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Bop Bop 10-28-04 06:06 PM

Fox,

Great news sounds like you are make solid choices.

DnvrFox 10-31-04 08:44 PM


Originally Posted by cbhungry
Came onto to this late.

First of all, atrial fibrillation confers a five fold increase in risk of stroke and studies with other blood thinners, including asprin, just don't hold up when compared to the efficacy of coumadin. With that said, it is a difficult and dangerous drug and must be monitored carefully on a monthly basis and is affected by vit k rich foods. However, should you have to stay on a blood thinner (if the cardioversion does not work) there is another alternative that has been out in europe for a long time and is making its way here. http://www.drugdevelopment-technolog...ojects/exanta/

Exanta does not need the monthly monitoring and is not affected by vit k rich foods. Thus, it is not prone to flucuations that are inherent to a drug such as coumadin since it is a direct thrombin inhibitor. It has been well studied in atrial fibrillation and stroke prevention.

It appears that Exanta is not going to be available for awhile, having been rejected by the USA

http://edition.cnn.com/2004/BUSINESS...razeneca.reut/

DnvrFox 11-09-04 08:59 PM

Brief update.

1st, and most importantly, I went for a wonderful 15 mile ride today. Weather was cool, which I enjoy. Took my heartrate going up a hill and it was 80 (remember I am on a heavy dose of beta blockers, but, still it was very heartening!)

Okay, now to the less important stuff.

Had my appointment with the cardiologist today. WOW, what a difference from the Kaiser-Permanents docs - you may remember that they refused me a visit with a cardiologist. Really nice, knowledgeable guy with a nice sense of humor.

I had a list of 14 questions, all of which he answered. Some good things that I wasn't sure about - I am likely to live about as long as I would without the AF, assuming I take care of myself and the AF; Exercise is GOOD - I was worried that I might get too exhausted, hurt my heart, etc.; there is an alternative to coumadin on a drug trial basis for which I might be considered - everything will wait upon the results of the cardioversion, and a bunch more information which greatly relieved my anxieties.

So, next week we will try an electric cardioversion, which requires a general anesthetic, and then they put paddles on my heart to try to get the heart back in rhythm.

1st time we will try it with no special drugs and see what happens. Chances are about 25-50% that it will work and last 1 year or more.

If the 1st time doesn't take, we will consider another cardioversion with drugs (these drugs have some major, nasty side effects).

Anyway, I was GREATLY pleased by the appointment, and I feel comfortable riding my bike as much as I want within reason. I have to remember that I am sort of operating on 3 cylinders rather than 4, and that I am on drugs which really slow down the heart rate. But, so far, in my riding, I have not gotten winded or even tired!

Have a great day, everyone!

dharleyd 11-09-04 09:22 PM

have you talked with a cardiologist about an ablation. i just finished the holter monitor for 24 hours. if that results are the same as last months i believe i will have the ablation. the need for for bata blockers will gone. i have had the pacemaker put in to control the low resting heart rate. maybe then will get back to somewhat normal.

DnvrFox 11-09-04 10:39 PM


Originally Posted by dharleyd
have you talked with a cardiologist about an ablation. i just finished the holter monitor for 24 hours. if that results are the same as last months i believe i will have the ablation. the need for for bata blockers will gone. i have had the pacemaker put in to control the low resting heart rate. maybe then will get back to somewhat normal.

I guess that I wouldn't go that direction until I see that the cardioversion(s) don't work and I can't control the heart rate, which I am now. I have read there are some significant dangers involved with the ablation, but have not yet fully investigated. Right now, I feel as if I am doing pretty well - let's see about the CV next week! My resting heart rate is fine - about 72.

I have not yet used a Holter monitor - perhaps because the AFib is continuous, so we all know what is going on all the time!

DnvrFox 11-16-04 07:58 AM

I am scheduled for my electro cardioversion on this Thursday at noon. They give me a full anesthetic which only lasts about 10 minutes, and then they will zap my heart.

They will be using one of the newer "biphasic" machines, which is supposed to have a higher rate of success than the monophasic machines.

Just a bit scary! :eek:

Stubacca 11-16-04 10:16 AM


Originally Posted by DnvrFox
I am scheduled for my electro cardioversion on this Thursday at noon. They give me a full anesthetic which only lasts about 10 minutes, and then they will zap my heart.

They will be using one of the newer "biphasic" machines, which is supposed to have a higher rate of success than the monophasic machines.

Just a bit scary! :eek:

Good luck!

