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Going from a stable 50-60 beats per minute to over a hundred beats per minute. She had been stabilized for over a year, and she had been having some issues with retaining too much water. The doctor prescribed a special diuretic to use when her usual one didn't keep her water weight down. I feel that she let it go too far, and now her A-fib is out of control again and her heartrate has been in the 90-119 range for the last two weeks. The doctor seems to be taking a cautious approach and while he doubled her amiodarone he has cut it back down and she still is having the high heart rate with some irregular beats. The home health nurse comes once a week and she contacts the doctor if she feels that he needs to assess what is going on. I am concerned and worried about how long she can go on like this. Has anyone else had these issues and how did you handle them?

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Katielab, at 83 she is still younger than my mom was when she had her first stroke. From what I've seen, I would (of course) want to have confidence in her doctor...but, I wish Mamma had been willing to get a pacemaker when her doctor first recommended one. Your mom is still young enough to come out of this with good results. I did note, though, that you said that she is not a very strong person, so I can see where that would give you some anxiety going into a procedure under 4 to 6 hours of sedation. Our story did not have a happy ending. I lost Mamma last June. As it turned out, she developed more problems, and eventually was diagnosed with colon cancer. She was 95 at the time, and underwent surgery to remove the tumor. They were not able to reconnect and she ended up with a colostomy. She didn't do well with the surgery and I did feel that the anesthesia affected her in a negative way. Saying this, remember that your mom is 12 years younger, and that is very much in her favor. My heart goes out to you...you and your mom will be in my prayers. Please write back and let us know how you are doing.
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My mom is 83 she is not a ver strong person , they want to do the AFib surgery , I am so worried about her being put under for 4 to 6 hours ! Any feed back would be appreciated
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I know meow how you feel, i don't feel alone anymore
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We are three months down the road and are learning to cope with the constant ups and downs. This week, my Mom is stable...but, oftentimes she will lapse back into the a-fib without warning and then just as unexpectedly, go back into the normal rhythm! At least I am learning not to panic when it changes now! I am thankful for everyday that we have. I want to thank all of you who have taken time to relate your experiences to me and who have been instrumental in giving us more peace of mind! I love this forum...it's a wonderful feeling when you know you are not alone.
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Hi Pink, i agree with you.. You have to be the advocate for them and believe me. When you see things are not working out for you or mom get someone else. This is what i did for Frances. She had a doctor in which Frances was going to the hopital almost twice a month. For blood presure and heart beat out of control. So i changed her doctor and now it's under controlled.
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Hi Meaw, i understand your situation, i am having the same problem with Frances. But i notice that the metoprolol Tratrate is works best for her. It keeps her heart rate under controled
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Hi Meow, (another cat lover I take it!) My Mum who is almost 92 was diagnosed about a year ago with a fib. She is on a blood thinner and 3 different blood pressure meds. and something to control her heartbeat which seems to be working :) There was talk of a pacemaker but thankfully the meds are working. If I were in your situation, I'd explain to your visiting nurse that you want to talk to your Mom's cardiologist yourself, and she should understand your concern. You are the caregiver and your Mom's advocate. I've been in situations where I surprise myself by standing up to dr's and nurses. I'm usually not outspoken! But when it comes to my Mom.....I'm a fighter! Let us know how everything works out.
Susan
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Meow - My dad was diagnosed as having a fib about 1995. He would go from 75-80 heart rate up to 150 with no warning. His blood pressure would also fluctuate with his heart rate, sometimes getting as high as 200/120. The doctors tried cardioverting him (shocking the heart) at least 5 times. He would go back to a regular rhythm for a short time and again without warning, or him even knowing, he would go back into a fib. Tried several meds to control abnormal rhythms, including Amiordarone, with no success. They also tried an ablation (cauterizing the abnormal electrical activity in the heart) and what is called a MAZE procedure while he had his first open heart surgery. Nothing would keep him stable. Finally they did another ablation, interrupting all impulses from the top chambers of the heart with the bottom chambers, putting in a pacemaker first. He was pacemaker dependent after that but at least he stayed stable. He was much younger than your mom when all of this started - 69 or 70 years old. He also suffered from congestive heart failure and lung problems which was made worse with the a fib. Sounds like your mom may be dealing with some congestive failure now. When they are in a fib, the heart is not pumping effectively so they can retain fluid and go into congestive failure relatively easily. That's when they have to have an extra diuretic to get the fluid off or they will have trouble breathing. Sounds like the home health nurse is managing it as well as possible and can continue to manage it based on what you have said here. I hope she is able to enjoy her greatgrandchild for years to come. But understand that a fib is a very difficult thing to control. The focus used to be on very aggressive approaches to getting it to a normal rhythm. Now, they focus more on controlling symptoms, leaving patients in a fib, because sometimes the methods used to try to maintain a normal rhythm cause more problems without actually solving the problem. My dad passed in October of 2011 at the age of 86. He lived with and felt relatively well for at least 14-15 years with a fib but then started having other health issues that compounded everything. Good luck, Kuli
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Thank you all for your comments....it's always reassuring to know that we aren't alone and to get perspectives from others who have been through the same challenges. I keep praying that we can keep Mamma here a while longer...as we have a new greatgrandchild for her who is coming this summer. We'd so much love for her to have the joy of holding this little one...we'll keep praying and searching for answers. I truly appreciate all of you here who take the time to help alleviate our anxiety.
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Hi, Meow. My 90-y/o father has had a-fib for about 3 years now. At first, they had to thin his blood enough to do the cardioversion (using the 'zap' paddles) as there is a high risk of clotting. It took a month to get his blood to the right level - very harrowing time for all of us, as you can imagine. They zapped him once and he was back in sinus rhythm. Several months later, he 'felt' it go out again (they don't always know or feel when they're 'out of rhythm, we found) and had to have the cardioversion done again. This time, he was put on Amioderone and so far has remained in sinus rhythm. They never spoke of any of the invasive type of procedures - I'm not sure he'd be a candidate at his age, though he is otherwise in good health.

