Mechanical heart valves and PAF

Hi everyone,

Just curious if anyone has mechanical heart valves and PAF too. I’m a 41yo male who was diagnosed with PAF a few years ago.

Currently I am having 3 to 4 episodes of AF a week lasting between 30mins to 5hours. I am seeing an EP who is helping me adjust to my new increased dose of Sotalol 120mg twice a day. It has worked well and has kept my HR between 40 and 60 bpm. Prior to this increased dose my HR was sitting between 70-90, and when I would have an AF episode I would be at 140bpm easily for at least an hour.

I have discussed the idea of having an ablation with my EP as I’ve heard many positive experiences from people who have had the treatment. However, I was informed that due to my mechanical valves the procedure is a moderate risk. A risk my EP does not want to take due to the possibility that the ablation catheter may get caught in a the valves and break off and travel to other parts of the body.

I guess my question is, does anyone else here have mechanical heart valves and PAF and what sort of treatment options were you given from your EP.

[Hidden]

Perhaps try the BHF section of Health Unlocked. More on there have had valve replacements and may have AF too.

Pat x

[Hidden in reply to Hidden]

Thank you for your reply.

[Loukas]

I have had a mechanical mitral valve for five years now and was PAF free for three years which made me think I was cured. Not so...last year it came back with a vengeance and I needed a cardioversion then a year of taking Amiodarone which did work amazingly well, but, of course, has bad side effects. Last week my cardio stopped the Amiodarone and switched me to Sotalol which I hope will hold off the PAF. So far so good but it’s early days yet. No mention was ever made of having an ablation as an alternative but I will ask him on my next visit if this would be considered too risky.

[Hidden in reply to Loukas]

I’ve been on sotalol for two years now. I was originally on 80mg twice a day now I’m on 120mg twice a day. It’s working well so far. I have heard many bad stories about amiodarone and it’s effects on the body so I’m not keen to go on it.

Did you have the mitral valve replacement to fix the AF? I have read articles that say AF is a common side effect of valvular disease. I’ve had my mechanical valves since I was 17 and I haven’t had any issues with the valves, just this damn AF. What are your triggers? For me (like so many) it’s alcohol. It used to be anything cold (ice cold water, ice cream) but my increased dose of sotalol has fixed that.

[Loukas in reply to Hidden]

Very good to hear the Sotalol is working for you. I had a prolapsed mitral valve for many years but the valvular PAF only started about five years before I actually required the valve replacement. Before the surgery I initially took Metropol and then later Bisoprolol. I’ve never really been able to identify any particular triggers but I feel certain Novocaine caused the last episode when I needed a cardioversion.

[Hidden in reply to Loukas]

Thanks for your reply. It’s interesting that a local anaesthetic can cause an episode of AF. I’ve never required cardioversion because I’ve always reverted back to sinus rhythm after a period of time. How frequent are your episodes? Sounds like you are not having very many at all. That’s great!

[Loukas in reply to Hidden]

Before surgery it was fairly regularly but I always reverted back to sinus rhythm. The only episode I had after surgery went on for four days so I ended up in hospital where they did the cardioversion and loaded me up with Amiodarone which I continued on for a year. It really did the trick as I had no more episodes. Just hope Sotalol works as well!

[Hidden in reply to Loukas]

Sotalol hasn’t cured my PAF but it has improved. Negatives - I get dizzy spells occasionally and I’ve noticed that I’m more tired than usual. Positives - I haven’t had an episode of rapid AF since I’ve had my dose increased, BP is lower, I can enjoy a nice cold (non-alcoholic) drink. Lol

Good luck with your treatment and thank you for sharing your experience with me.

[Loukas in reply to Hidden]

Thank you, too.