Conflicting docs' opinions

[Guest guest]

Hi

My wife has recently been diagnosed with AFib and left ventricular

hypertrophy and has seen two doctors who have given her conflicting

opinions about the drugs she should take. We are not sure who to

believe, and it's very stressful for her. The first cardiologist

told her that the results of her Holter (sp?) monitor showed that

she was in AFib for a prolonged period of (I think)several minutes,

only once during the time she wore the monitor; therefore it wasn't

necessary for her to take a blood thinner. The second cardiologist

told her that the results of the monitor showed that she had had

something like 62 brief episodes of AFib, and therefore *should* be

on a blood thinner. We would be very grateful for any advice that

people might have concerning these two takes on my wife's

condition. Thanks in advance!

DC

[Guest guest]

>

>

> Hi

> My wife has recently been diagnosed with AFib and left ventricular

> hypertrophy and has seen two doctors who have given her conflicting

> opinions about the drugs she should take.... snip.....

> DC

In general, younger patients who only have AF for brief periods are not nearly

as susceptible to stroke as older patients and/or those who have longer

episodes. On this board there are have been discussions about how long

episodes have to be before they become likely stroke-causers, and thus

pretty much mandate use of coumadin. As I remember, 45 minute episodes

was a key figure in those discussions. Others will chime in.

For most people, there is a nuisance to being on coumadin (and potentially

expense, depending on your insurance), but not much risk, as long as your

INR stays in range. The risk of too much coumadin would be excessive

bleeding external (like with a cut...) or internal (potential bleeding into the

brain). But as heart valve patients are often kept at an INR of 3.0 to 4.0

rather than the 2.0 to 3.0 used for AF patients, I suspect the risk of brain

bleeding or other critical internal bleeding is pretty small - for most people.

Of course none of us here can tell you what to do, other than keep asking

around until you get recommendations for a VERY good cardiologist, one

who is experienced with AF. Then, even if it costs a few bucks, get yet

another consultation (or even two more, I had four when I got into this ugly

AF business). And then draw your conclusions. It's your life, so ultimately you

have to make the choices (or in this case, you and your wife).

It's a tough issue, like so much of AF, and I wish you well. (PS, on the

downside, in many people, but certainly not all, episodes of AF get longer

over time, so you'll have to keep checking on that over the months and

years). My best,

Kathleen (24/7, coumadin, digoxin, atenolol)

[Guest guest]

> > Hi

> > My wife has recently been diagnosed with AFib and left

ventricular

> > hypertrophy and has seen two doctors ….

Here

Kathleen gave some ideas about the anti-coagulation issue.

Coumadin is usually the " price of admission " for any Doctor to treat

AF.

I would disagree with Katheleen that you should shop for doctors at

this point.

When one has AF one should not be isolated or alienated from the

medical system.

The Medical community tends to overreact to early AF. I try to

comment only on " lone AF " . Ventricular

hypertrophy may be considered underlying heart disorder but it could

be a simple observed situation. Does you wife have an athletic

history? Athletes often have a slightly enlarged left ventricle .If

so then one could target prevention. If one is successful then the AF

treatment may not be necessary. Does she have high blood pressure or

any other heart history? Could you give us a more complete picture?

Please provide a lot of history. Sometimes changing some key

aggravating stimulus can make the AF less likely to occur.

At this stage it is good to take stock of the possible factors to see

if eliminating one or more factor can help.

I assume your " idenity " adequately protects your privacy.

(Whole food lifestyle, NSR 1.5 years after 9 months in

persistent AF.)

[Guest guest]

In a message dated 10/16/04 5:41:59 PM Eastern Daylight Time,

kb_kbrown@... writes:

> We would be very grateful for any advice that

> people might have concerning these two takes on my wife's

> condition. Thanks in advance!

>

Hello .

Question? Have you seen an Electrophysiologist yet? This a cardiologist who

specializes in the hearts electrical system and heart arrythmia's. The heart is

an electric pump. Most cardio's are plumbers. You should consult an

electrician.

Side note: I gave my EP (electrophysiologist) a pin from a electricians

union, Local 3. He got the biggest kick out of that. Now he wants two breaks a

day

and an hour for lunch!

Rich O