Cardiofront Logo
Jafib Logo
St. Jude Medical

October 13th, 2015
Submit Manuscript
Meet the Expert
Enter your question
Browse All Questions Answered upto now
     ... 34 35 36 37 [38] 39 40 41 42 ...    
Hello Doctor, I am a 72 year old female still working full time, and suffer from Lone AFib on a once every 10-14 days for around 5-6 hours. Had it for about 10 years and from once every 6 months to current, but has stayed this way fro last 2-3 years.I was taking Flecainide which really didn\'t do much at all, then was put onto Metoprolol which made me gain 10lbs and feel like a zombie. I currently take 12.5mg met per day and Magnesium 2000mg Vite D 2000mg Calcium 1000mg Taurine 1000mg and potassium every other day 100mg.Food is a big trigger for me as is eating too much or too fast, can bring on a very chaotic attack. Also bending or even rubbing the front of my chest hard. My questions are \'as a lot of people I know have these same triggers why is there no study to find out how the Vagus nerve plays a part in AF? My second question is \'when I get an attack I usually just take it easy and put my feet up and do the minimum of physical exercise until it stops. However increasingly I find the effects such as chest pain, nausea, breathlessness and dizziness are becoming harder to take. My Cardiac nods and says I\'ll be fine which is very frustrating. What\'s my next step
2013-03-03 Answered By : Dr. Gregory Feld M.D., F.A.C.C. F.H.R.S.

The vagal triggers of AF are well known, and include large meals, slow heart rate at night, bending over, etc. as you have noticed. Actually extensive research has been done that shows that vagal nerve stimulation may trigger premature beats from the pulmonary veins, then can then initiate episodes of AF. The problem is eliminating the vagal triggers. Some recent research has shown that low level vagal nerve stimulation may actually reduce AF recurrence, but this treatment is not clinically available in the U.S. yet. We also know that ablation of the pulmonary veins may eliminate the triggers of AF. Thus, if you have not had a good response to antiarrhythmic drugs such as flecainide, then an AF ablation may be appropriate for you, to eliminate your symptoms. However, ablation is not always required if your symptoms from AF are tolerable. Just remember, that in some cases the frequency and duration of AF episodes may increase over time if not treated, eventually leading to persistent AF, which may be harder to treat. Vitamin supplements are not typically too helpful, although magnesium has helped some of my patients. Just as a reminder, previous studies have shown that even 5 hours of AF in a 24 hour perior increases your risk of stroke, and a more recent study suggests that even 5 minutes of AF may increase your risk. Thus, since you have a CHA2DS2VASc score of 2 (age over 65, and female gender), the European guidelines recommend that a patient with a CHA2DS2VASc score of 2 should be on an oral anticoagulant such as warfarin or one of the newer factor Xa or direct thrombin inhibitors to reduce the risk of stroke.

Hello. Recently I have needed to nap more in the daytime and feel excessively tired. My GP wants me to have a sleep test for Sleep apnea. I have also had another of my blackouts. I am concerned that my unexplained blackouts could be caused by Brugada Syndrome. I am considering going back to my Cardiologist but it is expensive here so I want a second opinion to review my ECG results before I make an appointment.
2012-11-28 Answered By : Dr. J.David Burkhardt M.D., F.A.C.C. F.H.R.S.

For Brugada or passing out from heart rhythm disturbances, the best person to see is a heart rhythm specialist. There are some tests which can provoke the Brugada pattern.

Hi. I am 37 years old Female, recently I had a blood test and scored 6% on the Framington heart test. I thought my chances of having a heart attack or having heart disease within the next 10 years then was only 6%. However, I decided to look the framington score up, and I'm confused. If a score of 10% suggests heart disease, does that mean a 6% score indicates a heart that is just over half way diseased? My question is, what exactly does my 6% score mean for my heart?
2012-11-28 Answered By : Dr. J.David Burkhardt M.D., F.A.C.C. F.H.R.S.

The Framingham risk score indicates the risk of developing significant disease in a decade. It is not for people who have known disease. Your risk score is relatively low, so continue to keep the risk factors down.

Hi. My mom is 50 years old. She visited the doctor and he gave her Medication for her heart and he gave her a heart monitor thing which kept beeping at night a lot. Also my grandma died when she was 63. Whats the risk? What does having your lips turn bue mean? Thanks. Also can she fly to Europe with this condition its a 10 hr trip? My mom has never tried alcohol or smoking and im 100% sure. Is my mom at risk of heart attack.? please help?
2012-11-28 Answered By : Dr. J.David Burkhardt M.D., F.A.C.C. F.H.R.S.

I am unable to answer all these questions as they are too specific without knowing the patient personally. I would suggest follow up with the doctor who prescribed the treatment and either accompany your mother or have a list of questions prepared that you would like answered.

Hi.My boyfriend had a Heart attack on last tuesday he is in ICU, he has been sedated and underwent a "rewarming process" on thursday as responding to simple commands and could squeeze hands and lift his head. Today he spiked a fever of 103 and was taken for tests. He is still under Sedation. What happens now? Kindly suggest me?
2012-11-28 Answered By : Dr. J.David Burkhardt M.D., F.A.C.C. F.H.R.S.

I am sorry to hear about your boyfriend. The fact that he is responding after rewarming is a good sign. The doctors will likely look for infection as a cause of fever and begin medications for his heart and start rehabilitation when he is able.

