Johns Hopkins Health Alert
A Revised Strategy for Controlling Atrial Fibrillation
In atrial fibrillation, the upper chambers of the heart (or atria) contract in a rapid, uncoordinated manner, quivering (fibrillating) instead of beating normally. Because the heart cannot keep up with the body’s demand for blood during an episode of atrial fibrillation, people may feel breathless and have mild palpitations, chest pain or decreased endurance. Many patients, however, experience no symptoms during an episode of atrial fibrillation.
Atrial fibrillation usually poses no immediate danger. However, it is one of the greatest risk factors for stroke if left untreated. The American Heart Association estimates that atrial fibrillation is responsible for 15 to 20 percent of the 700,000 strokes that occur each year in the United States. Therefore, effective treatment for atrial fibrillation is crucial and can be lifesaving.
In the past, the goal in treating atrial fibrillation involved getting the heart back into normal rhythm with medication or an electric shock, followed by maintenance antiarrhythmic drug therapy. But an expert panel from the American Academy of Family Physicians and the American College of Physicians issued new guidelines in 2003 recommending that for most patients, treatment for atrial fibrillation should now focus on controlling the heart rate with drug therapy rather than attempting to restore normal heart rhythm (though rhythm control may still be appropriate in certain cases). For patients who have been restored to normal rhythm, recent studies suggest that certain drugs can help reduce the risk of recurrence of atrial fibrillation.
Any patient who experiences an episode of atrial fibrillation needs to be evaluated by a cardiologist, who can evaluate whether rate or rhythm control is the best course of therapy.
Posted in Heart Health on May 18, 2006
Reviewed June 2011
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I am wondering why more Doctors don't try a combination of drugs to help control not only the fibrilations so many of us suffer from, i.e. "PVC's", (a combintaion of say Atenolol along with a small dose of Klonopin?) to help get our moods and PVC's under better control, and faster?
In my case, they tried three drugs over the course of 6 months and none of them worked for long (or they had bad side-effects, such as Inderal's effect on my sex-drive?) and I had several "Shocks", all of which helped stop the PVC's, but only for short periods. They always returned.
It was only AFTER my Doctor added a small dose(.25mg) of Klonopin twice per day (to help control my moods when the irregular beats began) that I finally got relief, long-term relief, as in for most of 20 years now...? At the height of my PVC episodes, I would sometimes be awake for 2 days at a time, walking, sitting, relaxing (or trying to anyway), and on and on and on. Nothing worked, and I was totally frustrated. Only after he addressed the terrible mood swings that I suffered from when these PVC's started, did I finally get a non-invasive and long-lasting answer to the problem.
Iknow that many people suffer from these things, and for many reasons, but the vast majority of us suffer from worry and dread when these things start, and it only feeds on itself making the episodes worse and lasting longer. Do I still get "episodes" of PVC's? Sure, but they NEVER last more than a few seconds, ever.
Shocks are NOT the long term answer. This drug combination works folks, it REALLY does, and it does not make you groggy or "down", far from it. I felt as if my life had been restored, and my activity level has tripled since then, my heart is beating just fine, thank-you.
Posted by: Bill Fold | October 8, 2006 6:08 AM
I am relatively new to AFib. In looking around the WEB, I did not find any extensive study as to the "triggers' of AFib. Some of the Forums listed a handfull of "triggers", but nowhere did I find a list of the result of an authoritative study of the causes. Anyone found such a list???
Posted by: HDM | January 31, 2007 4:06 PM
I am a male 52 years old and at age 51 was diagnosed with atrial fibrillation
I had always been healthy as a horse and had NEVER even been admitted to a hospital before. That changed and now I am a genuine a-fib preacher. I looked all over the internet and was more confused than ever. SO, I started my own website about Atrial Fibrillation. Feel free to take a look.
http://www.afibtreatment.com
NEVER GIVE UP.
Steve.
Posted by: stingram | August 18, 2008 1:10 PM
Check into Multaq, a drug on fast track through fda with conclusion originaly expected by 1/31/08. It has been referred to a panel of experts for review on 3/18/08. It is a non iodine containing version of amiodarone, which worked for me for 1 1/2 yrs...then thyroid side effects from iodine. Multaq is very promising based on research for FDA.
Previously, I used fleckanide acetate until it lost effectiveness after a year or so. After amiodarone, I have been using tikosyn which worked beautifully for 1 1/2 years. Now I have 24 -36 hr episodes every couple days. Thus awaiting Multaq.
If Multaq ineffective, I will consider catheter ablation theraphy (via blood vessel in groin) I believe FDA just approved a new catheter specifically to be used for AFib. Also, there is a new procedure called "mini matrix", which is laproscopic (not "matrix" which is open heart). Mini matrix is very promising and had the added advantage of removing the ear shaped appendage in the heart that is the place where blood can develop clots (stroke!). Coumadin no longer needed with this procedure. I'd like to know more from others who may have checked into this procedure. Please post.
