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St. Jude Medical

October 21st, 2016
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Hi I suffer from paraxisimol AF and now I take warfarine but It is very difficult for me to maintain the range betwwen 2 - 3 . So can change it with the new brands thanks

2016-05-31 Answered By : Dr. Pete Weiss, MD

Answer:Hello! Several other medications have been approved for this use as an alternative to warfarin. The are effective and likely at least as safe. The most common barrier to use is often cost and insurance coverage. Please ask your provider about these alternatives.

I am a 60 yr old male with constant AFib for at least Two years with an average pulse of 60 in AFib. Four months ago I had an ablation and was back in AFib by morning. I was than put on a dosing of ticadin and cardio verted that day and failed to convert. I was than given Amiodorone at 800 mg a day for 30 days and cardio verted again and did go into normal sinus. I am now on 400 mg daily , I have had some instances of AFib but they were short and I seemed to go back to sinus. I walk 5 to 8 miles a day,is this drug save for me for any length of time? I have been on it for 4 months as of now.

2016-05-31 Answered By : Dr. Pete Weiss, MD

Answer:Hello! Amiodarone is quite commonly used in this setting, as it is the most potent of our rhythm control medications. This is especially true during the few months after an ablation where the inflammatory phase is resolving. However, toxicities have been very well documented. Usually these are quite rare with short term use. However, long term use can be quite problematic and requires appropriate monitoring. We always recommend that you discuss this with your prescribing physician.

Hi Sir, My husband has high blood pressure and also he has atrial fib and is on sotalol, still he was put on azor. afib twice he has been back in the last time has been 4 weeks still, yesterday saw cardiologist and wants to do another cardioversion he has had two in last 5 years, azor was ordered by primary doc, he did not talk about the since,i read that azor may interfere with atril fib ,is this true.plz tell me

2016-05-31 Answered By : Dr. Pete Weiss, MD

Answer:Hello! Azor is a combination of two commonly used classes of high blood pressure medication (Amlodipine and Olmesartan). It should not have much in the way of interference with Afib management. In fact, good blood pressure control will likely be beneficial.

my husband having Altert Fibralation, so am looking for homeopathic for that to avoid medition.With Aspirin 81mg, he don't want that Medication before Metropolol then changed to Sotalol, how can i do for it.He said like this, felling extra weight.He wants get only herbal pills for A-Fib

2016-05-31 Answered By : Dr. Pete Weiss, MD

Answer:Hello! The management of Afib requires good communication with your provider about treatment options. There are clear guidelines for care that have been published and that represent the best that we now know about management. Unfortunately little is known or has been demonstrated about herbal pills. Non-prescription strategies that are well established include exercise, weight loss and treatment of sleep apnea.

In 2010 i had open-heart surgery.For many years i had Atrial-Fibrillation, mitral valve repair, aortic valve replacement nd Mazz Procedure. I have taken Flexanide, Amirodione, Multaq and am presently taking Tikosyn.Ablation has been mentioned to me but I have concerns. How bad does the A-Fib have to be before Ablation is done.Is the A-Fib cause more damage to my heart?

2016-05-31 Answered By : Dr. Pete Weiss, MD

Answer:Hello! Your Afib is certainly complex considering your prior treatments. We have performed many catheter ablation procedures on patients who have had prior surgery such as yours. Success varies. If the clear goal is to maintain sinus rhythm, catheter ablation is certainly a consideration. Some patients have reached a point where there is not much chance of success, at which time we change focus to managing the afib with a rate control strategy (either with meds or AV Node ablation and implant of a pacemaker). The issues are complex. Please have an detailed conversation about this with your electrophysiologist.

He having atrial fibrillation, he has episodes every one to two years but this time after 6 months he had that episode.Totally fine my dad echo and he is taking very small doss of beta blockers and warfarin still not respond his body we ll to drugs but even he is not taking warfarin every day but every other day Just some answers please

2016-05-31 Answered By : Dr. Pete Weiss, MD

Answer:Hello! It is common for afib episodes to come and go for many years in many patients. Beta Blockers are quite safe and a fine place to start for folks who have rare events. Warfarin use must be closely monitored in order to be safe and effective. If not used properly, there is increased risk of bleeding complications which can be life threatening, as well as reduced effectiveness in preventing stroke. Please speak with the prescribing provider about making sure it is being used properly.

I have about 2 episodes of Afib per month. Each time I have polyuria with the episodes. My doctor says its due to Naturetic proteins. What can I do to stop the Polyuria? It is dehydrating me.