Hello Doctor. I am a 40 year old male Caucasian 172cm, 71kg, normal blood pressure. I exercise a couple of times per week and don't drink or smoke. I had a heart exam 3 years ago following some unexplained chest pains which included a treadmill stress test. My heart structure showed up as normal in the echo and so I was told that I had nothing more than IRBBB. The Duke Treadmill Score was -29. I have unexplained blackouts twice per year and sometimes feel like I have strange heart rhythms before I go to sleep. What could be my problem? Please explain??
2012-11-28 Answered By : Dr. J.David Burkhardt M.D., F.A.C.C. F.H.R.S.

With a normal heart and good exercise tolerance, your risk is considered low, but heart rhythm problems are occasionally seen in people with normal hearts. I would suggest seeing a rhythm specialist, who will likely order two types of monitors. One to see what your are feeling at night and another (which could be implanted under the skin) to see if you have any rhythm problems during episodes of passing out. Otherwise, the most common cause of passing out is simple fainting (vasovagal syncope).

I am a 48 year old female that was diagnosed with AFib, back in March of 2011, my espisodes seem to flucuate with my menses cycle and they last from any where up to 12 hours every 10 to 14 days. I take asprin and toprol xl 25mg a day. I am very confused as to what I should be doing?? Should I take coumadin too, start an antiarrythmic (I am very sensitive to meds). I have not been told what type of Afib I have but I think it is genetic. My mother and my brother both have it. And my dad was recently diagnosed with it this year. I am scared and confused!! Your expert advice will help thank you!
2013-03-03 Answered By : Dr. Gregory Feld M.D., F.A.C.C. F.H.R.S.

With such a strong family history of AF, yours may indeed be familial (genetic). Nonetheless we typically treat it the same as sporadic or lone AF. According to your history you donít have a very high risk score for stroke (CHADS2 score 0, CHA2DS2Vasc score 1), since you are less than 65 years of age, and do not have congestive heart failure, hypertension, diabetes, vascular disease, or prior stroke. Therefore, you do not need to be on Coumadin. If your AF episodes are very frequent, and that depends on your perspective, but every 10-14 days if fairly frequent, then an antiarrhythmic drug may be advisable. We usually use flecainide 50-150 mg twice a day, with Toprol, to see if it helps suppress the AF. If AF continues to recur even on flecainide, then an ablation may be required.

I am 64, diagnosed almost 2 years ago with persistent asymptomatic afib, left atrium 48 cm, no other health issues except treated moderate sleep apnea. I am athletic and my weight is fine. I take Bystolic and Pradaxa with noisses. My EP allows me to exercise freely (weights and treadmill jogging). When is it time, if ever, to go on rhythm meds or get an ablation? Thank you.
2013-03-03 Answered By : Dr. Gregory Feld M.D., F.A.C.C. F.H.R.S.

Since your persistent AF is asymptomatic, rate control is an appropriate option for treatment of AF in your case. If you have been in AF for more than a year, it becomes much more difficult to prevent recurrence with either antiarrhythmic medication and cardioversion or ablation. You do not have to undergo treatment with an antiarrhythmic drug or ablation if you are asymptomatic. In fact, if you are under age 75 and have no other risk factors in the CHADS2 score (congestive heart failure, hypertension, age over 76, diabetes and prior stroke), you theoretically donít need to take Pradaxa either, just aspirin may be appropriate.

Do beta blockers cause cardiac remodeling because of fibroblasts
2012-11-28 Answered By : Dr. J.David Burkhardt M.D., F.A.C.C. F.H.R.S.

Beta blockers have many potential benefits that promote beneficial remodeling including reduction in cardiac response to stress hormones. They also have some effects directly on cells such as fibroblasts, but they are better known for blocking the signals that promote such activity.

Hi Doctor, My father recently underwent a hipsurgery where a bipolar prosthesis was inserted in his leg. It has been more than 11 days since the surgery. He is only able to do limited exercise. He is diabetic and has high blood pressure (170/80). Should I give him aspirin for anti- coagulation , Tiotropium bromide for bronchodilation and Telvas AM (Telmisartan + Amlodipine ) for blood pressure. Thanks Regards Manoj Thankyou for the answer. When my dad tries to walk using a walker, he is able to walk only for 5 min. My father says pain and lack of energy are the main reasons for this short duration of the walk. However, after walking when he sits down on the bed, he perspires profusely. Before his hip surgery, his haemoglobin level was low at 9.8. Thats why ~600 ml of blood was transfused before surgery. What do you think is the reason for excessive perspiration? My dad thinks that this may be another reason why he cannot walk more. Your reply is greatly appreciated.
2012-11-28 Answered By : Dr. J.David Burkhardt M.D., F.A.C.C. F.H.R.S.

I am sorry. I am not an expert in orthopedic issues. Certainly discuss this with your surgeon.

No.of Questions Asked in All Sessions: 1055
No.of Questions Answered in All Sessions: 1053

Meet the Expert Doctor


1. JAFIB and the invited expert reserve the right to decline any question. The question declined will not appear in the list of questions asked.
2. The questions or advice from the expert can not be considered as alternatives to your clinician's advice. This discussion is only for educational/informational use. Your EP doctor is THE person to advice you on treatment and management of your condition.

Feedback : Your suggestion on this new initiative are much appreciated. Please write to the managing editor( about your feedback on "Meet the Expert".
Powered by - Jafib Team   Privacy Policy | Site Map
hits counter