Medication Question

vickikt · 11-05-2003, 05:02 PM

I am unsure if any of you could answer this but, I was wondering what medication they prescribe for atrial flutter?

The situation is this: I was born with a congential full heart block (due to mother having Lupus). Last year they put in a pacemaker. When they were running test they found I was in atrial flutter. When they did the pacemaker surgery they also did ablation for the atrial flutter. When I went in for my yearly exam about a month ago they found the ablation did not work and I was back into atrial flutter or basically never went out of it. Since I have a dual lead pacemaker they activated the 2nd lead to help pull me out of atrial flutter when I go into it. The other lead is for my slow heart rate. My doctor said in 3 months when I have my over the phone check they will analyze how things are going with the pacemaker and atrial flutter and if it is the same they will put me on medication. My question is what medication is most common for this problem?

projapoti · 11-05-2003, 07:28 PM

Quote:

Originally Posted by vickikt

I am unsure if any of you could answer this but, I was wondering what medication they prescribe for atrial flutter?

The situation is this: I was born with a congential full heart block (due to mother having Lupus). Last year they put in a pacemaker. When they were running test they found I was in atrial flutter. When they did the pacemaker surgery they also did ablation for the atrial flutter. When I went in for my yearly exam about a month ago they found the ablation did not work and I was back into atrial flutter or basically never went out of it. Since I have a dual lead pacemaker they activated the 2nd lead to help pull me out of atrial flutter when I go into it. The other lead is for my slow heart rate. My doctor said in 3 months when I have my over the phone check they will analyze how things are going with the pacemaker and atrial flutter and if it is the same they will put me on medication. My question is what medication is most common for this problem?

This is a weird situation because your ventricles are already being paced. The biggest risk that I'm sure you're aware of with atrial flutter is that you eventually can go in to atrial fibrillation. While that's not immediately life threatening, you're at risk for forming a clot in your L. atrium and throwing emboli towards your brain--i.e. stroke. Now, normally, for atrial flutter, they can do the ablation surgery, which unfortunately failed for you.....you can try to have the procedure again, 'cause you definitely have reason for it.

You can also get medications to slow down your sinus rhythm like beta-blockers or calcium channel blockers....the weird twist in your story is the fact that you have the heart block. I'm not totally sure what they'd do for that other than symptomatic treatment with the drugs I mentioned above and prophylactic warfarin anticoagulation.

The other thing is, even if you did go in to atrial fibrillation, it would be weird because of the AV block. Normally, with patients in afib, you can opt for rate control or rhythm control (amiodarone, or procainamide)... In Canada, at least, we go with rate control...the evidence is better. SOOOOOOOOO, I'm thinking that at the very least they can give you some symptomatic treatment with a beta blocker...they should consider recathing you too.

DJBlod, do know much about this situation? (I'm asking seriously)

dettiger2003 · 11-06-2003, 12:21 AM

[FONT=Comic Sans MS][SIZE=2][COLOR=Navy] Your doctor should be able to just pace you out of flutter. Speed up your heart rate by the way of the pacemaker... That is what my doctor does the heart will go back to normal or should at least.

vickikt · 11-14-2003, 11:31 AM

Quote:

Originally Posted by dettiger2003

[FONT=Comic Sans MS][SIZE=2][COLOR=Navy] Your doctor should be able to just pace you out of flutter. Speed up your heart rate by the way of the pacemaker... That is what my doctor does the heart will go back to normal or should at least.

My doctor is pacing the flutter with the pacemaker hence the dual lead pacemaker. In a about a month and a half I am being re-checked. They want to see how often the pacemaker is pacing me out of flutter. The problem they see with keeping me pacing is that my pacemaker will need to be replaced much sooner since I am using both leads. He has mentioned going back in for ablation but he is waiting to see the results in about a month. That would be a 3 month period of the pacemaker pacing me out of flutter. Thank you projapoti for your knowledge you really gave me more of an explanation of what exactly I am looking at now and in the future. I will definitely suggest to my doctor about having the ablation again.. Thank you!