Hi
I had a CABG X2 and a mitral repair on 19 Feb 2019. 11 days post Op I developed AF. I am on a Beta Blocker and Blood thinner. The cardiologist has mentioned a cardio aversion if the medication doesn’t stabilise the heart rhythm and high pulse.
Does anyone have experience of Cardio. Aversion, and any views in it success rate long term.
I was a fit healthy man of 52 I recovered well post Op and the AF came as a surprise.
It's called cardioversion. It's where they shock the heart and sometimes a normal rhythm is restored.
I have had quite a few , first one I approached in trepidation but its such a relief to be in sinus rhythm that I would never hesitate to have another cardioversion if required.
Dont leave it off if the drugs dont get you into normal rhythm .
Success Depends very much on personal circumstances, it is usually the intervention used after drugs and before ablation. It didn’t work for my husband but has worked for very many people who post. It does however indicate whether or not you are able to be converted to NSR. It looks as though for my husband it may be permanent but he is much, much older than you and age does make a difference.
The only way is to know is to try.
any views in it success rate long term.
Just my experience its been successful every time - its just I have been a slow learner about what not to do once in NSR. I've had no AFIB for three and a half years now by being sensible with what I eat and do.
OK so you had cardioversion a number of times, what lessons did you learn between the various sessions? what did you not do once in NSR to maintain that confutable rhythm.
My original thoughts ( all in hindsight ) was I dont have AFIB , it was all just a once off and I can continue doing what I always did. Soon found out that those little palpitations I used to get when eating food with MSG or sulphites were not just a warning but also the precursor to going into AFIB . Because I was quite a long time in NSR it took two of these occurrences before I fully realized the value of the warnings.
All my attacks have been linked to bodily reactions to four ingredients so I have stayed away from them totally.
Insecticides - household surface spray
MSG - Chinese food
Sulphites - wine , cider and beer - preservative also cured meats and dried fruit.
and something you would never , 99% of people would never come in contact with was the carrier agent for back lining sheep - for lice
Just the fumes could start my heart palpitating.
You have probably realized my experiences as a farmer are outside the average member of this association in the exposure to chemicals.
The meal I had in hospital after having my pacemaker fitted was not the chicken casserole I expected but rather orange and full of MSG. I had an immediate reaction to it.
I went into AF after having my aortic valve replaced. I was surprised as all my pre op research did not mention the possibility nor had the surgeon. Evidently it happens around 30% of the time. Some go back into NSR after a day or so others need medication but stubborn ones need a cardioversion. I had a cardioversion around day four that did not work. I was put on the dreadful drug Amiodarone for about three months prior to a then successful cardioversion. It was fine for fifteen months when another non cardiac procedure put me back into AF.
I think that when AF has been induced by your surgery cardioversion is more likely to succeed than if it developed by the usual means.
Thank you very reassuring. And sounds feasible to me. Stressful all the same.
There are two types of AF that you can look up to explain the difference Valvular and non valvular.
Hope the rest of your post op recovery goes well. Soon they will have you at Cardio Rehab.
In some countries they put patients on Amiodarone as a matter of course for a while after surgery to prevent AF. Some surgeons remove the left atrial appendage during surgery as a precaution against blood clots forming in it and removing the need for 'blood thinners' if in AF. It is more usual evidently after mitral valve surgery than atrial valve as it is more easily done during mitral valve replacement.
Makers say that NOACs are contra indicated for patients with replaced tissue atrial valves although some cardiologists disagree. I'm not sure what the case is with mitral valves.
Yes, your AF after a heart procedure is not uncommon. It's even termed POAF, or post-operative AF. I had AF for years before my ablation, then 15 years later had POAF 1 week after a large heart/aorta op. One common methodology is you go on amiodarone for a while (weeks or a month or two), then get a cardioversion. Amiodarone is the best anti-arrhythmic med in terms of conversion, and the one most likely to hold you in NSR after a cardioversion (if it doesn't already convert you). If successful, what you're then waiting for is for the inflamed and "remodelled" heart muscle ("AF begets AF") to remodel itself back again to normal. After some months back in NSR, then you might be able to come off the amiodarone. Amiodarone is a drug with a big fear factor, but it takes a fair while to get to any of the bad side effects, and this is only in about 20% of cases. With thyroid and other tests regularly, you and your doctors will get to know whether you are reacting to it. I have been on it nearly a year and my 6 month and a couple of other tests have shown I am not having any change in my thyroid function. Good luck
Yes, thanks, back in NSR, albeit at a very slow rate (45 or so)! Bisoprolol is pretty much always "effective", but the problems are (i) what dose do you need before it has its rate-slowing / anti-hypertensive properties - some get away woth 1.25 mg, some need 10 or more (ii) what dose can you withstand before it slows you down too much and makes you so sluggish you can't function / are dizzy too often (and is this above or below its effectiveness dose) and (iii) if your objective is to get out of AF, back into rhythm, it's my *personal* opinion that beta blockers are not the right meds for that, you need a proper anti-arrhythmic, flecainide, amiodarone etc. Beta blockers really only slow the rate (very important with some folk at a very high AF rate) and reduce the force of the heart's pumping; if they convert you, it's fortuitous, IMO. Problems with "proper" anti-arrhythmics are (a) they're not always very effective (b) they can have pro-arrhythmic effects. Quite a tricky thing all round! Good luck to you
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