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I%E2%80%99m Havng Afib.called My Dr @nite After Hours. He Says
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
I understand your concern and would like to explain that your doctor's prescription could be an option of managing atrial fibrillation. Other anti-arrhythmic drugs like Propafenone (pill-in-pocket), Flecaininde, etc. could be used as well.
Aspirin should be used as well; although it is not so effective as anticoagulants at preventing cardio-embolic events found in afib patients.
Coming to this point, as your doctor advised, if irregular rhythm doesn't resolve in 24 - 48 hours, you should contact your doctor to review your clinical conditions and try alternative medical strategies to manage your rhythm disorder.
It is necessary to check your ECG and renal function test while on on Sotalol to prevent potential adverse effects (increased QTC interval on ECG) leading to pro-arrhythmic phenomena.
It is necessary to check your QTc interval on ECG; if QTc> 450 ms use of Sotalol is contraindicated.
Before starting Sotalol an ECG, BUN and creatinine, blood electrolytes level should be checked.
In case you have an actual ECG done, you could upload it here for a direct review and a second professional opinion.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
I understand your concern and would like to explain that your doctor's prescription could be an option of managing atrial fibrillation. Other anti-arrhythmic drugs like Propafenone (pill-in-pocket), Flecaininde, etc. could be used as well.
Aspirin should be used as well; although it is not so effective as anticoagulants at preventing cardio-embolic events found in afib patients.
Coming to this point, as your doctor advised, if irregular rhythm doesn't resolve in 24 - 48 hours, you should contact your doctor to review your clinical conditions and try alternative medical strategies to manage your rhythm disorder.
It is necessary to check your ECG and renal function test while on on Sotalol to prevent potential adverse effects (increased QTC interval on ECG) leading to pro-arrhythmic phenomena.
It is necessary to check your QTc interval on ECG; if QTc> 450 ms use of Sotalol is contraindicated.
Before starting Sotalol an ECG, BUN and creatinine, blood electrolytes level should be checked.
In case you have an actual ECG done, you could upload it here for a direct review and a second professional opinion.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
I understand your concern and would like to explain that your doctor's prescription could be an option of managing atrial fibrillation. Other anti-arrhythmic drugs like Propafenone (pill-in-pocket), Flecaininde, etc. could be used as well.
Aspirin should be used as well; although it is not so effective as anticoagulants at preventing cardio-embolic events found in afib patients.
Coming to this point, as your doctor advised, if irregular rhythm doesn't resolve in 24 - 48 hours, you should contact your doctor to review your clinical conditions and try alternative medical strategies to manage your rhythm disorder.
It is necessary to check your ECG and renal function test while on on Sotalol to prevent potential adverse effects (increased QTC interval on ECG) leading to pro-arrhythmic phenomena.
It is necessary to check your QTc interval on ECG; if QTc> 450 ms use of Sotalol is contraindicated.
Before starting Sotalol an ECG, BUN and creatinine, blood electrolytes level should be checked.
In case you have an actual ECG done, you could upload it here for a direct review and a second professional opinion.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
I would explain as follows:
Detailed Answer:
Hello!
Welcome on - Ask a Doctor - service!
I understand your concern and would like to explain that your doctor's prescription could be an option of managing atrial fibrillation. Other anti-arrhythmic drugs like Propafenone (pill-in-pocket), Flecaininde, etc. could be used as well.
Aspirin should be used as well; although it is not so effective as anticoagulants at preventing cardio-embolic events found in afib patients.
Coming to this point, as your doctor advised, if irregular rhythm doesn't resolve in 24 - 48 hours, you should contact your doctor to review your clinical conditions and try alternative medical strategies to manage your rhythm disorder.
It is necessary to check your ECG and renal function test while on on Sotalol to prevent potential adverse effects (increased QTC interval on ECG) leading to pro-arrhythmic phenomena.
It is necessary to check your QTc interval on ECG; if QTc> 450 ms use of Sotalol is contraindicated.
Before starting Sotalol an ECG, BUN and creatinine, blood electrolytes level should be checked.
In case you have an actual ECG done, you could upload it here for a direct review and a second professional opinion.
Hope to have been helpful to you!
In case of any further questions, feel free to ask me again.
