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Forum Name: Arrhythmias

Question: New Onset A Fib


 lastryl - Sun Sep 16, 2007 12:49 pm

My fiancee is a 34 y/o male with no chronic health conditions other than he is however a recovering alcoholic who used to drink 4-12 beers a day for about 10 years and hasn't had a drink in well over a year. He has no significant past surgical history (tonsillectomy and deviated septum repair in 1997 and a hernia repair at age 6 months). He has a strong family history of heart disease on both sides. He currently takes no medications prescribed or OTC. 3 days ago I took him to urgent care because his heart rate was very irregular, he said he felt SOB and "just didn't feel right". Turns out he was in new onset A-Fib confirmed by 2 12 lead EKG's. His ventricular rate was not really tachy (ran between 72-114 but stayed in the 80's and 90's the majority of the time). He was transferred to the ER via ambulance on a monitor where they repeated a 12 lead and admitted him to telemetry. No interventions were done and he converted back to normal sinus on his own approximately 6 hours from the time I brought him in. Stress test and echo were normal. All blood work was normal except for a minimally elevated thyriod level. The consulting cardiologist discharged him without any concern other than to decrease his caffiene intake (my fiancee said the only thing he did different that day was drink a large green tea smoothie), and doesn't want to follow up with him. This doesn't sit well with me considering his past alcohol use and family history. (I am an ICU nurse, but brand new..just out of school.) Should we get a second opinion or is this the standard of care?
 John Kenyon, CNA - Wed Sep 19, 2007 6:31 am

User avatar Hello - Given your fiance's personal and family history, plus the slightly elevated thyroid level, I would think a doctor would want to follow up routinely in a few weeks, unless there were more occurrences of the arrhythmia there's really not too much to be done, except perhaps to apply an event monitor, which might not have been a bad idea anyway. Very brief episodes of supraventricular arrhythmias, including A-fib, are not unusual, and given the history of alcohol use the episode described is not terribly surprising either. A second opinion might be wise, if only to establish a relationship with a cardiologist who could follow your fiance in the future if any further problems come to light. Otherwise, it is pretty much a judgement call.My personal preference would be to take a conservative approach.

Hope this is of some help.
 lastryl - Mon Sep 24, 2007 8:37 am

Thank you very much for your help, it was very much appreciated. I know that with one episode there's not much to do but I think from now on he will follow up with a different cardiologist. Thanks again!!!

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