"SPARKY"

Hello All,

Have had a-fib for about six weeks. It seems to be the persistent version. Will be having a Cardioversion wed @ 7am after an esophogeal echo. Current meds include warafin,100mg atenolol, 300mg flecinide... Strong, but we hoped to restore the sinus rhythm.. It is a little scary to think you will be jump started. Has anyone had the pleasure of this procedure? Has anyone had any luck restoring with natural means. I've thought @"static electricity" but am not sure how to try it. How will this affect the pm and should there be any changes in the settings. Should a Medtronic tech be there? Doc does not get along with Medtronic for some reason.
Any thoughts would be appreciated

Thanks -Philman

6 Comments

Thanks for the comments

by Philman - 2010-04-22 01:04:16

Hey Guys, You have lowered my fear factor. I'm not sure it is a-fib or a-flutter that has become my companion. I only know that it would always abate itself with a minimum dose of atenolol when I would feel it. When I noticed my hr at 70-80 instead of 55-60, that was the the tip-off .... it increased, and now I have to take a very strong dose of meds to keep in the 70-90 range. Does anyone know how to tell the difference between a-fib and a- flutter?

Thanks again for you help!
-Philman

Atrial fibrilation and pacemaker

by musser75 - 2010-04-22 02:04:03

Hi Philmann,
first let me tell you cardiovarsion is safe procedure. You will an anesthesia for app. 5 minutes. TEE ( esophageal echo) should be definietly performed bfore DC cardioversion to exclude a thrombus ( blood clot ) in the left atrium ( small chamber on left side). Atrial fibrilation causes wekening of your heart and reduces the pumping capability app. by %25-30. So you will experience shortness of breath during exercise etc. Ans if your atrial persist, you take warfarin life-time. warfarin is not a simple drug. It's like going on the edge of a sword :)).
You have not mentioned Your device type ( an ICD?? or pacemaker??). If it is an ICD, there should be definitely some one medtronic in order to do some arrangments because an ICD can sense the electric shock as an fetal arrthymia. If it is a pacemaker, there should be still someone from medtronic in order to adjust the device after cardioversion. If a patient develops atrial fibrilation, the pacemaker senses it and switches to an other mode which is called "VVI". This option is called "mode switch". If the cardioversion succeeds, it should be put on the "DDD" or "DDDR" mode. Otherwise atria ( small chambers) and ventricles ( large chmbers) won't contract in an appropriate sequence. In my practice, I do it on myself, becuase I have got a controller from medtronic.
musser75, md, cardiologist

I had several cardioversions in the 1st

by janetinak - 2010-04-22 02:04:32

year of my Afib. One lasted 24 hrs & boom it was back. So after lots of SOB & fatigue I went the AV node ablation & PM route. That was in 2000 & been good since. As Anne says they give you the good stuff IV, looks like milk, go to sleep & wake up fast. I had no problems with all 5 cardioversions, other than that they didn't work for me. I was a esp. hard core case, according to my doc's. I have heard & known lots of folks that it works 1st time & stays fixed or if not get another zap & it works then. Sure hope you are one of those. As I had PM after mine don't know what happens but I would trust my docs if they said they had to do it again.
Will be thinking about you. Let us know how it goes,

Janet

Had this last month

by nutria - 2010-04-22 09:04:13

Because my heart was in AV and they could not get me to "convert" with medication, they did a TEE (esophageal echo) and a cardioversion immediately thereafter. They gave me a mild anestisia and I dont remember a thing. They said they only had to "shock" my heart one time and it "converted". The procedure was no big thing. You can expect to be connnected to several pieces of equipment and lots of wiring will be connected to you and your chest. There were several techs and dr. around. At the time I had this done, I did not have a PM. My PM was just installed last week. Good Luck!

No worries

by Angelie - 2010-04-22 10:04:28

I've had to "jump starts" from having constant atrial flutter (a cousin to a-fib).

I got the propophyl as well and was out like a light for about 15 minutes and awake with no ill side effects at all. The cardioversion worked without any problems, but unfortunately returned the next morning. A-fib is A LOT harder to fix than flutter. I wish you great luck with trying to get a handle on it.

There is no need for a Medtronic tech to be there. Your doctor will know immediately whether you've returned to your paced rhythm. If there any complications from the cardioversion than he can always call the Medtronic tech in, but I had no problems at all with mine.

best wishes,
Angelie

I had this done

by Ashregan - 2010-04-22 12:04:13

Hi Philman,

Last year, for reasons that no one seems to be able to explain, I had a high ventricular rate after getting a pacemaker for bradycardia. Never had it before, and after an ablation, never had it again.

But at the time this thing happened, ie before I got the ablation, I had to have a cardioversion to stop the high rate---and that was funny too, I had no symptoms at all, just this fast rate--- but the consensus for what it was worth was that it should be stopped.

But you know, the cardioversion itself was really not much at all. They made me sign a lot of papers re obscure side-effects/outcomes, and they started me an iv and gave me "propofol" or whatever the Michael Jackson drug is called, and I was out for a very few minutes. And woke up feeling fine---I could see how poor Michael lliked this drug----and, specifically, with no arrhythmia remaining.. Went home right away although they didn't want me to drive, but I really felt as if I could have if needed.

So hope it goes as smooth for you as that. No effect at all on the pacemaker at least in my experience.

It's a wonderful time to be alive if you have heart problems, that's my perspective.

Good luck

Anne

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