Kind regards,
Dr. Ilir Sharka
cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I didn’t have room to write everything before. I had my first afib 7 years ago and this is my third. Sotalol 80 mg bid has worked well and dr. took me off Eliquis first 3 months. My immediate concern is will waiting 2 days be dangerous. This started about 10 hours ago and it’s better than it was. I had a few drinks last night which I rarely do. My guess it will resolve on its own. Do you agree. Will a clot possibly develop in 48 hours presenting potential danger to me. I’ll tell you this. I’ll never drink again. I had 5 last night which is highly unusual. Heart rate is in the low 79s and earlier around 95. Also earlier it would speed up and slow down quickly. Now it’s much more gradual. I feel like I’m coming thru this. What do you think Dr?
I didn’t have room to write everything before. I had my first afib 7 years ago and this is my third. Sotalol 80 mg bid has worked well and dr. took me off Eliquis first 3 months. My immediate concern is will waiting 2 days be dangerous. This started about 10 hours ago and it’s better than it was. I had a few drinks last night which I rarely do. My guess it will resolve on its own. Do you agree. Will a clot possibly develop in 48 hours presenting potential danger to me. I’ll tell you this. I’ll never drink again. I had 5 last night which is highly unusual. Heart rate is in the low 79s and earlier around 95. Also earlier it would speed up and slow down quickly. Now it’s much more gradual. I feel like I’m coming thru this. What do you think Dr?
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
I agree with you that there is a high likelihood the heart rhythm issue will resolve in the next hours and Sotalol will should effective considering the fact it has been in the past.
The possibility this new onset afib will develop a dangerous clotis quite seem to be quite low (irrelevant), considering the fact you don't have any prior cardiac structural disorder, no issues of heart failure, no hypertension, diabetes of prior thromboembolic event.
In case Afib doesn't resolve in the next few hours, switching to anticoagulation therapy would be an option.
As your heart rate is becoming less variable, the probability of conversion to normal sinus rhythm is high.
Anyways, it is necessary to check your rhythm repeatedly.
Let me know in case of any further questions.
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
I agree with you that there is a high likelihood the heart rhythm issue will resolve in the next hours and Sotalol will should effective considering the fact it has been in the past.
The possibility this new onset afib will develop a dangerous clotis quite seem to be quite low (irrelevant), considering the fact you don't have any prior cardiac structural disorder, no issues of heart failure, no hypertension, diabetes of prior thromboembolic event.
In case Afib doesn't resolve in the next few hours, switching to anticoagulation therapy would be an option.
As your heart rate is becoming less variable, the probability of conversion to normal sinus rhythm is high.
Anyways, it is necessary to check your rhythm repeatedly.
Let me know in case of any further questions.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Brief Answer:
Opinion as follows:
Detailed Answer:
Hello again!
I agree with you that there is a high likelihood the heart rhythm issue will resolve in the next hours and Sotalol will should effective considering the fact it has been in the past.
The possibility this new onset afib will develop a dangerous clotis quite seem to be quite low (irrelevant), considering the fact you don't have any prior cardiac structural disorder, no issues of heart failure, no hypertension, diabetes of prior thromboembolic event.
In case Afib doesn't resolve in the next few hours, switching to anticoagulation therapy would be an option.
As your heart rate is becoming less variable, the probability of conversion to normal sinus rhythm is high.
Anyways, it is necessary to check your rhythm repeatedly.
Let me know in case of any further questions.
Regards,
Dr. Iliri
Opinion as follows:
Detailed Answer:
Hello again!
I agree with you that there is a high likelihood the heart rhythm issue will resolve in the next hours and Sotalol will should effective considering the fact it has been in the past.
The possibility this new onset afib will develop a dangerous clotis quite seem to be quite low (irrelevant), considering the fact you don't have any prior cardiac structural disorder, no issues of heart failure, no hypertension, diabetes of prior thromboembolic event.
In case Afib doesn't resolve in the next few hours, switching to anticoagulation therapy would be an option.
As your heart rate is becoming less variable, the probability of conversion to normal sinus rhythm is high.
Anyways, it is necessary to check your rhythm repeatedly.
Let me know in case of any further questions.
