Knee replacement op

[rothwell]

Well I went into hospital at 7 this morning. Had discussion with anaesthetist and decided on what type of anaesthetic. Discussion with surgeon etc etc. Operation scheduled for 11.30.

At 9.30 went into Afib and was sent for ECG .

After long wait, had ECG ...back in nsr. Went back to ward and after 10 minutes Afib kicked in again.

Following discussion with anaesthetist, agreed with her that surgery would be too risky because trauma and possible blood clots. Sent home.

Now have to get AF under control as I have more than one episode every day.

A few months ago my EP suggested Dronedarone but I am concerned about side effects on liver, kidneys etc. Anyone taking this and if so, any side effects?

I am on list for second ablation.

Bit fed up as was looking forward to new knee but getting AF under control now a priority. Currently taking Bisoprolol and Apixaban.

Should I try Dronedarone and is this less "toxic" than Flecainide?

[rosyG]

Hi Rottweil,

I'm not on any news except Apixaban but just wanted to say sorry you had your op cancelled- very wise but disappointing for you. I hope you get AF sorted

[Maureens46]

Sorry to hear of your disappointment rothwell.As someone who has had two knee and one hip replacements plus an Ablation my advice would be , get your heart sorted first and try and injure the crippling pain that accompanies knee problems. I can't offer any advice on your choice of medication, but I would always discuss with your GP and Cardiologist. Hope your Ablation is successful.

[BobD Volunteer]

Multaq (dronedarone) was hailed as the great hope for AF when it came out some years ago .It is a little brother of amiodarone without the iodine so less toxic. Unfortunately because of all the publicity lots of patients demanded it with the result that some (notably in USA ) who were unsuitable for the drug got it and became ill , As a result it fell out of favour but I have noticed a resurgence in prescribing it of late. My understanding is that provided that regular liver and kidney checks are done there should be no problems.

Do note that it is an antiarrhythmic drug so a rhythm control one unlike bisoprolol which is a rate control drug. As far as comparison with flecianide goes ,toxic is not a word I would use but yes all drugs can have side effects the only one which doesn't being amiodarone which has effects! Since we are all different there will always be those for whom a drug is not suitable.

[Hidden]

Hi, what rotten luck, so sorry for you, highly disappointing I do understand.

Matter of interest did you decide on a GA or local ?

John

[rothwell in reply to Hidden]

I decided on spinal anaesthetic with sedation on recommendation of the anaesthetist.

[WallMatt in reply to rothwell]

That is how we did my knee replacement two weeks ago. Multaq had controlled my syptoms but had been in such frequent afib that I had ablation 5 months ago and did fine. Surgeon had decided to use nerve block to control knee pain post op but that didn't work at all, had no feeling in the leg and discontinued early instead of going home with portable version. Don't recommend that option

[jedimasterlincoln]

Argghh no! I let out an audible tut of exasperation here at your situation!

I was on dronedrone when nothing else worked, back in 2013/144. As people will tell you it wasn't the golden pill everyone was hoping for. I had to had regular LFTs (liver function tests) to make sure there weren't any ill effects (there weren't) and I don't remember any particular side effects once it was in the system and running, the tiredness and fatigue has been present regardless of the drug.

[rothwell in reply to jedimasterlincoln]

So is there any drug which can help with rhythm control. Of the 3 that I am aware of....Amiodarone, Dronedarone and Flecainid, they all seem to have really damaging side effects.

[jedimasterlincoln in reply to rothwell]

Yes they all have side effects but can be monitored. All drugs have side effects, in fact if you looked into paracetamol in depth and saw what "could" happen when taking it you probably wouldn't either.

[Cally53]

I'm not surprised that you're feeling fed up, I would be too.

I have a pre op appointment for my knee replacement tomorrow, I don't have a date for the actual op yet though! I am currently getting AF anything between 1 and 2 weeks apart and take flecainide as a Pip.

I hope that I don't fall into it on the day I have my knee done, the pain is definitely getting me down now.

I'm also on the waiting list to see an EP to discuss ablation.

I hope you get your AF under control so that your op can go ahead as soon as possible.

[Barb1]

I had spinal anaesthetist and sedation for a back operation last November. I was supposed to have GA but my heart beat was fast and erratic with sky high BP, so they wouldn't do the GA. I am just glad they went ahead with sedation, even though it was an experience that I would not want to repeat.