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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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How Can Palpitations Be Treated While Suffering From Atrial Fibrillation?

My 90 year old mother (who cannot tolerate medication) has atrial fibrillation and experiences fast heartbeats from time to time. Lately, the fast heartbeats last 4,5 or 6 hours before becoming more normal. She takes atenolol 1x per day. Her cardiologist recommended a pacemaker (since medication cannot be tolerated). Is a pacemaker effective for a fast heartbeat. NOTE: She had rheumatic fever as a teenager and upper chamber valve replacement 5 years ago.
Mon, 30 Apr 2018
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General & Family Physician,  's  Response
Hello,

Based on the history you have shared, at this age priority is to control heart rate rather than reverting the normal rhythm. It can be achieved by beta blockers which she is using, but the dose doesn't seem to be enough for her.

Another option is rate limiting calcium channel blockers which is another group of drugs which may be used for the same purpose. It is better to consult the cardiologist again and readjust her dosing accordingly.

Another concern would be to put her on blood thinners as valve disease as well as atrial fibrillation may contribute to building clots in the heart which may dislodge leading to complications like strokes as should be considered for that as well.

The pacemaker may not be needed in her case. Implantable defibrillator also doesn't seem to be needed but cardiologist second opinion may be sought. All in all, close follow up with the cardiologist from time to time is needed.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Saddiq Ulabidin
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How Can Palpitations Be Treated While Suffering From Atrial Fibrillation?

Hello, Based on the history you have shared, at this age priority is to control heart rate rather than reverting the normal rhythm. It can be achieved by beta blockers which she is using, but the dose doesn t seem to be enough for her. Another option is rate limiting calcium channel blockers which is another group of drugs which may be used for the same purpose. It is better to consult the cardiologist again and readjust her dosing accordingly. Another concern would be to put her on blood thinners as valve disease as well as atrial fibrillation may contribute to building clots in the heart which may dislodge leading to complications like strokes as should be considered for that as well. The pacemaker may not be needed in her case. Implantable defibrillator also doesn t seem to be needed but cardiologist second opinion may be sought. All in all, close follow up with the cardiologist from time to time is needed. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Saddiq Ulabidin