Aortic Valve surgery

I had my aortic valve replaced ten days ago and two days after the op experienced atrial fibrillation (whilst still in hospital). I was put on an Amiodarone drip which eventually (after 2 hours) stopped the condition. When the drip ran out it was replaced by the tablet form of the same drug.

On leaving hospital I was given a prescription for these tablets (3 a day week 1, 2 a day week 2, and 1 a day week 3. (This is a very strong drug with the potential of causing liver and thyroid damage).

Has anyone had this drug and if so was it stopped completely after 3 weeks? If yes, did you stay free of AF?

[aika]

Hello Fossicking, I have been on amiodarone for 1 year so far to control ventricular tachycardia. So far all has been approving nicely the past year. At one point over the previous 2 years I was in the ER and hospital stays so many times when my defib discharged. Your doctor must do regular blood tests every 3 months to check your liver/kidney function. Also they have to periodically do a chest xray to check your lungs. This is a drug that is not for everyone which is why the constant checking. However I can say it has been controlling my heart. Be Well and take care and I wish the best for you.

[Hidden in reply to aika]

Hi Aika, Many thanks for your feedback. I had no feedback whatsoever from my surgeon regarding this drug nor from the hospital. To hear you have been using this drug for a year is reassuring and the three month blood test and periodic X-Ray is complete news to me. I have booked an appointment with my GP and will be very interested to see what he has to say. Many thanks, Mike

[Shar28]

Hello, my husband developed AF after his AVR too. In his case he needed 3x drip for 24 hours each which only very temporarily stopped the AF then. DC Cardioversion, which stopped it permanently. He came home on Amiodarone tablets for 6 weeks, gradually reducing. It stays in your system for about 6 months after you stop, so the protective effect lasts for quite a while.

Blood tests will check liver & thyroid function, so please try not to worry too much. If you have a predisposition to problems with either your liver or thyroid perhaps discuss closer monitoring with your GP.

[Hidden in reply to Shar28]

Hi Shar28, Many thanks for your response. It is interesting that Cardioversion stopped it. I suspect as in your case that it is used if Amiodarone does not work. How long ago did he have his Cardioversion out of interest?

Regards, Mike

[Shar28 in reply to Hidden]

Hi, my husband had the Cardioversion on day 4 of AF, which was day 5 after surgery. So he’s been clear for 18 months now. The chances are it was a one-off situation caused by the surgery.

[Hidden in reply to Shar28]

Many thanks for your quick response. Mike

[Hidden]

Hi,Yes I had a tumour removed from my heart nine weeks ago I too experienced arterial fibrillation, I was kept in ICU for eight days then on a normal ward for two days. When I was discharged I was given exactly the same prescription that you was.

I kept taking them ( one a day ) until I saw the consultant last week, six weeks after being discharged. I had an ECG and a chest X-ray. The consultant told me to stop taking the Amiodarone tablet and he saw the worry on my face ( I thought I would be on them for life) he said not to worry and that I didn’t need them anymore. I presume they did the trick of regulating my heart.

I too was told of the potential damage that they could cause and had a blood test two weeks after returning home.

All the best

Elaine

[Hidden]

Elaine, Many thanks for passing on your experience. I was never told by my surgeon about the potential side effects of this drug, but when I asked him what the chances of AF recurring after coming off Amiodarone the answer was "it is possible" but he could not tell me what the chances of this were. When I had AF (2 days after my op and still in hospital) I was extremely worried as I had no idea what it was. When the nursing staff attended and put me on a drip I was told "this is common and occurs in 50% of cases after AVR". In fact the correct number is 30%. Had either my surgeon or anyone else advised me of this before the op I would at least known what it was!

It is really re-assuring to get your feedback, especially as your surgery was so recent. Even now no-one even advised me to see my GP. Fortunately I had booked an appointment with him prior to my op so will be seeing him this Thursday.

It seems to me that HealthUnlocked is a godsend.

Kind regards, Mike

[chrisj68]

Hi I had my AVR op in April this year, your story is exactly the same as mine. I too went into AF approx 2 days after the op when back in the recovery ward. I also had the amiodarone IV drip and then was prescribed the tablet form in the descending weekly dose. I also was concerned about having this drug long term as I understand it has a few side effects. However, I am happy to let you know that after the third week of tablets my consultant advised me to stop the tablets as I had remained in sinus rhythm and have so since then - I am now 12 weeks post op. I hope my tale gives you hope that it’s not always going to be long term, I know I was pretty down at your stage when I thought that it might be. Good luck in your continuing recovery.

[Hidden in reply to chrisj68]

Chris, You have (in one post) cleared up all my specific concerns especially as your situation mirrored mine. In fact I had never heard of HealthUnlocked until I spoke to one of the cardiac nurses at the BHF. I was at a loss to know where to get specific information (neither my surgeon or the hospital could help) and here we have a classic example of how one AVR patient can provide this invaluable information to another.

I am so grateful. Regards, Mike.

