Back in Rhythm - by Ane

Mark's sinus rhythm returned to normal a day or so ago with the help of heart meds. An ECG yesterday and contact with Dr. Zemsky today confirmed that he's back in sync.   As long as there are no glitches there will be no need for the cardioversion.  Yea!  He'll likely have to stay on the heart meds that regulate the rhythm, but he can get off the beta blocker which will allow him to return to regular activities without getting so tired.  He can hardly contain himself with this nice weather - there's work to be done in the yard and he's anxious to get to it!

My Beating Heart - by Mark

We met with Dr. Zemsky yesterday and found out that my heart is most likely in atrial-fibrillation instead of atrial-flutter although it is hard to tell for sure. (A-fib is in the left atrium whereas A-flutter is in the right.) The treatment plan is:

1.       Stay on Metoprolol until the heart gets back into sinus rhythm.

2.       Start to thin the blood tonight with Coumadin (Warfarin) and monitor carefully to get it to just the right level over the next 3-4 weeks in preparation for a cardioversion.

3.       Do a stress test this Friday to determine the right kind of medication to put me on to try to medicate the heart back into rhythm.

4.       Start the rhythm correction medication right after the stress test results.

5.       Do the cardioversion on March 6th unless the heart has gone back into sinus rhythm with the meds or on its own (not likely).

6.       If the heart stays in rhythm then off the Coumadin nine weeks after the cardioversion.

7.       If the heart stays in rhythm until September, see if it will stick without the rhythm medication.

8.      If the heart does NOT stay in rhythm after the cardioversion it is possible to have a catheter ablation on the left side of the heart. This procedure has more risk than the one for A-flutter and may not work as well, but is certainly an option.  

So...here we go!! This is all fairly routine so there are no big concerns. We do appreciate your care and concern.

Warmly,

Mark

A Racing Heart - by Ane

Friday night after Mark was out playing with some of the grandkid he came in feeling light-headed and faint.  He checked his heart rate and it was close to 140 and didn't return to normal after resting. Saturday morning it was still high so he e-mailed the oncologist and the electrophysiologist who had done Mark's catheter ablation. Right away he heard back from Dr. Urba (he is truly amazing!).  He, of course, would defer to the heart doctor, but if we didn't hear anything Mark was to take it easy.  If his resting rate got over 140 Mark was to go to the ER.  If Mark did much of anything it would get close to 140, so he had to lay low all week-end.

This morning we had a previously scheduled appointment with Dr. Urba.  Before we left the house we tried to get an appointment for today with a cardiologist, any cardiologist in the Providence system, with no success.  We particularly wanted to see Dr. Zemsky since he was the electrophysiologist that did Mark’s catheter ablation.  The earliest appointment  we could get with him was March 2^nd.  Fortunately, Dr. Urba has more clout than we do! J  While we were with Dr. Urba Mark had an EKG.  Dr. Urba got the results and called Dr. Zemsky’s office.   Before we even got home Dr. Zemsky’s medical partner called us, and then called in a prescription of Metoporlol. Mark now has an echocardiogram scheduled for the 9th and an appointment with Dr. Zemsky on the 11th. Wow, how thankful we are that Mark already had the appointment with Dr. Urba this morning so he could get the ball rolling!  

With the medication Mark's resting heart rate is fluctuating between 75-95. His normal resting rate is 60.  While it's not back to normal he feels so much better and isn't in danger of a stroke.  Hopefully he will be able to have another catheter ablation.  We’ll know more next week after we meet with Dr. Zemsky and find out why this has happened. We’re not worried.  Mark just hates to have to slow down! J