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Atrial fibrillation after gall bladder removal, stopped after eating, prescribed Metroprolol and Warfarin. Will the medicines cure this?

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Cardiologist, Interventional
Practicing since : 1998
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yes i recently had a surgery that produced an afibrilation condition ..i have questions about treatment Last week gall bladder removed surgically-in post op, started some fast, irregular heart beating felt stressed and nervous - i felt i went afib from stress and not being allowed to eat or drink for 3 days -- after the op, after getting intravenous drip of regulation meds, i was finally allowed to eat whole food again two day later ,,, and only then its stopped! , it stopped i think because i was allowed to eat.. --ive been released from hospital taking meds now metroprolol 25mg, sotalol 160mg and warfarin ... will the meds cure this? do i need electrical conversion?? to me that seems a bit drastic i am home and comfortable and ive never had any heart problems before
Posted Sun, 15 Apr 2012 in Hypertension and Heart Disease
 
 
Answered by Dr. Prabhakar C Koregol 2 hours later

Hi,

Thanks for the query.

There are quite few issues I need to understand from you:

1. First, are you still in atrial fibrillation (AF) or has it now reverted back to sinus rhythm.

2. If AF is gone how long did it persist?

3. I understand you mentioned you were healthy prior to surgery, did you mean you did not have any underlying heart disease, diabetes or hypertension? - Because by and large post operative AF are transient and we just treat them for week to ten and no permanent medicines are prescribed unless the cardiologist considers possibility of AF being always there and only picked up while admitted for surgery.

4. In that case did it show on ECG prior to surgery?

Combining metoprolol and sotolol is also not very common strategy. So please get back to me with all this information I shall be able to guide you better.

Awaiting your response.

Best Regards
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Follow-up: Atrial fibrillation after gall bladder removal, stopped after eating, prescribed Metroprolol and Warfarin. Will the medicines cure this? 1 hour later
1. I was released yestereday because I was out of AF.
2. It occurred for some hours after surgery #1 on monday to remove a stone in the bile duct , resolved on tuesday, back for gb surgery on Wednesday, af again, resolved on Friday morn after i was allowed toeat food for the first time in five days!! . it happened after both surgeries -- but were resolved within a day, so that's why i was releasred from hospital. i am home now and not monitored i don't notice any irregularity'
3. i have never had any surgeries or major health issues prior to this. ekg was normal prior to surgery i assume.

yes i am taking both of those meds and he wants me to also take warfarin - with some talk of electric treatment down the read -- i am very concerned this is going too far too fast
 
 
Answered by Dr. Prabhakar C Koregol 7 hours later

Hi,
Thanks for getting back.
I believe that you are having simple peri operative atrial fibrillation which has resolved now. But as you had two episodes, your treating physicians may be concerned.
However, you should visit a cardiologist and one of the two medications should be removed. After a couple of days, even the second medicine can be withdrawn.
Your CHADS score (a score which helps predict risk of stroke in patients with AF) does add up to make your physicians consider warfarin. Electrical therapy needs to be instituted only if the AF is recurrent and without precipitating cause. However, you had obvious precipitants both time.

I hope I have addressed your concerns. I would be available for follow up queries.

Regards
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Follow-up: Atrial fibrillation after gall bladder removal, stopped after eating, prescribed Metroprolol and Warfarin. Will the medicines cure this? 2 hours later
I am contacting a new cardiologist about this. i think you are exactly right and i want to stop the medications if possible. . I can understand taking the medication if i am still A Fib, but guess i am not,,, i am not being monitored now, so how do they know?? --and my heartrate seems normal.

Should i hold off the Warfarin too? i did not start that ...

 
 
Answered by Dr. Prabhakar C Koregol 10 hours later
Hi,

Thanks for writing back.

Two or three things, if your AF(Atrial Fibrillation) is decided to be requiring medicines than medcines would be prescribed even if the rythm is sinus which will be so many times. Unless you are symptomatic you need not be monitored. If you have nt started on warfarinn, than you can definately hold on till you have second opinion.

Hope I answered all your questions. If you do not have any more queries, please close this discussion.
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