Suggest Treatment For Slow Heart Rate And Tiredness

Brief Answer:
Do go through the detailed answer, Regards

Detailed Answer:
Hello Mam, I am Dr. Mody and I will be addressing your concern.
Atrial fibrillation may result because of instability in th the electrical circuit of the heart.
Some important points that will make things more clear.
1) what was the indication for mitral valve repair at that time .
2) if atrial fibrillation is established why is he on holter.
3) has he been put on any medication for atrial fibrillation
4) are you monitoring the heart rate with a machine, because in atrial fibrillation the machine will not be able to accurately measure the heart rate.
If you can just upload the ecg and echocardiography report if done recently, it will help me give you exact advice.
Now to help you understand the condition and answering your doubts.
In atrial fibrillation the heart rate in on higher side more than 100 (atrial to rate more than 350), and not lower like you mentioned 41-51, the only possibility is when atrial fibrillation is over treated with medication the heart rate may go down to the level you have mentioned which may then cause weakness
So do send me the medication list.

Now the cause of atrial fibrillation in your husband may be many.
Most likely age, hypertension, presence of mitral valve disease ( atrial enlargement) , electrolytes imbalance like potassium, magnesium deficiency, acute stress events and overworking thyroid.
There is a possibility of the valve going bad as 14 years have already passed is surely a possibility , though many other other more common cause may cause atrial fibrillation like I mentioned , which should be evaluated at ruled out as they are easily reversible .
A 2D echocardiography should clear the valve status so if not already done, I strongly recommend to get it done and do forward me all the available medical reports so I can help you better.
Regards Dr Priyank Mody

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Brief Answer:
Heart status should be evaluated. 2d echo cardiography best test for him

Detailed Answer:
Y thank you for the information, so for severe stenosis, in most probability if no cut on chest wall they must have done a balloon mitral valvuloplasty, ie. To open the orifice of mitral valve.
Holter is a type of ecg only, it's 24 hours recording of ecg.
So long he has been put on holter and considering that no medication is started so only maybe one episode of atrial fibrillation was noticed and no repeat episode since than.
Now as weakness is the most important reason why you consulted me.
So yes a restenosis of the mitral valve again or any other pathology with the valve like regurgitation or any change in the pumping of left /right chambers of the heart will cause weakness.
2 d echo cardiography is the most simple and non Invasive method to know status of your heart, and I strongly recommend it for your husband.
Other reason may be intermittent atrial fibrillation, low hemoglobin, hypo - thyroid ism (less production of thyroid hormone in the body).
Atrial fibrillation may bit necessary occur only if there is a problem with the valve again, however it should be ruled out.
Ideal heart rate for him should be 50-60. Though the holter will give us an objective evidence of whether there are any pauses, as less than 50 pulse may cause weakness particularly when he is walking or exerting.
I would be happy if you can upload any doctors note or reports available, so I can guide you with further course of action.
Hoping I could help.
Let me know if any clarification needed
He can consider a multi vitamin and vitamin D supplement apart for Co Q.

Regards Dr Priyank Mody

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