Several approaches for treatment of a...

Several approaches for treatment of atrial fibrillation

There are 6 comments on the SouthCoastToday story from Feb 22, 2011, titled Several approaches for treatment of atrial fibrillation. In it, SouthCoastToday reports that:

Dear Dr. Donohue: Will you please discuss heart fibrillation? I take a medicine for high blood pressure.

Join the discussion below, or Read more at SouthCoastToday.


United States

#1 Mar 21, 2011
I have been in coumadin since 1999. Inever had a problem and went for my blood tests every 6 weeks. In January I had a valve replaced and now they cannot get my coumadin level. I haven't been over 1.7 since coming home. they have increased the coumadin now to 7.5 4 days and 10 mg 3 days and still its under 2.0. What could possibly be going on. I eat no Vit K. No interaction from any other meds and no affects from any vitamins I take. Very interestred if something else could be causing my low numbers

Murrieta, CA

#2 Mar 21, 2011
I would worry more about being on coumadin then the low numbers and just before my husband died they said "Oh he should be on Vit. K "and gave him a prescription for them. I have 2 bottles of them sitting here. I think the drs are so busy taking too many patients to make more money they don't have the time they should to take care of anyone.

If i sound bitter it may be because i am.

United States

#3 Mar 22, 2011
I have been on coumadin for ten years now...personally I think there is very little science behind the doctor's office management of my INR
I think I guess how to manage dose better than them. Anyone else feel the same?

Los Gatos, CA

#4 Mar 23, 2011
I can't believe they gave a man on coumadin. Vitamin k. Some drs dont do their homework. that alone would be mal practice. I take coumadin. The dr only gave me vit k once and it was because my one was extremely high.

Ho Chi Minh City, Vietnam

#8 Jun 6, 2013
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Since: May 12


#9 Jun 6, 2013
Treatment of atrial fibrillation involves drugs or cardioversion.
Atrial fibrillation
Cardioversion—if it is clinically appropriate to attempt cardioversion, the drugs of choice are the class Ic agents (e.g. flecainide) for patients without significant underlying heart disease; class III drugs are somewhat less effective but are safer in the presence of left ventricular dysfunction or ischaemic heart disease (e.g. sotalol or amiodarone). Normally, only one drug should be tried in any individual patient: if drug therapy fails, DC cardioversion is commonly effective.

Risk of thromboembolism—because atrial fibrillation is a risk factor for the development of intracardiac thrombus formation, cardioversion—by chemical or electrical means—should not be attempted if arrhythmia has been present for longer than 48 h. Anticoagulation plus rate control with a β-blocker, calcium-channel blocker, or digoxin should be considered in these circumstances. Prophylaxis against thromboembolism should be considered in all patients with atrial fibrillation.

Paroxysmal atrial fibrillation—drug therapy may not be necessary for patients with infrequent paroxysms, or a ‘pill-in-the-pocket’ approach can be used in those without structural heart disease, whereby they take a dose of an antiarrhythmic drug after the onset of arrhythmia. No drug is entirely satisfactory for recurrent paroxysmal atrial fibrillation: a β-blocker is often prescribed as first-line therapy.

Persistent atrial fibrillation—usually requires electrical cardioversion to achieve sinus rhythm and has a high recurrence rate even after successful cardioversion. The key decision is whether to employ a rhythm or rate-control strategy. In general, a rate-control strategy (AV nodal blocking drug, e.g. β-blocker, calcium channel blocker, or digoxin) should be employed in patients with few or minor symptoms, elderly patients, and those with contraindications to antiarrhythmic therapy or cardioversion. A rhythm-control strategy (elective cardioversion) may be best in more severely symptomatic or younger patients, or in those with atrial fibrillation due to a treated precipitant.
Read more:
this article covers the treatment of cardiac arrythmias including atrial fibrillation in detail.

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