Regards,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
fyi. I went to the dr. today to follow up on this. I felt totally normal and when thd dr. listened to my heart he said it sound excellent. the only ofd thing was on my ekg the p wave was minuscule. virtually unseeable. the dr. was skeptical and mentioned the computer very possibly was not picking up thr p wave. so he told me to resume all normal activities inclusing exercuse, no alcohol, minimal caffiene and to comd back in a week to do another ekg. for safety he advised taking eliquis for that week as the absense of thd p wave, if accurate, could inducate afib even though he could hear nothing and was very skeptical about the reading or me being in afib. what are your thoughts Dr?
fyi. I went to the dr. today to follow up on this. I felt totally normal and when thd dr. listened to my heart he said it sound excellent. the only ofd thing was on my ekg the p wave was minuscule. virtually unseeable. the dr. was skeptical and mentioned the computer very possibly was not picking up thr p wave. so he told me to resume all normal activities inclusing exercuse, no alcohol, minimal caffiene and to comd back in a week to do another ekg. for safety he advised taking eliquis for that week as the absense of thd p wave, if accurate, could inducate afib even though he could hear nothing and was very skeptical about the reading or me being in afib. what are your thoughts Dr?
come back in a week for a follow uo ekg and in the meantime to eliquis until then just in case. thoughts dr?
come back in a week for a follow uo ekg and in the meantime to eliquis until then just in case. thoughts dr?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
I am glad to hear that you are actually on normal sinus rhythm.
I perdonally would recommend performing an ambulatory ECG 24-48 hour monitoring( Holter ) in order to examine your heart rhythm trends for a prolonged period of time and investigate for the possible presence of episodes of atrial fibrillation, that may not be registered on the resting ECG.
This test would also guide on the decision of taking eliquis or not.
In clinical practice, after conversion of longstanding Afib, atrial muscle ( that is the upper heart chamber) may remain stunned for 2-3weeks.
In such case anti coagulation use is justified during this period to prevent thrombosis complications.
But in your case, atrial fibrillation has been present for no more than 48hours and the thrombotic risk is quite low. So, Aspirin 100mg daily would be a reasonable treatment choice.
Anyway, if there is no increased risk of bleeding, eliquis will be OK for a week.
I remain at your disposal for any further questions whenever you need!
Regards,
Dr.Iliri
I would explain as follows:
Detailed Answer:
Hello again!
I am glad to hear that you are actually on normal sinus rhythm.
I perdonally would recommend performing an ambulatory ECG 24-48 hour monitoring( Holter ) in order to examine your heart rhythm trends for a prolonged period of time and investigate for the possible presence of episodes of atrial fibrillation, that may not be registered on the resting ECG.
This test would also guide on the decision of taking eliquis or not.
In clinical practice, after conversion of longstanding Afib, atrial muscle ( that is the upper heart chamber) may remain stunned for 2-3weeks.
In such case anti coagulation use is justified during this period to prevent thrombosis complications.
But in your case, atrial fibrillation has been present for no more than 48hours and the thrombotic risk is quite low. So, Aspirin 100mg daily would be a reasonable treatment choice.
Anyway, if there is no increased risk of bleeding, eliquis will be OK for a week.
I remain at your disposal for any further questions whenever you need!
Regards,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Kampana
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello again!
I am glad to hear that you are actually on normal sinus rhythm.
I perdonally would recommend performing an ambulatory ECG 24-48 hour monitoring( Holter ) in order to examine your heart rhythm trends for a prolonged period of time and investigate for the possible presence of episodes of atrial fibrillation, that may not be registered on the resting ECG.
This test would also guide on the decision of taking eliquis or not.
In clinical practice, after conversion of longstanding Afib, atrial muscle ( that is the upper heart chamber) may remain stunned for 2-3weeks.
In such case anti coagulation use is justified during this period to prevent thrombosis complications.
But in your case, atrial fibrillation has been present for no more than 48hours and the thrombotic risk is quite low. So, Aspirin 100mg daily would be a reasonable treatment choice.
Anyway, if there is no increased risk of bleeding, eliquis will be OK for a week.
I remain at your disposal for any further questions whenever you need!
Regards,
Dr.Iliri
I would explain as follows:
Detailed Answer:
Hello again!
I am glad to hear that you are actually on normal sinus rhythm.
I perdonally would recommend performing an ambulatory ECG 24-48 hour monitoring( Holter ) in order to examine your heart rhythm trends for a prolonged period of time and investigate for the possible presence of episodes of atrial fibrillation, that may not be registered on the resting ECG.
This test would also guide on the decision of taking eliquis or not.
In clinical practice, after conversion of longstanding Afib, atrial muscle ( that is the upper heart chamber) may remain stunned for 2-3weeks.
In such case anti coagulation use is justified during this period to prevent thrombosis complications.