[SerenK in reply to Hidden]

I have learned so much on here too, very helpful in understanding why they give certain medications. (I was alarmed when they said I must keep out of the sun when taking Amiadrone, as I was planning sitting in the garden )

[Hidden in reply to chrisj68]

Chris, Just one other question occurred to me. Last Christmas I had my prostate gland removed due to prostate cancer (a four hour operation). I was given 28 syringes containing heparin (an anticoagulant) to avoid post op DVT. I had to inject myself once a day for 28 days.

For my AVR there was no evidence of me having any anticoagulant in hospital and certainly not on discharge. (They may have used some during the op). Did you ever receive any anticoagulant whilst in hospital or for use after going home? All I received was two pairs of elasticated socks.

Regards, Mike.

[Hidden in reply to chrisj68]

I am now on the final 7 days of one (Amiodarone) a day but have to wait another 3 weeks for my consultant surgeons post op appointment (6 weeks after surgery). My GP advised me to keep taking one a day until I see the consultant. I have one question as I have read that the incidence of AF can be affected by age (I am 74). Are you much younger than me (I do not wish to ask you for your age!) I would prefer to stop taking this drug like yourself, and it is interesting that this decision came from your consultant.

Regards, Mike.

[chrisj68 in reply to Hidden]

I Mike yes I am a little younger - born in 1968.

I too had to wait for my consultant to prescribe me to stop taking amiodarone; the GP wouldn’t want to make that decision. I guess it just comes down to when you can get the consultant appointment

[Hidden in reply to chrisj68]

Chris, thanks for that. I will let you know how I get on.

Regards, Mike

[Hidden in reply to chrisj68]

Chris, Now that you are some way down the line, how is your general fitness -do you find it has improved post op compared with pre op? In particular are you able to exert yourself without getting too breathless.

I am approaching 7 weeks since my op and have seen no improvement and I wonder if it takes more time. One other question I have -when you had your follow-up appointment with your surgeon did you have any tests at the hospital (chest X ray, echo cardiogram etc.)? I have my appointment end of next week.

Regards, Mike.

[Hidden in reply to chrisj68]

Chris, Now that I am 3 months down the line since AVR I just wondered how you were feeling, particularly from a fitness point of view. Are you able to undertake a reasonable amount of physical effort without getting breathless (in comparison with your physical condition prior to the op? Or in other words, have you seen much improvement?

Regards, Mike.

[chrisj68 in reply to Hidden]

Hi Mike

Hope your recovery is going well. After 6 months I am quite pleased with mine, as I am now doing everything I was before the operation. I am able to do a similar gym session to before including indoor rowing and elliptical trainer and I am also back at work full time as well. I wear a heart rate monitor when exercising just to ensure all is ok and have also been on an exercise treadmill in cardiology with ECG connected and again results are fine. I am also on the NHS exercise referral scheme at my local leisure centre which helps keep my fitness up. I am looking after my diet etc so all in all feel fairly up beat

Hope this is useful for you and helps you be positive about your continuing recovery

Regards Chris

[Hidden in reply to chrisj68]

Chris, That was extremely helpful.

Kind regards, Mike

[seasider18]

AF is quite common after heart surgery over 333%. for some it rights itself for others Amiodarone does it but others need a cardioversion. My surgeon said the heart doesn't like being handled. I went into AF a couple of days after my aortic valve was replaced. They did a cardioversion that did not work and put me on Amiodarone that gave me a lot of problems until another cardioversion that did work three months later. However two later medical procedures that stimulated my vagus nerve put me back into AF.

[Hidden in reply to seasider18]

Thanks for your feedback. What is your situation now?

[seasider18 in reply to Hidden]

The valve is fine and I have an annual echo to check it. My AF is now permanent but I don't notice it. They say that another cardioversion will not work due to the size of my left atrium but if I have an ablation that may reduce the size and allow me to have a cardioversion. I said no to that and the EP asked 'Why do you want to be in NSR anyway"

I paid to have an Amplatzer amulet so that I no longer need to take Warfarin. Makers say NOAC's are contraindicated with tissue valves. Cardiologists say that is only because they have not been tested on us and they in their God like way can ignore that.

[chrisj68]

Hi definitely had daily anti coagulating meds in hospital due to inactivity of being in hospital (and the stockings) On discharge these stopped but I am now prescribed a daily preventative dose of dissolvable aspirin (75mg) - the stockings lasted until I regained ‘normal’ Mobility.

[Hidden in reply to chrisj68]

Chris, Thanks for that -I have a GP appointment on Tuesday and will mention this to him.

Regards, Mike.

[Ianc2]

If you are still on amiodarone did you get a care plan agreed between the hospital and your GP? I had my heart remodelled and a year later had an ablation which worked for a good while. May be worth considering. Unfortunately it has returned in a fairly gentle way which I am usually totally unaware of.

[Hidden in reply to Ianc2]

I managed to get off amiodarone after 3 weeks. Apart from the published side effects I did wonder if it also affected my heart's recovery. During that time I had occasional faint and dizzy spell as well as difficulty walking any distance. I am now almost six weeks down the line from my op and feeling almost back to normal. As for a care plan I got no help from the hospital or my GP so I organised my own by deciding to come off that drug, and asking my GP to organise an ECG and full blood test.

I do hope you will remain stable -I have come to the conclusion the heart is very resilient.

Regards, Mike