First Time dealing with afib

I am new here and recently diagnosed with afib. It started immediately after I had surgery to replace my aorta for an aneurysm along with my aortic valve at the end of July (only diagnosed a year prior). At first it really did not affect me, but lately, I can feel it and get dizzy spells when bending over/standing up. Up until then, I had never had afib. I do have the Kardia mobile device and check it several times a day. It appears I am in constant afib.

Saw an electrophysiologist and he suggested a 3 day stay in the hospital to treat it with dofetilide and possibly an electrical cardio-version.

I talked this over with my cardiologist and he thought it was a bad idea and wants to put me on 400mg of Amiodarone a day with an electrical cardio-version to follow in 2 weeks, followed by 2 more weeks of 200mg Amiodarone.

Just curious as to anyone thoughts on this.

Thanks
Mike

I had double bypass with afib as a complication besides pleural effusion. First time it went away with medicine after one day. Then came back. Then one week of meds did not do anything and had a cardioversion. One shock (at 70 joules I think) did it and put me back into sinus. Then went home and got it again. As the Amiodarone as an AF agent (with Metoprolol as beta blocker) had very bad side effects (nausea, hard to breath, could not eat,...) I am now on Solavert - a combined beta blocker/AF agent. It brings my heart rate and BP down, but I am not there yet. Afib is still there (as good as permanently) and I may be heading towards another cardioversion. Tried numerous supplements as well and while there is some help with body recovery and inflammation, it does not seem to fix heart. I am 5 weeks post-op. I found that having a copy blood test results helps to understand what is going on, at least to some extent.

Amiodarone is a drug of last resort. It's extremely effective, which is why cardiologists like it, but it's also extremely toxic with long-term use. It can cause life threatening damage to multiple organs, particularly the lungs. It also has a ridiculously long half-life. It takes months to clear from your body when you stop taking it, which can delay other drugs and procedures.

That's why it should always be the last choice. If dofetilide doesn't work for you, you can still go to admiodarone. Just my opinion but I think your EP is right. I wouldn't take amio if I were you.

I don't think your bed-ridden the 3 days, doing the Dofetilide. My Doc told me I could get up and move around in the Hospital. If it was me I would find out exactly what the 3 days will be like.

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The Anti-Fib
I don't think your bed-ridden the 3 days, doing the Dofetilide. My Doc told me I could get up and move around in the Hospital. If it was me I would find out exactly what the 3 days will be like.

Been there, done that. You're not bedridden at all unless there's something else going on. You're free to do anything you want as long as you stay within range of their monitoring equipment. In my case, that included the family room down the hall with vending machines. I brought a pair of sweatpants and a t-shirt to wear instead of those silly hospital johnnies they give you so I could walk around without my ass hanging out. I also brought a laptop and cell phone. Most hospitals these days have free wifi.

It's fair to point out that a lot of this forum and its users deal with "lone" AF, or AF not caused by valve replacements or other heart surguries. That's not to say that there isn't expertise here, but do be careful mapping treatments for lone AF to valvular AF. The objection to amiodarone amongst the LAF community is grounded and well understood, but I'd solicit more expert opinion as it applies to post-surgical AF.

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wolfpack
It's fair to point out that a lot of this forum and its users deal with "lone" AF, or AF not caused by valve replacements or other heart surguries. That's not to say that there isn't expertise here, but do be careful mapping treatments for lone AF to valvular AF. The objection to amiodarone amongst the LAF community is grounded and well understood, but I'd solicit more expert opinion as it applies to post-surgical AF.

Good reminder, but he's getting conflicting recommendations from two cardiologists, so it's probably safe to assume both are familiar with his full clinical picture and both are offering reasonable advice for his situation.

Thanks for all the advise. I did the Amiodarone route based on my cardiologists advise. He has been treating me since the beginning, whereas the electrophysiologist was only a 1 time consultation. I had a successful Cardioverison yesterday. Let's hope it stays that way.