Anyone have A-fib?

[Marnid2014]

I have been in the hospital, I had an episode of first time Afib, I don't think it's apnea related, but who knows. Does anyone else have it?I ended up in the end having to have a pacemaker installed. My heart rate was so slow, especially when I was sleeping, even with cpap, it was in the low 30's. They decided that after conversion of my heart from an Afib pattern of almost 12 hours, my heart converted into normal sinus rhythm but not without stopping for 8 seconds. I have been there for a week making sure that the meds they are giving me will not cause a problem. It's always something, scared the heck out of me. The cardiologist told me that Afib is becoming so common and they don't know why. Now I will have to be on Coumadin or another blood thinner like Xeralto, for the rest of my life as well as an anti areythemia. The Xeralto would be my first choice, because there is no dietary problems, with interactions with food, but the Xeralto is $300.00 for 30 pills. Wow, the whole thing is overwhelming.

[justMongo]

I don't have it yet. It's coming my way!
Afib is caused by changes in the heart muscle or valves.
Thickening of the left ventricle wall -- enlarged atria, et cetera.

I know they use blood thinners for people with rhythm problems. I didn't know you needed them with a pacer.

I do know one of the down sides of Xeralto (besides cost) is they typically withdraw a person from it for surgery.
The anesthesiologist needs to be able to control coagulation time; and cannot with Xeralto.

[PaulaO2]

There's a lot of us here who have them. I don't. Yet. Right now I'm having fun with PVCs and am hoping that's where they stay.

It may or may not be linked to sleep apnea. Treatment for sleep apnea early enough may or may not be able to prevent it but I don't think it can make already existing "damage" better. If damage already exists, it may or may not slow down the progression.

[DocWils]

Okay, relax - we (the medical profession) have a long history of dealing with heart problems, and what you describe is not something we lose a lot of people on. In fact, you are getting very good treatment, based on the little you told us here, and your team is giving you good guidance.

Xarelto is expensive where you are (it is a relatively new drug, approved for a-fib in 2011, although around for deep vein thrombosis for quite a few years before that), and you must decide if it is worth the cost, and if your insurance will cover some of it (they won't cover all, I think), however, some things you need to be aware of - while Coumadin is difficult to dose properly, if there is a bleed developing (mostly intercranial), vitamin K will bring it under control fast, with Xarelto (and Pradaxa and Eliquis, the other two new(ish) drugs to replace Coumadin) that won't work - you would need fresh plasma until the drugs clear your system, and this has its own risk. However the risk of bleeds developing is a bit lower than badly managed Coumadin, if that is any reassurance.

Now, cost aside, you need to think about how to manage your daily health a bit more - this is not likely to be apnoea related, so don't worry on that point. But adjusting your diet and exercise is definitely in the cards, and a bit of relaxation therapy, like meditation or cognitive training is also recommended. Most of all, be glad you live in a time where these treatments are routine. Just relax, take it as it comes, follow your team's advice as best you can, and work toward your goal of good health.

Good luck.

[retired_guy]

My wife is on Warfarin (Coumadin). Not for Afib, but for DVT's. Anyhow when the new drugs came out I tried to get her to switch to them. The insurance would cover most of the cost. She won't do it.

Her logic is Warfarin is dirt cheap, and manages her condition very nicely. So why screw around with the expensive stuff even if Medicare is picking up the tab?

You have to monitor your warfarin dose with a blood test similar to those used for diabetes. You can get (by prescription of course) a home unit to use for this purpose. The machine and supplies should be covered by your insurance and certainly are by Medicare.

[Marnid2014]

THANK YOU SO MUCH!!!!!!! You are all so awesome. I was so scared, the doctor seems to think I might have sick sinus syndrome, she said my heart is fine, they did an Echo Cardiogram and other than a VERY VERY VERY slight thickening it all checked out. They are going to do a stress test in a few weeks just to make sure, but I have to settle in first. My doctor wants to adjust my Coumadin to my diet, not the other way around, he said, since I have always eaten healthy, it's not time to become a junk food addict just because of Afib, he said that the worse thing about Afib is clotting and if that is under control, then I should live to be a ripe old age. That all sounds wonderful to me. I am faithful on my Cpap machine and my AHI is very low, about 0.24 or lower so I think that is good as well. I had taken a dose of Zpack with the pneumonia I had a few weeks ago and there is a risk associated with that antibiotic now and the FDA is putting a warning lable on it. It might just have caused it, but it doesn't matter I guess, the end result is STILL going to be Coumadin. I agree Doc Wills, I think Coumadin might be best, it's been around since dirt LOL and next week we will find one of those "IF YOU HAVE BEEN INJURED BY BLAH BLAH BLAH, CALL US, 1800 BAD DRUG" Sign

[herbm]

I have AFib, treated with Pacerone (Amiodarone) which is a new 'anti-arrhythmic' that is supposedly safer than it's predecessors.