My mother had an electro cardioversion done about 6 years ago - procedure went entirely to plan.

DnvrFox 11-16-04 10:19 AM


Originally Posted by Stubacca
Good luck!

My mother had an electro cardioversion done about 6 years ago - procedure went entirely to plan.

That is good news!

Is she still out of AFib?

Stubacca 11-16-04 11:07 AM


Originally Posted by DnvrFox
That is good news!

Is she still out of AFib?

Interesting question....

Was just checking dates, and she would have had it six years before she passed away. She did remain out of AFib for the whole six years, though, before an unrelated long-term illness finally overcame her.

cbhungry 11-16-04 11:34 AM


Originally Posted by DnvrFox
I am scheduled for my electro cardioversion on this Thursday at noon. They give me a full anesthetic which only lasts about 10 minutes, and then they will zap my heart.

They will be using one of the newer "biphasic" machines, which is supposed to have a higher rate of success than the monophasic machines.

Just a bit scary! :eek:


good luck!

Prosody 11-16-04 06:33 PM

Good luck. Hope they rip the adhesive thingies off before you wake up.

DnvrFox 11-18-04 06:45 PM

Had the CV done today - lasted for about 3 hours, then I went back into some other rhythm. Will have an ekg tomorrow to find out exactly what rhythm.

Talked with the cardiologist, who was not discouraged, stated this is not unusual, that my heart has been beating out of rhythm for some time, and that it may take a couple of CV's to fully establish the proper rhythm - sort of retrain the heart. He will likely put me on some antiarhythmic drugs, depending upon the results of the EKG. It is also possible the heart will reset the rhythm by itself, although I feel that is unlikely.

Wish it had taken fully the first time!

UPDATE:

Okay, after EKG today, Doc put me on Rythmol drug.

DnvrFox 11-22-04 08:35 PM

Going in for my 2nd cardioversion tomorrow at noon, after several days on the drug rythmol.

Prayers and positive thoughts greatly appreciated.

This is important, especially as right now I have lost about 20-30% of my heart output, a loss I DO notice!

Bop Bop 11-23-04 06:11 AM

Fox,

We are hoping and praying. Just take it one step at a time. Listen to the doctors, I'm sure it will all work out in your favor.

Stubacca 11-23-04 10:04 AM

Many positive thoughts coming your way... I'm sure everything will go smoothly!

DnvrFox 11-23-04 03:53 PM

They tried 3 times, but the cardioversion did not work. This time another anesthetist used a different anesthetic that hurt like he!! WOW!

They put me on a new med for 3 weeks, then we will try the CV once more.

If that doesn't work, either ablation therapy with a catheter through my pulmonary vein into the heart or learn to live with it!

jazzy_cyclist 11-23-04 04:39 PM

Hang in there! We are all pulling for you.

Stubacca 11-23-04 04:41 PM

Sorry to hear it didn't have the desired effect this time, Denver. Thoughts are with you hoping the next plan of attack sorts it out!

jgeezer 11-23-04 08:25 PM

Sorry to hear about the failed cardioversion. I have been living with the paroxysymal version of afib for about 6 years. Mine is controlled with a calcium channel blocker. Since the advent of the Calcium meds I have had no episodes. Prior to these meds we tried to control it with Digoxin. That didn't do the trick but even though the episodes occured I have never needed to have a cardioversion. My cardiologist has me on childrens aspirn.

Regarding the ablation there are two types available the first uses a cauterizer that attempts to "burn" the area of the AV node that is the problem. The second is a cryogenic version. The people that I know that have had this done seem to have good results. As the procedure was described to me you are awake and the cardiologist stimulates various places in the AV node area to try to throw the heart into arythmia. Having found the area it is then cryogenically destroyed.

This may be an option you want to discuss with your cardiologist. By the way I'm glad you stuck to your guns on the cardiologist, mine has helped me tremendously.

Good Luck

DnvrFox 11-23-04 08:32 PM


Originally Posted by jgeezer
Sorry to hear about the failed cardioversion. I have been living with the paroxysymal version of afib for about 6 years. Mine is controlled with a calcium channel blocker. Since the advent of the Calcium meds I have had no episodes. Prior to these meds we tried to control it with Digoxin. That didn't do the trick but even though the episodes occured I have never needed to have a cardioversion. My cardiologist has me on childrens aspirn.