2016-04-04 Answered By : Dr. Y Madhu Reddy, MD, FACC, FHRS

Answer:Typically its does not dehydrate you. Its a natural response to you going into AFib. Afib increases pressure in your hearts upper chambers (atria) which releases hormones controlling the fluid levels in your body/blood vessels (called atrial naturetic peptide) and as a result you end up urinating more. Generally you urinate the extra fluid you retained when you go into Afib. So you are less likely that you are getting dehydrated. Its how your body controls fluid retention.

I am a 65 y/o male diagnosed with Afib 2 weeks ago after visiting a local ER. I am very active and have long history of athletics. I played D-1 college basketball, ride bikes, snow ski, etc. I had not been sleeping well for 2-3 nights and after my routine 3Xper week mile swim I went to ER. Diagnosis of Afib, treated with Metoprolol 50mg qd and Eliquis 5m qd. I went home after the ER visit and saw a Cardiologist the next day. 3 days later I had an Echo and although I don\'t have the exact report available the Cardiologist said my heart was very strong and all my valves were good. The left atria was enlarged. I am waiting 3 weeks to have a Cardioversion. I have lots of anxiety and uncomfortable feelings in stomach and can feel irregular beats. I hate the Metoprolol side effects. My pulse has been in the 60-80 BPM range and blood pressures in the 110-130 /60-80 range. Not sure I am comfortable with the Cardiologist I saw but he could be ok. He left on a scheduled vacation the week after I saw him. I am scheduled for office visit in a week and then cardioversion the next day. Any advice would really be appreciated this problem really has me worried. Thank you, Ken Krell

2016-04-04 Answered By : Dr. Y Madhu Reddy, MD, FACC, FHRS

Answer:Im sorry about how you are feeling. AFib is the most common arrhythmia and athletes have a slightly higher risk of having it. You clearly have symptoms from Afib. Your cardiologist did what we normally do for evaluation and treatment. Typical management includes short term and long term. For short term we recommend cardioversion. But since you may have a blood clot in your atrium, we do one of the 2 things. 1) we anticoagulate for 3 weeks and consider outpatient cardioversion. 2) We can consider TEE (ultrasound through the food pipe; an invasive procedure like an upper GI endoscopy) and cardioversion to make sure you do not have a blood clot. This can be done sooner than 3 weeks. Long term management would be based on how enlarged your atrium is and how likely you will have recurrent AFib. If your LA is enlarged, you are at a higher risk to have it again and may benefit from anti-arrhythmics which you have to be for long term (to decrease recurrent AFib). Other option is to consider AFib ablation. Sometimes this can be considered prior to failing any arrhythmic drugs also. However the risk benefit supports the procedure only if you have recurrent symptomatic AFib. Discuss with your cardiologist the long term options for your Afib.

I have paroxysmal afib and will be undergoing ablation soon. Will I continue on Tikosyn and Eliquis after the procedure?

2016-04-04 Answered By : Dr. Y Madhu Reddy, MD, FACC, FHRS

Answer:Typically yes for the first 2-3 months. Immediately post ablation, due to irritability of the heart, pts tend to have atrial arrhtymias which may or may not mean a whole lot in the long term. So we generally continue antiarrhythmics (Tikosyn) in your case for at least 2-3 months. After that based on how you do, we generally discontinue it. Eliquis is typically continued for the first 4-6 months. Long term Eliquis would be based on you stroke risk as defined by CHADS2Vasc or CHADS2 score.

I have PAF and use PIP for once a month episodes, my pip is 100mg flecanide, I had conflicting advice from EPs, one said I must take a beta blocker or calcium channel blocker before taking the flecanide to avoid 1-1 conduction and flutter, the other EP said no need to take, I would rather take the flecanide alone, because I have bradycardia, resting heartbeat in 40s and would like to avoid any unpleasant symptoms, I know patients who do that, is it ok to take flecanide alone to convert to nsr?

2016-04-04 Answered By : Dr. Y Madhu Reddy, MD, FACC, FHRS

Answer:We generally recommend taking AV node blockers (beta blockers) or calcium channel blockers with Flecainide even when using it a PIP to prevent the risk of 1:1 conduction. Having said that, if you are having resting bradycardia, and if your heart rates are not in the tachycardia range when you are in Afib, the likelihood of you going into flutter with 1:1 conduction is very low. Since its only PIP approach, it would generally safer to take at least one dose of a low dose, short acting AV node blocker and it should not be impacting your rates for too long.

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