Name | Vicky |
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Location | London, UK |
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Age | 47 |
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Diagnosed condition | Atrial Fibrillation - now Persistent. Still vagal characteristics, but more mixed now |
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Years with condition | 6 |
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Frequency of episodes | was 1-7 weekly, now continuous if not on drugs |
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Duration of episodes | currently 2 days on 2days off |
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General health | OK, apart from the AF (!) Minor asthma, back/neck problems. |
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Current state | Persistent AF only partially controlled by dofetilide. Looking at ablations now. |
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Triggers | All the usual vagal AF triggers, night-time, after exercise, after eating, etc, but all triggers require pre-existing digestive upset - without this, triggers have much less effect. However, as at 2 Aug 2001, triggers have to be less than before to set off AF. |
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Preventions | None of the earlier preventions (being careful about digestive status) work any more. AF seems to have this adaptive characteristic where it runs around whatever it is you did last time to stop it. |
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Current medications/side effects | Dofetilide 2 x 500 ug / day. Just starting on 3 x 500 ug / day under medical supervision to see if this helps - I have soem headroom available on my QTc interval.
Side effects: dry mouth at night. I also feel it makes the ectopics bigger and thumpier.
Aspirin enteric coated 300 mg/day |
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Past medications/side effects | Tambocor (Flecainide) 100 - 200 mg / day (self-varied)
side effects: pro-arrhythmic (ectopics & flutter) at 200 - 300 mg/day, pain in heart area at ~200 mg/day or above. Verapamil - severe constipation. Propafenone - severe gut reaction. Disopyramide: dry mouth, difficulty peeing, blurred vision, *desperate* depression. |
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History of surgery | Originally not thought suitable for ablation, now scheduled for a flutter-line ablation and possible PVA, if teh higher dofetilide dose doesn't work |
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Future plans | Become a philosopher? I shan't ever complain about work, travelling, politicians or whatever, if I can just get my lide back again. |
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Check list | acebutolol | amiodarone (cordarone,pacerone) | anisindione (miradon) | atenolol (tenormin) | aspirin | azimilide | bepridil | betaxolol | bisoprolol (monocor,emconcor) | bretylium | bucindolol | carvedilol | cibenzoline | dicumarol | digitoxin | digoxin (lanoxin) | diltiazem (cardizem) | diphenylhydantoin | disopyramide (norpace) | dofetilide (tikosyn) | dronedarone | encainide | esmolol (brevibloc) | ersentilide | flecainide (tambocor) | gallopamil | ibutilide (corvert) | lidocaine | mibefradil | metoprolol (lopressor,toprol xl) | mexiletine | moricizine | nadolol | phenytoin | procainamide | propafanone (rythmol) | propranolol (inderal) | quinapril (accupril) | quinidine (quinaglute) | sotalol (betapace) | tedisamil | timolol | tocainide | trandolapril (mavik) | valsartan (diovan) | verapamil (calan,isoptin) | warfarin (coumadin) | asthma | diabetes | GERD/acid reflux | hypertension | hypotension | hyperthyroidism | hypothyroidism | adrenergic | vagal | familial | idiopathic/lone | paroxysmal | permanent/chronic | atrial flutter | cardiomyopathy | CHF | PAC | PVC | SVT | syncope | bradycardia | tachycardia | heart block | myocardial infarction | rheumatic heart diease | sick sinus syndrome | stroke | WPW | electrical cardioversion | defibrillator | pacemaker | ablation | bypass | maze | Male | Female | |
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