Regarding the ablation there are two types available the first uses a cauterizer that attempts to "burn" the area of the AV node that is the problem. The second is a cryogenic version. The people that I know that have had this done seem to have good results. As the procedure was described to me you are awake and the cardiologist stimulates various places in the AV node area to try to throw the heart into arythmia. Having found the area it is then cryogenically destroyed.

This may be an option you want to discuss with your cardiologist. By the way I'm glad you stuck to your guns on the cardiologist, mine has helped me tremendously.

Good Luck

I am on beta blockers, digoxin, coumadin, lopressor, diovan (I believe this is an angiotension receptor II). HCTZ, and as of this evening Paceron - a powerful and somewhat scary medicine.

I feel like I am running a drugstore. Besides slowing the heart and lowering the blood pressure, they are not yet helping with the Afib. My AFib is constant.

I am investigating the ablation therapy, and really thank you for the cryogenic words of wisdom.

DnvrFox 11-24-04 05:46 PM


Regarding the ablation there are two types available the first uses a cauterizer that attempts to "burn" the area of the AV node that is the problem. The second is a cryogenic version. The people that I know that have had this done seem to have good results. As the procedure was described to me you are awake and the cardiologist stimulates various places in the AV node area to try to throw the heart into arythmia. Having found the area it is then cryogenically destroyed.

Would you be so kind as to advise where your friends had their cryogenic ablation procedure?

The Docs around here claim they don't yet know how to do it.

Thanks

jgeezer 11-24-04 05:58 PM


Originally Posted by DnvrFox
Would you be so kind as to advise where your friends had their cryogenic ablation procedure?

The Docs around here claim they don't yet know how to do it.

Thanks


The procedure was done in Massachusetts. I have lost contact with the guy that had it done so I don't know the hospital but the two big ones in this area for cardiology are Brigham and Womens and Massachusetts General Hospital. They may be able to help. I'll see if I can get some more information.

dharleyd 11-25-04 08:18 AM

just got the doctors report on the holter monitor test. the tackicardia or fast heart has backed off. so the ablation is not going to be done at this time. maybe in the spring when the riding season starts agian. i also do xc skiing and if heart rate problems start agian prehaps the ablation will be an option agian. so i guess its back to taking chemicals and hope for the best

Velo Dog 11-26-04 11:55 AM

I've been in atrial fib for 15 years, on warfarin the whole time, and if my experience is typical, your life isn't going to change much. I'll be 60 in January, and I still ride regularly, do everything I did when I was in my 30s and 40s, and I've survived a couple of epic falls with no more problems than some pretty spectacular bruises.
You WILL find that your speeds decrease, I imagine. I was primarily a runner when I was diagnosed, though I'd ridden off and on for years. When my 10k time went from the high 30-minute range to 45 minutes plus, I moved more into cycling because I had no previous times to make me feel bad. I average 175-200 mi/wk in summer, do a couple of centuries every year for fun (?) and haven't had any more problems than other guys my age. I did my fastest 50-mile ride ever in July, at age 59 1/2 (it wasn't FAST, but it was faster than I could do 20 years ago).
Regarding the cardioversion: Technology may have changed since the last time they tried to convert me, but my heartbeat didn't change at all. With luck yours will, but it's not the end of the world if it doesn't.

DnvrFox 11-26-04 02:13 PM


Originally Posted by Velo Dog
I've been in atrial fib for 15 years, on warfarin the whole time, and if my experience is typical, your life isn't going to change much. I'll be 60 in January, and I still ride regularly, do everything I did when I was in my 30s and 40s, and I've survived a couple of epic falls with no more problems than some pretty spectacular bruises.


Thanks for the kind and thoughtful response.

It is quite scary when you get the diagnosis accompanied by a trip to the hospital in an ambulance. A bit of overkill, I think, on the part of the MD's, after a month of no kill!

Today, I went for a 3 mile hike with the wife on a beautiful local trail in nearby Roxborough State Park.

http://parks.state.co.us/cnap/Natura...mages/rox2.jpg

http://www.johnfielder.com/Merchant2...370_500pix.jpg


Some decent hills - saw about 15 deer. I was still the fastest person walking - beat everyone else. No bikes or pets allowed!

http://www.pacificislandtravel.com/n...rado/wpe28.jpg


It takes a while to learn what you can and cannot do, and I am learning that now.

Still going to try for that CV, though :D ! And, cryogenic ablation seems to be the most promising technique for cure.

http://www.news-medical.net/?id=3360

http://www.mainlinehealth.org/mlh/cl...ticle_2220.asp

http://www.cryocor.com/


Again, thanks!


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