But in your case, atrial fibrillation has been present for no more than 48hours and the thrombotic risk is quite low. So, Aspirin 100mg daily would be a reasonable treatment choice.
Anyway, if there is no increased risk of bleeding, eliquis will be OK for a week.
I remain at your disposal for any further questions whenever you need!
Regards,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Kampana
Your extremely thorough answers and interest are both appreciated and heartwarming. I sincerely thank you. I actually played 90 minutes of tennis today in 95 degree Florida weather. I am a 4-5 times a week player but I’ll admit to being nervous out there today. Turns out everything was fine. I played well, didn’t run out of breath, got a great sweat and my heart stayed in normal rhythm and only elevated to around 100 bpm. I go in for follow up ekg and consult on Tuesday. My plan is to continue living my life but abstain from alcohol as that is the obvious trigger. Any other hints RE keeping my heart healthy is appreciated. Last email you mentioned a 24/48 hour holter. Just FYI I had that and the echo this past fall. Both we normal. It’s the alcohol. The cause effect relationship is absolutely obvious. One problem I have is I own a very successful business where social drinking is part of the culture. In your opinion would a drink or two once or twice a month be ok? Or do you think once this cycle has started, totally abstaining is the key. God bless you Dr. Sharka. You surely are a great guy. My name is Rich.
Your extremely thorough answers and interest are both appreciated and heartwarming. I sincerely thank you. I actually played 90 minutes of tennis today in 95 degree Florida weather. I am a 4-5 times a week player but I’ll admit to being nervous out there today. Turns out everything was fine. I played well, didn’t run out of breath, got a great sweat and my heart stayed in normal rhythm and only elevated to around 100 bpm. I go in for follow up ekg and consult on Tuesday. My plan is to continue living my life but abstain from alcohol as that is the obvious trigger. Any other hints RE keeping my heart healthy is appreciated. Last email you mentioned a 24/48 hour holter. Just FYI I had that and the echo this past fall. Both we normal. It’s the alcohol. The cause effect relationship is absolutely obvious. One problem I have is I own a very successful business where social drinking is part of the culture. In your opinion would a drink or two once or twice a month be ok? Or do you think once this cycle has started, totally abstaining is the key. God bless you Dr. Sharka. You surely are a great guy. My name is Rich.
Brief Answer:
My opinion as follows:
Detailed Answer:
Dear Rich,
Your appreciation means a lot to me!
A small amount of alcohol time after time is quite Ok.
I would also recommend avoiding also caffeine intake and taking plenty of water in order to stay well hydrated.
I would recommend the Holter, because it can help register your heart rate for a prolonged period of time and also help 'catch' atrial fibrillation episodes which can not be registered by a resting ECG.
Hope you will find this information helpful!
Please let me know in case of further uncertainties!
Wishing all the best,
Dr.Iliri
My opinion as follows:
Detailed Answer:
Dear Rich,
Your appreciation means a lot to me!
A small amount of alcohol time after time is quite Ok.
I would also recommend avoiding also caffeine intake and taking plenty of water in order to stay well hydrated.
I would recommend the Holter, because it can help register your heart rate for a prolonged period of time and also help 'catch' atrial fibrillation episodes which can not be registered by a resting ECG.
Hope you will find this information helpful!
Please let me know in case of further uncertainties!
Wishing all the best,
Dr.Iliri
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Brief Answer:
My opinion as follows:
Detailed Answer:
Dear Rich,
Your appreciation means a lot to me!
A small amount of alcohol time after time is quite Ok.
I would also recommend avoiding also caffeine intake and taking plenty of water in order to stay well hydrated.
I would recommend the Holter, because it can help register your heart rate for a prolonged period of time and also help 'catch' atrial fibrillation episodes which can not be registered by a resting ECG.
Hope you will find this information helpful!
Please let me know in case of further uncertainties!
Wishing all the best,
Dr.Iliri
My opinion as follows:
Detailed Answer:
Dear Rich,
Your appreciation means a lot to me!
A small amount of alcohol time after time is quite Ok.
I would also recommend avoiding also caffeine intake and taking plenty of water in order to stay well hydrated.
I would recommend the Holter, because it can help register your heart rate for a prolonged period of time and also help 'catch' atrial fibrillation episodes which can not be registered by a resting ECG.
Hope you will find this information helpful!
Please let me know in case of further uncertainties!
Wishing all the best,
Dr.Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
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