Cardioversion Failure

I spent three days in the hospital this week to begin Fecainide. I am following the Cleveland Clinic protocol for preparation for a February ablation but it appears that my needs may lie in the maze, valve repair area.

I thought I would share my experiences with this group in the hopes that someone might have insights and also to help others who have similar experiences.

On Monday I had a TEE because my INR levels had dipped below acceptable and then a cardioversion (my first, despite having AF for over 10 years. The TEE was not hard; the worst part was gargling a foul tasting substance to numb my throat. The nurse played up the bad taste so much that when I tasted it, it didn't seem all that bad. The sedative knocked me out so I remeber nothing about the test itself. No clots but the test showed the 3+ mitral valve regurgitation I had been diagnosed with at the Cleveland Clinic in October.

I went straight from that to the cardioversion. Again, drugs are wonderful for things like this and I know nothing about what happened except that two attempts failed to sustain normal rhythm. After being paroxsysmal for years, I have slipped into the persistant state for the last couple of months - a progession that depresses me. I was disappointed that the cardioversion did not work.

The flecainide also has failed to get me into NSR. I have elected to stay on it for awhile to see if it kicks it.

My EP sent in Dr. Damiano (Barnes Hospital in St. Louis) to consust with me about mitral valve repair and the Maze procedure. I was very impressed with Dr.Damiano and he was optomistic about being to fix both problems. I have done some surfing about him and he is apparently a guru in the field of robotic cardiac surgery. I had been leaning to going to Cleveland because of an excellent valve repair guy there (whose name is escaping me), but would so much prefer not to have to travel so far for major surgery. Any ideas from anyone?

I also am, of course, concerned about the idea of having such an invasive procedure, but was told I would need repair at some point and success would be better if I didn't wait for things to deteriorate. How serious is the loss of gray cells and how common are complications from this surgery? Does anyone know?

Oh yes, I wanted to add one thing about the cardioversion. The test itself was nothing, but I was cardioverted again on Wednesday to see if better results could be gotten. No luck, but I did get some really annoying sunburn type burns and a feeling inside like I might be coming down with a bronchial thing. They shocked me several times. I was concerned until I spoke to the doctor today and was told why I was feeling these discomforts.

I hope this helps people who are facing these procedures.
Judy

If the valve repair doc at CC is Cosgrove, go with him. He's the best.

Thanks, Kerry

I hear Cosgrove is the guy to have; I just keep hoping I wouldn't have to go so far for such a major procedure.
So far the scale is tipping in his direction.
Judy

Judy - I'm so very sorry to hear how your situation has developed.

I have to vote for Cosgrove as well. I live here in Cleveland and we see and hear a lot of very positive things about Dr. Cosgrove and his whole approach. I would have no qualms about having him at the helm. I realize your hesitation because of the distance, but I definitely feel it would be worth it.

My thoughts and prayers are with you. Let us know your plans.

Kind regards, Jackie

Judy:
Does the Robotic valve repair require heart and lung machine? Are they planning to repair your valve, or replace your valve? I had never heard of Barnes-Jewish Hospital in St. Louis and looked up their rating for Cardiology in US News and World Report. They are #10 for Cardiology. Cleveland Clinic is #1. I had such bad experience at #6 Hospital for Cardiology, that I would either learn to live with my problems or go to the moon for #1.

Pam

You guys are great! I'm getting so much help. Pam, the robotic stuff Dr. Damiano does wouldn't apply to valve repair; it's the cutting edge (?!?) for ways to perform by-pass, etc. without the heart-lung machine and with a small incision. I don't think they have any thoughts about using it for valves yet. It's exciting, but still in its infancy.

Jackie, I have not sent my new records to Cleveland yet so have no idea what kind of wait time I might have for Cosgrove. I have also heard good things about Gillinov. Any thing about him you might know as a "local"?

Thanks again, everyone, and keep the advice coming!

Judy:

What I meant to ask was - Do you need a valve replacement with a prosthetic valve, or a valvuloplasty (valve repair)?

Pam

Pam,
My EP and the surgeon who consulted while in the hospital felt that repair was indicated. I worry, needlessly perhaps, that they don't really know until they see the situation first hand and then I want the best repair chances because repair is beter for the long-term health of the heart than replacement. So, is it over kill to go to Cleveland and have the repair experts involved when I may have a simple repair job? Is there a "simple" repair job? I don't know!