post op atrial fibrillation

[Regeton]

My husband has just been admitted into our local hospital with atrial fibrillation. He’s 3 weeks post aortic valve and root replacement and had been doing well at home until today. The doctor we saw in A&E said something about cardio version which we had not heard of before. This has come out of the blue because the AF immediately post op had settled. How worried should I be?

[Douglas91]

please don’t get too worried about your husband’s A/F episode. Believe me it’s extremely common after heart surgery. It’s the heart complaining after having invasive treatment. It will probably settle down in a few hours. The medics probably will just monitor your husband without much intervention. Cardio version can use shock therapy but it can also just use drug therapy. They won’t immediately use electric shock unless it’s an emergency. They will try other options first. So don’t get too bothered.

[Cliff_G]

Hi Regeton,

As Douglas has said, POAF (post-operative AF), as it's called, is quite common. It's due to the heart tissue becoming inflamed by the operation which alters the tissues' electrical properties. Obviously unnerving, but I wouldn't worry at this stage.

Cardiologists are familiar with POAF and as said, options are to use meds and/or to do an electrical cardioversion. A common sequence is to try to steady the heart on medication first, then when that's had time to work, and if it hasn't worked on its own* then to do an electrical cardioversion. Once that's got the heart in rhythm again, the meds are withdrawn some time (e.g. 6 months) later.

(* I had POAF after my emergency operation for an aortic dissection, and to my surprise (long story), the meds converted me back to sinus (normal) rhythm without electrical conversion.)

A couple of things I have learned: some post-op meds, such as Furosemide, can deplete the body's potassium levels. Potassium is an extremely important part of keeping the heart happy. Although being in the normal range of 3.5 to 5.3 means the heart should be ok, there is good evidence that having a 'high normal' potassium (upper half of that range) helps to settle the heart. Potassium can be low for other reasons too. I have made sure I eat plenty of potassium containing foods, and this has helped my residual arrhythmia. Work with the doctors on this; ask what his potassium level is. (It also must not be too high, and some meds will do that, too).

Many people (incl. from my own experience) also say that Magnesium helps. I use a Mag Citrate supplement (an easily absorbed type). Finally, anti-inflammatory foods and even high strength vitamin C, and a good gut pre-biotic, can all help.

Best of luck. Let us know how he gets on.

[Regeton in reply to Cliff_G]

thank you for your reply. We are on a steep learning curve and everything seem very scary at the moment but your advice is very helpful.

[Wenlock]

My Wife had Cardio Conversion +3, In nhs hospital, She was so I'll after they forcibly 'discharged'..her I wanted to take her to the adjacent A+E, but she just wanted to 'escape'...and go home!!! We live near Aintree racecourse, feels like she "fell at Beechers Brooke". Be exceedingly careful, get a second opinion. Good luck from Wenlock.

[Douglas91 in reply to Wenlock]

gosh that’s a lot. I didn’t think that doctors liked doing more than one cardio version. I suppose sometimes it’s necessary. When you think about it electric cardio version puts the heart under an enormous amount of stress so it stands to reason that when you have it done it can make you feel horrible. It’s just the experts focus on the positive aspects of the procedure and there’s not much information about the negatives. I hope she will feel better soon. Fingers crossed for you both x

[Rosie1066]

I suffered from AF after open heart surgery for quite some time and it eventually subsided, which is quite common. I was fine until about five years ago when it reared its ugly head again and now I have AF weekly. But it is very common after heart valve surgery.