Went in to have knee replacement surgery last week. Got to theatre and heart rate was 140bpm so op was postponed. Problem now is I have to get AF stable before they will do my knee but having had ablation and cardioversion in the past both only lasted 4 months before going back into AF. As waiting lists are so long I could get AF under control and be back in AF before I can get op done.
Is there any longer lasting solution ?
I’m also on list for hernia op but same applies.
What do they mean by "stable"? WIll they perform the operations if you get your rate controlled or do they want you to be in NSR? If it's the former, which I assume, then beta blockers and/or calcium channel blockers should get your rate under control even if you're in afib.
Jim
Have a telephone appointment with cardio in a couple of weeks so will ask if medication will help . Can’t take bisoprolol.
Maybe I'm misunderstanding you, but are you saying that you will be in afib with a continuous heart rate of 140bmp for two weeks? If this is the case, I would not wait for your appointment but would head to the A&E right away and get your heart rate under control. There are other beta blockers besides bisoprolol to get your heart rate down as well as calcium channel blockers like Diltiazem, which I use. I would think being in such a high heart rate continuously for that long would be dangerous.
Jim
Sorry perhaps didn’t explain it well. My AF is all over the place it peaked at 140 but settled down to between 80 & 100.
Thanks for clarifying. Makes more sense now.
Medication wise, you could either take a chance that your heart rate will be under control at the time of the rescheduled surgery, or ask your doctor for different rate control agent like Diltiazem and hope it represses your peaks. Alternatively, you could schedule a CV say a week before the surgery.
There are also anti-arrythmic drugs like flecainide and Amiodarone. Either could potentially put you back in NSR, or hold you in NSR longer post CV.
You need a structurally sound heart to qualify for Flecainide but not for Amiodarone. Amiodarone is associated with more side effects, but taking it short term so you will qualify for your operation might make sense.
Jim
Hi Jim.
I am in persistent, rapid AF but WHEN EXERTION takes place.
At rest since December I have a resting of 93 on Diltiazem 120mg.
Persistent does not mean continuous.
On Metropolol 186
On Bisoprolol 156
Both average and at rest
but at night 48 average.
cheers JOY
Hi Joy,
The definition I'm using for "persistent afib" is afib lasting more than seven days but less than one year. "Lasting" by definition does mean continuous. Afib can be rapid or with a normal rate. Not sure what your situation is from what you posted.
Are you saying that your afib turns rapid when you exert yourself? If so, while not always, this is typical with afib. However, an ambulatory (moving around) heart rate on afib can usually be controlled by medications like beta blockers or calcium channel blockers.
When I go into afib, it's rapid until I take enough dilitiazem, a calcium channel blocker, to bring the resting rate down. Then I take a little metroprolol, a beta blocker, to bring my ambulatory heart rate down. Others here have different protocols.
Not sure if this is helpful or not, but again not familiar with your situation and maybe just a difference in definitions/terminology used.
Regards,
Jim
I cant take beta blockers -they make me really ill but calcium channel blockers work well and I feel fine on them.......hope you get sorted! How frustrating. I must admit my heart rate would be high before an op as I would be anxious though! Hope your consultation with cardiologist goes well. Make sure you tell them about your problem with beta blockers.....as its their go to first! I tried different ones they all did the same thing to me!
HiSame here.
Controlled on 120mg Diltiazem a.m and 2.5 Bisoprolol at p.m.
Night rate avge 48 with 93 at rest day.
chers JOY
My sympathies. This is the sort of thing that I worried would happen to me with my extensive history! I had 22nd dccv in June last year and 4th ablation late July. I had hip replacement 9 weeks ago and no sign of AF. The anaesthetist wanted me to gave an echo and cardiologist report before he agreed to the procedure though !
I am wondering if you are on HR control medication ..... like Bisoprolol ?
Can’t take Bisoprolol but will ask if I can try other medication.
Some of us who can't tolerate bisoprolol take diltiazem which is a calcium channel blocker. You might bring that up when you speak to your doctor. They may question taking two calcium channel blockers at the same time (amolodipine is also a calcium channel blocker) but I've taken both amlodipine and diltiazem together with my doctor's support.
Jim
I asked to have a cardioversion about a month before the surgery and as it was my second I was offered amiodorone for a few weeks before and a few weeks afterwards. I was lucky and didn’t get any bad side effects from the amiodorone and it kept me in NSR.
I only got as far as pre-op when AF raised its ugly head. Anaesthetist said forget it even though I paid for letter from Cardiologist explaining all would be well.
Hi Bowler60, are you in persistent afib? Although react well to catheter ablation/cardio version. There are other drugs such as digoxin which is not a beta blocker so your cardiologist I am sure will discuss.
Less well know in the U.K. is the option for surgery, this ablates the pulminory veins from the outside and also clamps the left appendage to vastky reduce the risk of stroke. The best information is on the. Wolf mini maze website (a slightly different procedure) or the Swiss ablation website (same procedure). Success rate for NSR is 85% plus after a year.
Hope you get under control so you can access the surgery you need
HiI'm 73
I was warned by the local anaesthetist that if I was over 100 North Shore hospital , the op would not go ahead.
Luckily back in December I was finally CONTROLLED with rapid persistent AF a private specialist put me on CCB Diltriazem.
I have stayed CONTROLLED on CCB @ 93 bpminute.
On the day I was 93 controlled at rest.
Also my night rate is 48 average at rest sleep.
Try CCBs. with your specialist.
Also cant have NATS and ended up with OXY-NORM and paracytamol 1.000 (2x500mg).
When I had a thyroidectomy I was not controlled but because it was cancer They went ahead. With a n extra surgical person in the room.
The later op took 1 hr. Removal of my TVT Johnson Johnson kit which was causing lots of inflammation.
I am also waiting for a shoulder repair.
Take careand get CONTROLLED first. You dont say what drugs you are on.
cheers JOY
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