Irregular Heartbeat Arrhythmia

My mother has developed an irregular heartbeat after her heart attack. Can anyone recommend a good course of treatment for this? Thank you in advance.

Is it atrial fibrillation? Some other arrhythmia? First line of business is to get a specific diagnosis (emergency room if necessary). I’d rely on a cardiologist’s advice before anyone else’s.

Yes. My mother has been diagnosed with atrial fibrillation and Arrhythmia. The cardiologist is considering electro shock therapy to reset the heart rate or ablation. But sometimes I just want a second opinion to discuss with the cardiologist.

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I’ve been warned to not take too many potassium citrate at once or it can kill you, but this guy does sound like he knows what he’s doing, so I started with half what he said and sometimes do it twice a day. I’ve not had any more trouble, but who knows?

I had the cardioversion (electric shock) and it worked for me, no recurrences as long as I don’t chug ice cold smoothies (which triggered both of my two episodes of afib). Usually if the afib persists or recurs after cardioversion, the next choices are 1) controlling the rhythm with anti-arrhythmic drugs (which usually have some side effects) or 2) rate control with a drug such as a beta-blocker to just keep the heart from beating too fast but letting the afib continue. Either of those choices requires long-term anticoagulant medication (warfarin, Eliquis, Xarelto) or alternatively, a (relatively) easy heart procedure called the “watchman” where they install a device that prevents blood clots from forming in the heart which would otherwise cause a stroke.

An alternative to all of the above is the ablation procedure, which to my understanding is more risky but can potentially cure the problem (but not necessarily – sometimes the afib eventually recurs). I’m not sure if ablation still requires long-term anticoagulation just in case the afib recurs or partially persists as asymptomatic afib episodes.

Something to keep in mind is that untreated afib (rate control with no treatment of the underlying arrhythmia) can increase risk of multiple future health issues (I think dementia, heart failure, maybe others?). If I had persistent/recurrent afib despite cardioversion, personally I’d do everything I could to control the actual rhythm, most likely ablation since the anti-arrhythmic drugs can have some nasty/annoying side effects and drug interactions.

This is all off the top of my head and is not meant as medical advice, etc. Others who have more experience or training in this area, please feel free to correct me.


Wow. It just seemed that I was talking with my mom’s cardiologist. That was almost word for word what she said. I guess cardioversion is the way to go then. Thanks @Davin8r


Cardioversion will convert her from Afib to sinus rhythm, but that doesn’t mean she will not go back into Afib. Even in a normal rhythm, She also will remain at risk for blood clots and likely needs to be on a thinner.


When I had my first bout of A fib about 15 years ago, I was admitted to the hospital and they wanted to do electric cardioversion. A friend of mine who had also had a fib previously told me to try flecainide. I insisted they try Flecainide before shocking me and lo and behold. One hour after taking the pill, I saw a beautiful P-wave indicating I was back in normal sinus rhythm and the fluttering in my chest disappeared. Five years I continue to use flecainide as the atrial fibrillation occurred more and more frequent. But eventually, I had an ablation procedure and have been cured for almost 10 years.


Did you have any side effects from the flecainide?

This is pretty straight forward. It is best to restore a normal rhythm ASAP as the longer one’s heart is in AF, the more it remodels and increases risk for recurrence.
Early cardioversion is the approach - I do this frequently in the ER for acute AF as we know it is best to get this sorted early. If in the rhythm for more then 48-72 hours, then careful assessment for whether she has formed in clots is in order before cardioversion.
Cardioversion doesn’t always work - it relates to the size of the atrium (the smaller chambers of the heart) - but most of the time does.
The second issue is rate control until cardioversion - it is typical for the rates to be high, and this will cause poor cardiac output - and rate control generally around 100/min is reasonable in most cases - there are nuances obviously.
Overall, take the cardiologist’s advice - this is common stuff and I typically don’t even involve a cardiologist except in follow-up as I generally sedate, cardiovert and send home unless there are other issues.
I agree with @KarlT that there should be a period of anticoagulation unless there is a reason not to, and careful monitoring for recurrence.
I generally have my folks on a month of thinners, even if they have even had brief AF before I see them and cardiovert.
Take the Cardiologists advice - this stuff isn’t that complicated and delaying for more opinions is probably not the best plan.


None at all, but once I reached the point where I was taking it every day I decided to just do the ablation as I think with daily use the risk of things like pulmonary fibrosis goes up

I always refused to be anticoagulated because I could always tell instantly when I went into A fib, and take the flecainide. I was never in the rhythm more than an hour or 2. But I think a lot of patients can’t tell when they’re in the abnormal rhythm so they push for anticoagulation.

I had pulmonary vein cryoablation, which was like a half hour procedure that was a total cure (so far). The only annoying aftereffect is that my resting heart rate now never goes below 80. But I did not need to be anticoagulated after the ablation.