Went to ER - now what to do?

Yesterday I went to the ER to get converted from afib that had been ongoing for 33 hours. After trying to convert me with IV cardizem three times, they sent me home, saying that the doctor on call refused to come in and convert me because I had been in afib 36 hours. His own protocol. Too late to go to another ER, and now I'm home, in afib, and will probably start taking coumadin or pradaxa today, though I am loathe to do so.

I am and have been on Rythmol SR, and up until now it has worked well. Heart rate is very fast, though. Shall I keep taking nattokinase?

Any advice appreciated!

Thanks -

Cindy

Cindy, I've been in Afib now since first week of May..had to go in the Hospital with my blood too thin from taking Coumadin. What a mess I was, that's what put me in Afib, and I had been fine for 2 or 3 years on Amiodarone. For some reason they won't do Cardioversions after so much time has past. I've had 8 Cardios, but that was when the caught it right away..so I don't know what my Cardio has planned for me..he put me on Pradaxa which is a good thing, you don't want to have any clots since you are in Afib. You should be on it.. He also took the Amiodarone away and put me on Diovan hct, for blood pressure and also take florosemide. He thought I believe if he could get my BP. down low enough it may get me back in sr..nothing so far........good luck and please take pradaxa.....Nel

Cindy,

How much magnesium do you take? I would try to get as much magnesium into myself as I could. Bowel tolerance will be a problem with oral supplementation, so I would also use oils, gels or whatever you can get your hands on. Ideally if you can find someone to give you IV mag that would be better.

Steve

Cindy and Steve,

You can find an MD that will give you magnesium injections at: [www.acam.org]

Hans

Hi Cindy,

Do you know if your AF is predominantly vagal or adrenergic or a mix of both? Just thinking if you are vagal, then an IV of flecainide may be more useful in converting you, than cardizem, which is a beta blocker and contra-indicated for vagal AF.

Hang in there,

Justine

Justine,

cardizem is a calcium channel blocker.

Yes of course it is. Thanks you for picking that up. I was given cardizem along with the beta blocker solotalol and the two of them just about did me in given that I am about 99% vagal. Everything was slowed down in my system that was already slow anyway. I asked by cardiologist to take me off them both and then the next time I had AF I tried an IV of flecainide to convert and it worked within an hour.

In the 5 years since then I have used flecainide only when I go into AF, which is about once a month, and it usually converts me within 1 - 3 hours. Point remains that vagal afibbers do not respond well to things that make things slower and cardizem and beta blockers seem to interact together to make things slower.

So, maybe think about flecainide for your next attempt at a chemical cardioversion Cindy if there's any thought that you might be predominantly a vagal afibber. I was also given amiodorone and that didn't convert me either.

Thanks everyone for the good advice. I have increased mag and will try to find someone to do an IV with Hans' link.

My EP talked to me today, and said he would do a TEE and convert me on Monday if possible if I'm still in afib. Doesn't want to leave me in afib for a month. Pretty uncomfortable! I've moved, though, from the "totally not functional type" of reaction to the "impaired but somewhat functional" one. Don't know if this is a good thing...

I am, I think, a mixed afibber, but predominantly vagal, so that may be why the cardizem didn't work.

Thanks again -

Cindy

Cindy, you have unfortunately been hooked up with a doc who does not want to do TEE procedures just prior to a CV, perhaps you have upset him by not wanting to use a thinner post CV which is standard procedure for 4 weeks post CV, or maybe he is just a bit gun shy from being recently sued for malpractice. I had a similar experience with an EP and learned my lesson the hard way, as so many afibbers have to find out on their own, you have to find an EP that will do a CV after a simple TEE test to rule out a possible clot. This is best done prior to needing the procedure by doing your due diligence before the problem arises. I would advise Pradaxa ASAP and get on the phone to locate a competent EP that will give you the TEE and CV, get on Flec. and Metaprolol prior to and after the procedure, get on a good Trio regimen, reduce your Sodium drasticsally, buy a Cardymeter to know your Potassium level and give your body sometime to build up a good amout of Magnesium, perhaps 6 months or so, and then you might try to wean off the meds very slowly, one at a time in alternating increments, if you still go into afib then it is ablation time. Find a famous EP that has a Stereotaxis machine. After the ablation stay on the same regimen without meds and you just might be able to avoid another ablation. Things could be worse, you could be among the hundreds of afib victims that have never discovered this most informative forum and are clueless as to the reality of their situation.

Thanks, Tom, but I think you misunderstood my post - the ER wouldn't do the CV, but my EP WILL do it with a TEE first. This is Thursday, and I'm scheduled for a CV Monday unless I self convert. I've been taking nattokinase for clot control and resist taking coumadin or pradaxa because of the dangers. I was the ED of a group of community clinics for years, and saw what coumadin can do. Pradaxa has no known antidote in case of a bleed, and I have labile blood pressure, sometimes VERY high. I will take coumadin for a month if my EP wants me to.

We'll see if I have any clots on Monday under my nattokinase regimen. I'm sure my EPs anxious to see if I've formed any as he knows about my natto use. I also take Vitamin E and fish oil for thinning, plus drink lots of water. I take Blue Bonnet magnesium chelate - 800mg per day now. Was taking 400, and think I need more, so will go to a functional MD and get an infusion of magnesium next week. Also will do an Exatest.

Rythmol SR and labetalol have worked for me for several years, but this year I reduced my dose of Rythmol in January for side effects reason. Since then I've flipped into afib several times - about once a month- always self converting after 6 - 9 hours. So this continuous afib is new.

I plan to get in line for an ablation with Natale. He does ablations near where I live.

You are SO right about this bulletin board. It has saved my life, I'm sure! I've been reading it for over 8 years, I think. I am very lucky!!

Thanks again for all the advice, I really appreciate it!

Cindy

Just stay away from the magnesium suppositories. They taste terrible.

My cardiologist attempted a CV without success. I am on Coumadin to an INR of 2.5-3.0 and am pretty constant and don't mind the blood tests while I am waiting for ablation with Dr. Khaykin/Verma in Newmarket; but the wait seems so very long.

My quality of life is going downhill it seems weekly... shortness of breath and fatigue (extreme fatigue). I need to use supplemental O2 and a CPAP machine to get a night of sleep and cannot imagine what I would be like without same.

I have been in aFib since at least November.

And you are so very right about this board. God bless you all. And stay away from the suppositories.