at the time. As u say best leave the decision to them. But i find it difficult to let go of my negative thinking.

[BobD Volunteer in reply to ajaxaf]

No during my ten years AF free . Also had much bigger (five +hours) radical prostatectomy about six months earlier with no problems. In fact suspect hernia was doing too much too soon after major surgery.

[Hidden in reply to ajaxaf]

Negative thinking is my worst enemy. Im a newly retired nurse so I tend to remember the ugly stories and think they will happen to me. Ive learned to meditate which helps alot. I listen to a phone app called Headspace, which got me going. The guy that does the talking is an australian(?) ex monk. Interesting what Ive learned about myself trying to calm my mind

[ajaxaf in reply to Hidden]

Hoski, I have been using Calm for meditation for 2 or 3 years now. It has helped a lot. Also use lots of meditation and relaxation resources on YouTube.

[Hidden]

I had the pleasure of having two surgeries in two weeks last sept. I had a lumpectomy planned when my gallbladder decided to leave me. I made it fine going under gen anesthesia twice. My biggest fear was being off anticoagulant three weeks in total. Good luck with your surgery. Positive attitude helps... you dont want your body to hear rumors you are stressed

[ajaxaf in reply to Hidden]

Thanks for your encouragement, Hoski.

[Hidden]

While in A/F I was given a General Anaesthetic while having a hernia operation. Tell the person who comes to your bed to take your details before your procedure, normally the (anaesthetist)all your concerns, tell him/her how you feel, ask him to keep your head raised while they administer the anaesthetic, in to your canular, don’t be afraid to ask questions, they will treat you with respect and understanding. I have had three GAs since 2014 all while in a/f plus one GA 2013 to fit a pacemaker. And remember nobody expects us to be without anxiety, I wish you the very best of treatment.

[Bagrat in reply to Hidden]

Lucky you having a bed pre op! Day cases here sit in a comfortable waiting area in chairs!

[Bagrat]

I had the same op as you in 2015. I was not in AF at the time. I was given a pressure dressing over the usual one and kept overnight. Felt fine. This year my husband had same thing but an epigastric hernia. He is in permanent AF and his pre op ECG looked like a car crash but anaesthetist unconcerned and he was home like Bob in hours. We are both anticoagulated so just different surgeons opinion. We have both been fine since.

[Ianc2]

Hi Ajax

had a hernia mesh implant in my right groin about 20 years ago I didn't have afib at that time. The operation was done under a local and my most vivid recollection was that I couldn't have a pillow. I watched as the incision was made and I could feel him rummaging around as they put the mesh in - somewhat strange. All went well and I was told to go home and put my feet up for a while and that was that.

A few years ago I went in for an ablation and a complication occurred - the tube to slide up to the heart could not get passed through the mesh. So all stop, have a rethink and then back through the left leg and all went well. Back into the ward for the entry point to congeal and the off home the same day

[Barb1]

I had an umbilical hernia op many years ago. Was in for 5 days. Looks like things have improved. I've had many GAs whilst in AF. The anaesthetist likes to see a current ECHO and ECG. I've only been refused once when my BP was sky high. Very unusual for me. It dropped tight down after the op! That was done under sedation.

[PengieP]

Well, I had a mini-maze procedure and ablations while in A-fib and I didn't really notice any effects of the anesthesia other than post anesthesia nausea and vomiting.

[ajaxaf]

Thanks to all of u you for your replies and encouragement. I'm working hard on the relaxation front every day right now. Ironically my opposite worry is that the AF symptoms, HR, BP will stop the surgery going ahead. You can never please a neurotic!!!

[ajaxaf]

Just an update if anyone is interested.

Went to my pre-op assessment. An ECG showed a ventricular rate of 130. The anaesthetist wanted a max of 90, so I was refused and the surgery has not yet taken place.

At the same time my anxiety was so high that my INR went up. Bleeding haemorrhoids, bloodshot eye, bruising around ankle. Went to anti-coag clinic (same day as I had my pre-op assessment!!) INR checked at 3.3.

I guess if I had started taking the Digoxin when it was prescribed things might have been ok. Taking it now. After a week ventricular rate was measured at 104 on an ECG. This was at a pre-assessment for a cardioversion, my second.

So if that is successful might get the op then. Tho it might throw me back into AF.

The hernia surgery is scheduled on an NHS referral to a local private hospital. Interestingly the cardio nurse said that the ventricular rate would have been ok at the NHS hospital and the private hospital was being very cautious.