The Xarelto (or other blood thinner) is NOT for the AFib itself per se, but rather to reduce the chance of throwing a clot CAUSED by the AFib or valve issues.

I don't know how anyone could say the AFib was not caused by the OSA, since it is one of the known contributing factors.

(It's also not possible to say the AFib WAS cause by the OSA, but it would seem there is a significant chance.)

AFib can be due to ischemic heart disease, so a cardiac catheterization is a common diagnostic tool, after EKG, echo-cardiograms, and stress tests.

I had all of that. My ejection fraction was under 25% (55-60% is about normal). This is the amount of blood pumped out of your ventricle on each beat.

AFib can lead to heart failure (as OSA is also a contributing factor for heart failure.)

My AFib converted in about 2 days with the Pacerone.

I never stopped working out the entire time -- although for the first year the (idiot) doctor missed the diagnosis even though (I later learned) the symptoms I reported were almost exactly heart failure -- finally after a year he gave me an EKG and the next day I was at the cardiologist due to the arrhythmia.

If you convert and don't have other problems, then AFib may not be a big deal. Lots of us live fine with it.

Most of the scary stories are about people who are already in heart failure or having attacks.

[justMongo]

THANK YOU SO MUCH!!!!!!! You are all so awesome. I was so scared, the doctor seems to think I might have sick sinus syndrome, she said my heart is fine, they did an Echo Cardiogram and other than a VERY VERY VERY slight thickening it all checked out. They are going to do a stress test in a few weeks just to make sure, but I have to settle in first. My doctor wants to adjust my Coumadin to my diet, not the other way around, he said, since I have always eaten healthy, it's not time to become a junk food addict just because of Afib, he said that the worse thing about Afib is clotting and if that is under control, then I should live to be a ripe old age. That all sounds wonderful to me. I am faithful on my Cpap machine and my AHI is very low, about 0.24 or lower so I think that is good as well. I had taken a dose of Zpack with the pneumonia I had a few weeks ago and there is a risk associated with that antibiotic now and the FDA is putting a warning lable on it. It might just have caused it, but it doesn't matter I guess, the end result is STILL going to be Coumadin. I agree Doc Wills, I think Coumadin might be best, it's been around since dirt LOL and next week we will find one of those "IF YOU HAVE BEEN INJURED BY BLAH BLAH BLAH, CALL US, 1800 BAD DRUG" Sign

My oral surgeon would not put me on a Z-pack of Azithromycin when I had a tooth extracted about a year ago, because I have some prematures. The FDA put a "black box" warning on the Z-pack.

[PaytonA]

I have A-fib and it WAS caused by sleep apnea at least it was a major contributing factor. That is not my opinion it is my cardiologist's. My opinion on my sleep apnea is that I have had it off and on for 50 years although I was not tested for it until about 4 years ago when I started treatment.

Best Regards,

PaytonA

[MAPnea]

Hi, Marnid2014,

I, too, have A-fib and it was my cardiologist who sent me for a sleep study in October 2012. Since starting CPAP I've only had one A-fib "episode", but it was bad enough to get me admitted to the hospital over Thanksgiving. When I saw my cardiologist two weeks later for a "follow up" a DVT was found in my leg. A-fib plus DVT equals Xarelto for me.

I agree with Doc Wills about stress management (and "anxiety", I might add). I really believe I, myself, brought on this last A-fib episode because I was so … "stressed out".

Before CPAP I was afraid to go to sleep for fear I'd stop breathing. Now when I put my pillows in my nose and my head on the pillow at night, I go to sleep without anxiety. I bought a FitBit and walk over 10,000 steps a day (I walk a neighbor's dog). That helps with stress and anxiety.

If you don't have prescription insurance that will help pay for Xarelto, google "patient assistance program for Xarelto" and you will find help.

Good luck and let us know how you are doing.