Hi,
Let me describe my situation and then ask a couple of brief questions.
I’m 66 years old and have had several incidents of A Fib after the age
of 60. Prior to that time I was bothered by PVC’s to the extent that I
was put on tenormin (50mg) which seemed to help a little, but how can
you really know without stopping the tenormin which I am VERY reluctant
to do. On one of the A Fib incidents, I had a stroke and was put on
coumadin. In spite of this my HMO doctors never believed that I went to
A Fib ; they referred to this as irregular heart beat. Then, this year
I discovered that I required abdominal surgery (cholectomey and hernia)
which made it imperative to resolve my cardiac problems if possible
because I knew that I would have to stop my coumadin medication for two
weeks (one week before the operation, followed by a week afterwards).
Fortunately for me, I had an episode of A Fib just a month before
surgery was scheduled and I went to the ER where my A Fib was documented
for the world to see. My HMO Cardiologist put me on digoxin in addition
to the tenormin and postponed the surgery for a month or so to verify
that I stabilized OK. I had no A Fib since that time but for the first
month or two, I had a substantial number of PVCs.
I was concerned about my heart problems during surgery because I had
heard from the Cardiologist that both anaesthetics and surgical stress
tend to cause heart arrhythmias. Couple this with a 2 week shutdown of
the coumadin and a pessimist like myself starts to feel uncomfortable.
The surgery took place 9/26/96 and after 5 days in the hospital, I am
home again and back on coumadin. The amazing thing to me is that heart
arrhythmia has not been a factor at all during this period. I had
general anaesthetic for the surgery. Since I could not eat for four
days, my digoxin was administered by IV and tenormin was replaced by
LoPressor. In addition, I was given a nitro patch every day. My
question: why no problems? I would have thought that the week before
the surgery with the digestive tract purging which I know really screws
up your enzymes would have be enough to start some PVCs. In fact, if my
PVCs during my normal life were anywhere near as good as during that 2
week period, I would be delighted.
Second question: My Cardiologist seems very casual in his adherence to
guidelines for the use of digoxin. My pulse rate under tenormin alone
drops between 48 and 60 bps. Usually, around 55bps. The nurses in the
hospital wouldn’t provide tenormin and digoxin on my last day (I only
had two days of oral medication) because my pulse rate should be above
60 before the medication is administered. This requirement is confirmed
in the Physcians’ Desk Reference. I have been using both medications
for a couple of months now and my pulse did slow a little from that
under tenormin alone, but it still usually runs in the 50′s. Should I
be making an issue of this, especially since everything seems to have
worked out just great?
–
Regards,
=-=-=- Dick Held -=-=-=
= di…@earthlink.net =
=-=-=-=-=-=-=-=-=-=-=-=-=