Re: Ejection Fraction and Afib

[Guest guest]

>My question is this -- I've never had an echocardiogram while in NSR,

>I was always in varying degrees of afib, and with this last echo my

>heartrate was around 140 in afib. the doctors say whether your in

>afib or not doesn't effect your ejection fraction, but then again

>I've heard others say that it sure could effect it?

>

>does anyone have any feedback on this?

Hi Jim, I've never had an echo done when in Afib but I'm certain the cardiac

output is impaired when in AF. I've read in several place the average loss (in

cardiac ouput) is between 20 and 30%.

I don't know how they work out ejection fraction out (ventricular volume before

and after a beat??). Just because cardiac output is reduced doesn't necessarily

mean ejection fraction is reduced.

I've always considered it as a cardiac output problem rather than thinking about

ejection fraction. (Here's my first thoughts on the subject without doing any

research so please take with a large pinch of salt)

As I understand it the 'normal' ejection fraction is between 55 and 75%. My own

opinion is that the ejection fraction will vary quite a lot in AF - it comes

down to timing. One of the problems is that ventricular filling is pretty much

passive when you are in AF - if your ventricles don't fill as much as they

should before a beat wont they sometimes eject less? There's some really neat

pressure/blood volume sensors going off but I think these get mightily confused

during AF - your body is screaming out for more oxygen but the heart is

struggling to supply it.

It's also my uneducated view that some of the unpleasant palpitations we feel

are due to the ventricles giving a strong beat when there is hardly any blood to

pump - a real chest shaker! - surely the ejection fraction will be smaller. Of

course there are soma lucky people who are less symptomatic. If you can get your

rate down so the heart can passively fill between beats then ejection fraction

(and cardiac output) will be pretty good. I've read somewhere that the atria

only pump the last 20% of blood into the ventricles so if you can get 80% in

there before a beat it should be easier for you heart to pass half of that onto

the rest of the body.

I hope somebody who knows what they are talking about will also respond

all the best.

--

D

[Guest guest]

Dear Jim, sorry it's been a while since I made contact. In regards to

your post on ejection fraction, my left ventricular ejection fraction

was measured at 30 - 35% on the 17 July/01 after a failed

cardoversion

attempt. I was placed on 2.5mg of Ramipril per day to be increased

over time to a max of 10mg. per day. I am presently on 7.5 hoping to

go to 10mg. this week. The effects of this drug has been to help the

muscle relax between beats and to lower my blood pressure and heart

rate. I have experianced some problems with the drug (light head,

dizzy when geting up from a chair or bending over. The benifit that I

have recieved however have been worth while. I feel a lot better, do

not get tired as easily and I am able to enjoy life again.

I am also taking a bata blocker (metoprolol Tartrate 50mg) and also

4mg of Warfarin.

On Oct 09/01 I was sent to Winnipeg and had a MUGA scan, this was

instead of the follow up Echocardiograph and is supposed to give more

accurate information. i should get the results towards the end of

next

week, hopefully the ventrical ejection fraction will show an

improvement that reflects my overall well being.

I will let you know how I made out.

In the mean time, good health.

Best regards H

[Guest guest]

Dear Jim, sorry it's been a while since I made contact. In regards to

your post on ejection fraction, my left ventricular ejection fraction

was measured at 30 - 35% on the 17 July/01 after a failed

cardoversion

attempt. I was placed on 2.5mg of Ramipril per day to be increased

over time to a max of 10mg. per day. I am presently on 7.5 hoping to

go to 10mg. this week. The effects of this drug has been to help the

muscle relax between beats and to lower my blood pressure and heart

rate. I have experianced some problems with the drug (light head,

dizzy when geting up from a chair or bending over. The benifit that I

have recieved however have been worth while. I feel a lot better, do

not get tired as easily and I am able to enjoy life again.

I am also taking a bata blocker (metoprolol Tartrate 50mg) and also

4mg of Warfarin.

On Oct 09/01 I was sent to Winnipeg and had a MUGA scan, this was

instead of the follow up Echocardiograph and is supposed to give more

accurate information. i should get the results towards the end of

next

week, hopefully the ventrical ejection fraction will show an

improvement that reflects my overall well being.

I will let you know how I made out.

In the mean time, good health.

Best regards H

[Guest guest]

Jim,

Awhile back I looked into dofetilide and found (I think)

an afibsupport poll where people listed their doses. What struck me

was that the results were dose dependent.

I can't find it now, and I grubbed Everywhere - not just in polls,

but in the database, etc. I did find in the database that someone

seems to be on 500 whateverunits twice a day. I don't kow how this

corresponds to the max allowable.

[Guest guest]

Thank you VERY much for the reply, yes, I'll be looking forward to

hearing how the mugascan goes. Good luck to you!

Jim

[Guest guest]

Thank you VERY much for the reply, yes, I'll be looking forward to

hearing how the mugascan goes. Good luck to you!

Jim