Re: OT: The Dutch way with atrial fibrillation

On Mar 19, 10:10 pm, James Arthur <bogusabd...@xxxxxxxxxxx> wrote:
Bill Slomanwrote:
When I woke up this morning, I realised that I was in atrial fibrillation
again; irregulatr heart-beat, and going upstairs to my study made me
breathless.

Last night I'd noticed that getting up the stairs to my study was suddenly
hard work, so I figured that it had set in earlier that evening.

It is easy for a cardiologist to fix it - they knock you out with a fast
acting anaesthetic, stop your heart with a big electric shock, and start it
up again with a smaller shock, and the heart almost always starts up beating
regularly.

The catch is that if they don't do it within 48 hours of the onset of
fibrillation, your blood gets to pool in the stagnant bits of the upper
chambers of your heart (the atrium) and forms clots, which would get spread
around the body when the heart was shocked back into normal rythm.

This is also fixable. They give you rat poison - wafarin - for about six
weeks, until they are sure that your blood-clotting time is about three
times longer than normal, and any blood clots are too soft to produce a
stroke or deep vein thrombosis, and then - and only then - do they give you
the electric shocks.

So I spent the morning ringing my GP - who couldn't do anything, but likes
to have his authority acknowledged - and then the hospital that looks after
my heart. It took two phone calls before the assistant who answers the
relevant phone got to understand why I wanted my electric shock today, but
she then gave the cardiologist the right message, and I was given the okay
to go to the cardiac emergency room at the hospital.

I got there at three in the afternoon, and spent two hours lying around
while they measured everything that they could think of - and even X-rayed
my chest - before deciding that they agreed with me.

They knocked me out at five, and when I came to at about 5:30 pm the problem
had been fixed. I had to lay around for another half hour to prove that
there weren't any residual problems from the anaesthetic, and I had to hang
around for a little longer before my wife could pick me up, but I was home
again at 6:30pm, and had no problem with the stairs up to my study.

And it won't cost me anything - beyond what I already pay for my compulsory
(and universal) medical insurance.

Bill,
My Dad told me that when he was in medical school they
called a-fib "old heart," figuring it was inevitable,
even normal with age.  It needn't be.

My younger brother - who is a general practitioner - tells me that it
is almost always controlled with medication these days. I'm going to
have to up the dose of the stuff I take, which I could do without.

The base cause is usually clogged coronary arteries
near the sino-atrial node, which starves the wet-ware
heart-clock generating electronics there of oxygen
(ischemia) and nutrients. That makes them a little flakey.

That doesn't seem to be my problem - I do have a leaky aortic valve,
and the heart wall is getting thicker. It will be some years before
they do anything about the valve, and I may die of something else
before then.

Fortunately you've got redundant timing facilities, so
a-fib is usually just a nuisance, knocks your pumping
capacity down 20% or so, makes you tired, but is
not especially dangerous.  Lifespan isn't affected.

The stagnant blood in the corners of your upper ventricles is a
potential source of clots.
Strokes and deep vein thrombos are more commin in a-fib patients.

You can often reset an a-fib yourself with a valsalva
maneuver (hold breath and bear down),

I know the manoeuvre. It makes the aorta look strikingly different on
ultrasound scans, and we used it when showing off our phased array
scanner when I was working on diagnostic ultrasound at EMI 1976-79.
Didn't make any difference to my heart rhythm when I last tried it.

and omega-3s are
valuable as well.[1] (use extreme care though, since
you're on anti-coagulants.

I'm not on anti-coagulants, and would prefer to stay off them - it
takes ages before they get the dose that gives the right clotting
time.

 Fish-oil is also an
anti-coagulant, and may potentiate existing meds. Any
supplementation would have to be coordinated with
medical supervision--you don't want to stroke out)

You might also evaluate your magnesium intake.  It's
vital for proper rhythm, present in whole grains,
and deficient in many diets.[2]  ISTR some buzz that
the ratio of Ca to Mg is what governs, and that
supplements are not preferred.  You might want to
Google it.

If my doctors don't bother, I'm not going to get excited about it.

So, me not being a doctor, that's an engineer's guide
to a-fib.

--
Bill Sloman, Nijmegen
.

Relevant Pages

  • Re: OT: The Dutch way with atrial fibrillation
    ... Last night I'd noticed that getting up the stairs to my study was suddenly ... acting anaesthetic, stop your heart with a big electric shock, and start it ... up again with a smaller shock, and the heart almost always starts up beating ... called a-fib "old heart," figuring it was inevitable, ...
    (sci.electronics.design)
  • Re: OT: The Dutch way with atrial fibrillation
    ... It is easy for a cardiologist to fix it - they knock you out with a fast acting anaesthetic, stop your heart with a big electric shock, and start it up again with a smaller shock, and the heart almost always starts up beating regularly. ... I had to lay around for another half hour to prove that there weren't any residual problems from the anaesthetic, and I had to hang around for a little longer before my wife could pick me up, but I was home again at 6:30pm, and had no problem with the stairs up to my study. ... called a-fib "old heart," figuring it was inevitable, ...
    (sci.electronics.design)
  • Re: Atrial Fibrulation
    ... medication because he can't breathe while taking it. ... He tried electric shock to get his heart back in rhythm but that ... and informative purposes. ...
    (sci.med.cardiology)
  • Re: OT: The Dutch way with atrial fibrillation
    ... Last night I'd noticed that getting up the stairs to my study was suddenly ... acting anaesthetic, stop your heart with a big electric shock, and start it ... up again with a smaller shock, and the heart almost always starts up beating ... relevant phone got to understand why I wanted my electric shock today, ...
    (sci.electronics.design)
  • Re: OT: The Dutch way with atrial fibrillation
    ... hard work, so I figured that it had set in earlier that evening. ... acting anaesthetic, stop your heart with a big electric shock, and start it ... up again with a smaller shock, and the heart almost always starts up beating ... if the second electric shock that is supposed to restart your heart ...
    (sci.electronics.design)