Atrial Fib

[Larry]

Well this is interesting. I've had transient episodes of
Atrial Fib ... once in 1985 (resolved before I got to the
ER) and once in 1994 (took about 3-4 days on I think
Procainamide?). Last night, it happened again. I knew it
instantly. I am a 47 y/o male with no other hx of cardiac
problems. Cholesterol consistently in the 140-160 range with
HDL consistently in the 40-55 range. I run 1 miles @ 5.5 mph
on the treadmill 3X/week. Normal ECG every year at physical.
Echocardiagram in 1994 showed no abnormalities.

Went to ER last night. They spend 5 hours trying to get me
to convert, with no luck. CK-Total, CK-MB, Troponin all
normal. Administered Cardiazem IV 20mg followed by a drip,
and Corvert 1mg IV times 2. No luck, although they got my
resting rate down to 60-90 bpm. BP was about
120/60. They sent me home after consulting with on-call
Cardiologist who said that since I've had it twice
before, it would probably be ok to release me. I
asked them if I should get either Heparin or
Coumadin, and the ER doc said he didn't think I
needed it ... as I am a healthy 47
y/o. He gave me a Diltiazem CD Extended Release 240mg to
take once Saturday and once Sunday. Unfortunately
it's Saturday, so I'll have to wait till Monday to
see a Cardiologist. I'm ok, it's just that it's a bit
uncomfortable to have this "jumping around" feeling
in my chest.

Questions:

1. What should I avoid or limit over the weekend? The ER doc
said I could even do my treadmill run today, but I have
chosen not to. Do I need to stay in the house?
2. What is the drug of choice to convert AF?
3. Is it less likely that I will convert on my own over the
next few days since I didn't do so within the first few
hours after being administered Cardiazem and Corvert?
4. Would the next step likely be electric conversion, or
would I go for Ablation?
5. Any idea why this seems to happen in an otherwise-healthy
person once every 10 years or so?

Thanks for any help.

Larry

 

[listener]

On Sat, 13 Mar 2004 20:19:55 GMT, Larry <[email protected]> wrote:
>
>Questions:
>
>1. What should I avoid or limit over the weekend? The ER
> doc said I could even do my treadmill run today, but I
> have chosen not to. Do I need to stay in the house?

With your afib rate-contolled I would think you can proceed
as normal. I wouldn't drink tons of coffee or alcohol of
course and other such triggers.

>2. What is the drug of choice to convert AF?

There are quite a few, like sotalol, flecainide,
tikosyn, etc...

>3. Is it less likely that I will convert on my own over the
> next few days since I didn't do so within the first few
> hours after being administered Cardiazem and Corvert?

Probably so, but with afib you never really know.

>4. Would the next step likely be electric conversion, or
> would I go for Ablation?

That's up to you, really. EC is an option. Ablation is a
promising way to go but sucess rates vary widely (40-80%) so
you really have to do your homework on that. Some opt to
simply stay in rate-controlled afib, assuming they don't
feel the quality of life is diminsihed. The AFFIRM study
looked at rate vs rhythm control and surprisingly showed
that rate control is a positive option.

>5. Any idea why this seems to happen in an otherwise-
> healthy person once every 10 years or so?

Sorry, no.

Be sure to check out the Yahoo AFIBsupport group:

http://health.groups.yahoo.com/group/AFIBsupport/

It's a well run, moderated site with very helpful people
(over 1000 members at the moment).

L.

>Thanks for any help.
>
>Larry