We had a friend that slipped out several times. Finally, they were unable to get him out of a-fib. They simply kept his blood thin and monitored him closely. He lived a good year, I know, in a-fib. It sounds terrifying, to me and you, to survive heart arrythmia over a period of time, but it happens.

Hoping for the best for your mom...Lis.
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Thank you for responding. Actually, she does have a cardiologist with an excellent reputation..but, I was feeling that maybe even the doctors at times cast a blind eye at the older patients. We have home health coming in once a week, and they don't seem to be too concerned about it. She was stabilized for over a year, and it was so good to have a period of time without the anxiety of complications. She is on coumadin to thin her blood and has regular blood work to monitor it. She was originally a stroke patient...had a stroke over 8 years ago, so I know her care has been good to have kept her here this long. I've been there for her everyday, and I guess I've taken my 'caregiving' very seriously...I'm all she has...her only child. I don't think that they would consider doing surgery for a pacemaker at her age....just wondering if we are doing all we can. The home health nurse wants to be the 'go between' us and the doctors, so I hesitate to call the doctor. Just wishing we could get her stabilized again with a steady heartrate....this situation is causing me lots of anxiety. Thanks, again, for answering.
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I am very glad that your mother is monitored weekly by a nurse and that her doctor is kept informed of her status. That should be a comfort to you and reduce your worries. I suggest you ask your question of the nurse.

There are many different ways of treating A-fib, and many factors to consider. For example, my husband was on a blood thinner for several years. As his fall risk increased his doctor decided that the risk of internal bleeding after a fall outweighed the risks associated with the A-fib and she took him off of it. He remained on a diuretic and digoxin. It is good that a doctor who knows your mother's particular health history is monitoring this situation.

I have no experience with your mother's situation. I hope other posters can share their experiences. Expressing your concerns to the nurse may be useful, too.
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Everyone's different so it is hard to give advice. Does she go to a good cardiologist or is the primary dr handling treatment? (not that there are not good primary drs but I guess i'm partial to the specialists who see more patients with a fib so they have more experience) From my understanding the main concern with a fib is clotting which can lead to stroke. Is she on a blood thinner? plavix and/or aspirin ?. however with the blood thinner, there is risk of bleeding. i can only tell you that my family member was on sotolol for years and other high blood pressure medications, ended up with a pacemaker for other issues, had a stroke and then started on plavix and aspirin.and Diltiazem; b/c the sotolot was no longer controlling the a fib, dr took her off and now just on Diltiazem. she doesn't have water retention issues and seems to have adjusted to the a fib. Actually feels better (not dizzy all the time) off the sotolol.
Telling you all this is not going to help your situation but my point is, make sure you have a dr you feel is knowledgeable about treating a fib and other heart issues. Cautious approach is good sometimes especially with older patients. Some drs are too quick to want to do surgical procedures. Re meds for a fib: I think that happens with a fib, eventually medications don't work.There are surgical treatments but i think they are for younger people and don't always last. but you can always seek a second opinion if you are worried about the high ongoing heart rate.
There is alot of information about a fib on the internet.
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