J
Jerome R. Long
Guest
This is a serious post for which I request serious responses. To some extent this post is also my
test to see if this newsgroup still has any serious value. So TROLLS go away!!!! Here is my problem.
I recently had a DC cardioversion that failed to last but a few hours.Now I am on 7.5 mg/day
coumadin with no noticeable symptoms of my atrial flutter, but wondering what is next and if the
condition is going to lead to heart enlargement and if I will ever be able to get off of daily
coumadin. OK, that was the short version what follows is the history.
During my most recent 6 months visit to my cardiologist for a stress echo test (which I passed very
well) we noticed that my normally low resting pulse of about 55 was up to about 95 and that my
electrocardiogram trace had many irregular QRS pulses with missing p-waves. This was diagnosed as
atrial flutter. My cardiologist recommended cardioversion. I am 68 years old and in generally
excellent health, but have a coronary stent which was put in three years ago after some bouts of
mild angina. I have had no angina since the stents. The stress echo was for the purpose of checking
the stents for any re-stenosis. The cardiologist took me off my daily aspirin and put me on coumadin
with weekly protime tests and dose adjustments until my INR stabiliized at 2.6. Then I went into the
hospital with a Holter and a 24 hour IV of Amiodarone. The Amiodarone did not convert me to normal
sinus rhythm, so I was wired up and anesthetized for DC electro cardioversion. This restored normal
sinus rhythm and p-waves and I was released from the hospital later the same day. By bedtime, the
beeps from my home blood pressure cuff told me the arrhythmia had returned. When I returned to my
cardiologist a week after the DC electro-conversion I still had the arrhythmia. My cardiologist
asked me, "When did this start?" I told him it happened within a few hours of the conversion. He
responded that new attempts after a first failure were almost never successful, so he took me off
the 50 mg daily of amiodarone and put me back on 7.5 mg daily of warfarin. He said to come back from
time to time to check the INR to make sure my blood would not form clots in the right atrium and put
me at risk of stroke. Then he said to come back in four months for a re-evaluation. I have no
noticeable symptoms of all this. I do not feel missed beat or PACs or PVCs and I can do heavy
sustained work without any problems. I do not understand where my p-waves went or what I should not
expect.One main concern is that this condition could lead to gradual enlargement of my normal sized
heart. The only other prescription drug I take is 40 mg Zocor, which has kept me on a good lipid
profile for over ten years..
test to see if this newsgroup still has any serious value. So TROLLS go away!!!! Here is my problem.
I recently had a DC cardioversion that failed to last but a few hours.Now I am on 7.5 mg/day
coumadin with no noticeable symptoms of my atrial flutter, but wondering what is next and if the
condition is going to lead to heart enlargement and if I will ever be able to get off of daily
coumadin. OK, that was the short version what follows is the history.
During my most recent 6 months visit to my cardiologist for a stress echo test (which I passed very
well) we noticed that my normally low resting pulse of about 55 was up to about 95 and that my
electrocardiogram trace had many irregular QRS pulses with missing p-waves. This was diagnosed as
atrial flutter. My cardiologist recommended cardioversion. I am 68 years old and in generally
excellent health, but have a coronary stent which was put in three years ago after some bouts of
mild angina. I have had no angina since the stents. The stress echo was for the purpose of checking
the stents for any re-stenosis. The cardiologist took me off my daily aspirin and put me on coumadin
with weekly protime tests and dose adjustments until my INR stabiliized at 2.6. Then I went into the
hospital with a Holter and a 24 hour IV of Amiodarone. The Amiodarone did not convert me to normal
sinus rhythm, so I was wired up and anesthetized for DC electro cardioversion. This restored normal
sinus rhythm and p-waves and I was released from the hospital later the same day. By bedtime, the
beeps from my home blood pressure cuff told me the arrhythmia had returned. When I returned to my
cardiologist a week after the DC electro-conversion I still had the arrhythmia. My cardiologist
asked me, "When did this start?" I told him it happened within a few hours of the conversion. He
responded that new attempts after a first failure were almost never successful, so he took me off
the 50 mg daily of amiodarone and put me back on 7.5 mg daily of warfarin. He said to come back from
time to time to check the INR to make sure my blood would not form clots in the right atrium and put
me at risk of stroke. Then he said to come back in four months for a re-evaluation. I have no
noticeable symptoms of all this. I do not feel missed beat or PACs or PVCs and I can do heavy
sustained work without any problems. I do not understand where my p-waves went or what I should not
expect.One main concern is that this condition could lead to gradual enlargement of my normal sized
heart. The only other prescription drug I take is 40 mg Zocor, which has kept me on a good lipid
profile for over ten years..