Medical Dopers, what happened here?

NOT a request for medical advice–we both have doctors.

My family has a history of heart rhythm problems–my grandmother, all four of her children, my brother and I, we all have it. Sometimes the heart races, sometimes it “skips a beat”. My husband says sometimes mine sounds like someone tripping over a trash-can. I take atenolol. My brother takes something else. My mom was on inderal, although I don’t know what she’s on now. We all have xanax or similar for stress, because stress makes us more prone to attacks.

Yesterday, my brother woke up at 2:30 am with his heart racing so fast he couldn’t even feel his pulse. He refused to go to the doctor or hospital, hoping it would settle down as it normally does. Finally he went to his local clinic at about 4 pm. The doctor there said he was in atrial fibrillation (I think) and sent him directly to the hospital. DUH! :smack: When he got to the hospital, his heart was beating at 150 bpm and was irregular. They gave him an injection of something, and then set him up with an IV drip of the same. His heartrate was down to 102 bpm within minutes. They kept him overnight.

My uncle is the only other one of us who has had this extreme a problem, and he ended up eventually having the surgery to kill off the misfiring pacemaker.

So, what’s the technical behind all this? (This is in IMHO because I know that without examination, you’re going on your interpretation of what I’ve posted.)

IANAD, but I have relatives and friends with this condition. I do not believe there is any consensus on what causes it.
Your uncle apparently had an ablation. They used to do this as open heart surgery, usually when there was another reason to be poking around in there. A newer alternative is catheter based ablation. I had a friend who had this procedure, and he is now 100% without any drugs. It was not an easy procedure, however, and took over 5 hours. In your brother’s case, it may be worth looking into.

Inderal (Propanolol) and Atenolol are both beta blockers, which work by slowing the heart down.
My guess is your brother either got Digoxin or Amiodarone to try slow his heart down.

This is just a guess…
Lown-Ganong-Levine Syndrome or
Wolff-Parkinson-White Syndrome

The fact that your uncle had surgery (presumably to remove or burn out the abnormal pathway) rather than a pacemaker is a factor in making me think this is the case.

Sorry if those articles are too technical.

Basically, in those syndromes, as well as the normal electrical pathways in the heart that carry the signals for the heart to contract in a nice rhythmic way, there is an extra, abnormal pathway. This abnormal pathway has less resistance, and essentially acts as a sort of “short circuit”, bypassing the normal pathways and causing the normal rhythm of the heart to go haywire.

Again this is a guess, a fairly educated one, but really, still pulling it out of my arse.

Yes, exactly, my uncle had a catheter ablation, ethelbert.

irishgirl, thanks for the articles. I’ll try to give them a more in-depth read later. I sort of understand what the issue is. What exactly does *fibrillation * mean, though?

I’m sure someone will pop in with a more technical definition for ya, but simply put, fibrillation is a quivering movement caused by uncoordinated contractions of the fibrils that make up a muscle (in this case, the heart). It’s like major twitch-city o’ muscle. The heart being one such muscular organ, it spells bad news if it has uncoordinated contractions deep down in individual fibrils (fibers that make it up)…

Fibrillation means that the muscle cells of the heart are contracting randomly rather than in a synchronized, coordinated fashion, so the heart muscle just twitches uselessly instead of forcefully pumping the blood out of the heart chambers. In atrial fibrillation, the upper chambers of the heart aren’t working properly, but the ventricles (which are the chambers which pump the blood out of the heart and into the lungs and the body) are still contracting properly. It classically causes a fast, irregular pulse.

Ah, so! That makes sense. Thanks, both of you.

My mother just had a catheter ablation done on Friday. She had a pacemaker installed a couple months ago to regulate her atrial fib. The pacemaker and meds alone weren’t enough to fix it, so they had to do the ablation. They said that now if she goes into a fib for more than thirty seconds the pacemaker will regulate everything.

Basically, they said that with the different chambers beating irregularly, it wasn’t able to move the blood along, so it would work harder, speeding up until she was at 170-180. She had three cardioaversions, which would stop it temporarily, but within days she’d be back in atrial fib. We’re hoping this works, because she’s running out of options.


And it’s much better to be in atrial fibrillation than ventricular fibrillation. Folks can live with Afib for decades, even though that rhythm does carry some serious risks.

In Vfib, the heart does not pump blood, it just quivers. Unless emergency intervention is undertaken, Vfib generally degenerates into asystole, aka ‘really quite sincerely dead’.

Is ablation ever used instead of drugs (beta blockers) if the beta blockers are working to control an arrhythmia?

Qadgop the Mercotan, isn’t fibrillation the kind of thing that a MAZE is good to fix?

It is touted for that. I suspect it is good for certain types of afib.

But not every afib needs such a procedure, or radiofrequency ablation.

If lifestyle modification and relatively benign drugs can control it, they may be preferable.

Much depends on the cause of the afib, and the response to initial treatments, and whether or not it recurs. And “other” factors.

I get palpitations and wonky blood pressure if I have too much caffeine. Started about five years ago. Now, I take my Toprol and Altace, and both my heart and I are happy.

Curiously, when I asked my doctor if there were any way to cure the palpitations, he said I could either lose all the extra weight I’m carrying (around 80 lbs, and don’t think I haven’t been trying) or get pregnant.

Pregnant? That seems a rather drastic solution, especially considering my marital status. How on earth would that work?

Sounds a lot like what I have, AV-Node reentrant tachycardia. I was born with 3 AV nodes, and for any or no reason whatsoever the message for the heart to beat goes through all 3 nodes at once, tripling the message to the heart. It can last for a few seconds or several minutes. I’ve had the ablation surgery and am still on digoxin now for it, as they only cauterized the weakest of the 3 nodes, I still have two.

FWIW Category: A couple of years ago, after a hefty dose of Barqs root beer and some chocolate ice cream, I had these symptoms and went to the hospital for a day and a half. Since then I’ve avoided caffiene and have had no relapses.

The doctor told my mom to avoid caffeine, too. But you know, us caffeine junkies just can’t shake the habit that easily. She did cut back. I usually have two caffeinated drinks a day, but I take one teeny little half-pill of the atenolol each day and I very rarely have the attacks. My brother doesn’t have them all that often either, normally, but he’s been under a lot of stress lately.

I get the same thing, but I just avoid caffeine. Yeah, sucks a bit, as I like coffee, but it’s just not worth it.

Funnily enough, a cardiac nurse I know had no idea that coffee could cause palpitations. It took a resident to explain it to her.

Well, you see, when a man and a woman love each other very much…

…and then they smoke a cigarette.