I recently learned that about 50-60 % of AFib suffers experience loss of effectiveness after a period.
I've read that AFib runs in families (about 1/3 of cases), is caused by alcohol abuse (about 1/3 of time) or occurs for no aparent reason but may result from other heart maladies. So let's not be too tough on ourselves. The presumption of exclusive linkage between alcohol abuse & Afib is slowly being lifted.
See stopafib.org for more info. I stumbled across this recently and found it helpful...where I learned about mini matrix procedure.
Posted by: johngraf | December 8, 2008 2:36 PM
I HAVE ATRIAL FIB. DRS. PUT ME ON DIGOXIN, THIS MED MADE MY B/P 140 TO 130 OVER 100 PULSE 95 AND I NEVER HAD HIGH B/P. SHOULD I STILL TAKE THIS DIGOXIN? I WILL HAVE AN APPT WITH CARDIOLOGIST IN MARCH AS I JUST HAD ECHOCARDIAOGRAM DONE AND THEY WANT TO DISCUSS MY RESULTS. I STOPPED THE DIGOXIN FOR TWO DAYS AND MY B/P RETURNED TO NORMAL.
Posted by: sandra barnish | February 23, 2009 6:00 PM
I have been diagnosed with Bradycardia.I am 65 years old.It has been three years now.I experience symptoms like fainting often.My heart beats way too slow under 50 beats per minute when exercising.If I try to sing I pass out from the effort,and my heart hurts.I have a total left bundle 100%blockage.I have great fatigue and cannot do the things I enjoy,like singing.I am a first soprano and do descant.It takes enormous oxygen and lung power to do this.It is my passion,and I miss it.Have any thoughts.All welcome. The Shell Lady
Posted by: shell lady | January 4, 2011 9:17 AM
Tikosyn Time - My experiences with the afib drug Tikosyn.
I have had afib off and on for the last 3 years. I recently had a catheter ablation and my afib has now gone away "mostly" - I still have an occasional flutter or PVC.
I got just over 2 years of control of my atrial fibrillation with the drug Tikosyn. Many doctors are hesitant about prescribing it because possible side effects and a stay in the hospital is required to get started on the it. I thought it was worth a try and had great results and no afib for over 24 months. Might be worth a try to all the other afib sufferers before you go for the ablation.
I had no noticeable side effects except maybe a slowed, by a couple of beats per minute, heart rate that did not bother me at all. For more information read my article at
http://afibtreatment.com/tikosyn-time.html
Never give up.
Steve.
Posted by: stingram | January 4, 2011 12:39 PM
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I HAD ELECTRIC SHOCK RIGHT AFTER MY DOCTOR DISCOVERED THAT I HAD ATRIAL FIB. AND MY HEART WAS PUT BACK IN NORMAL RYTHYM IN THE EARLY 1990'S BUT IT ONLY LASTED IN NORMAL RYTHYM FOR ABOUT 8 MONTHS. ONE REASON WAS MY WEIGHT WAS A CONSTANT ROLLERCOASTER & THEN MY MOM PASSED AWAY. TODAY, I BELONG TO WEIGHT WATCHERS AND I AM DOWN TO 235 AND STILL LOSE ABOUT 1-2 POUNDS A WEEK. I DRINK PLENTY OF WATER, EAT FRUITS & VEGGIES. I'VE ALWAYS HAD A VARIETY OF BREAKFASTS WHETHER ITS OATMEAL WITH RAISINS IN IT OR CHEERIOS WITH YOGURT OR EVEN RAISIN BRAN, BUT VARIETY IS THE KEY. I TRIED PROTEIN DRINKS RECENTLY. ANYWAY, I HAVE TO TAKE 3MG OF WARFARIN SOD AND 2 DIOVAN GELCAPS WITH HCT,AND ONE ATTENOL PER DAY,& FINALLY POTASSIUM TO REPLACE THE EXCESS WATER DISPLACED BY THE HCT.IT HAS BEEN AN EXPERIENCE,BUT I AM STILL IN GOOD HEALTH 15 YEARS LATER-I JUST TURNED 55 LAST JANUARY. I USE A BLOOD PRESSURE MACHINE EVERY MORNING AND WALK AT SHOPPING MALLS ON A DAILY BASIS & OWN A PEDIMETER.I KEEP ALL FOOD TO PORTION SIZE & DO NOT EAT SALTY CHIPS OR SALTY FRIES. I ENJOY RICE CAKES ON OCCASION AND AM LEARNING THE SECRETS OF EATING THE RIGHT FOODS.IT HAS TRULY BEEN A LEARNING EXPERIENCE-THANK YOU, ALAN BINTZ
Posted by: abintz | May 30, 2006 9:39 AM