18th November 2004
Listening to the history you've given, it sounds like your father likely has atrial fibrillation. This is a condition where the small chambers of the heart (the atria) do not contract rhythmically...instead, they quiver like jelly. Because the ventricles (the larger chambers) are still able to contract in rhythm, you are able to pump blood to your body. The problem with atrial fibrillation is that, in the long term, it can cause heart problems (as you've seen in your father in terms of CHF) and it can also, more importantly, precipitate blood clots and cause an embolic stroke.
You mentioned they shocked your father, but it doesn't sound like his heart was stopped or anything. Did they have him on any medications before they shocked him? The shocking they did for him is different than the shocking you see on a show like ER. This is a "cardioversion" shock rather than a "defibrillating" shock. It attempts to get the heart out of atrial fibrillation and back in to normal sinus rhythm. Usually, they only do this if they know the person has been in atrial fibrillation for less than 48 hrs. Otherwise, they have to put the patient on coumadin for about 3 weeks before doing the shock or they can cause the stroke.
In terms of the management of atrial fibrillation, it doesn't sound like your doctor explained it very well to you. I'm sorry for that. Anyway, he's right that your father will likely have this irregular rhythm for the rest of his life, but that doesn't mean that it's not treated. The first thing for treatment is to put your father on a blood thinner to reduce his chances of having a stroke. If he's on coumadin, then that has been done.
The second thing is, an irregular heartbeat in terms of atrial fibrilation can be fine as long as the heart isn't beating really fast. If the heart is beating at a regular rate, just coumadin is fine. If however the heart is beating really fast (like more then 120 beats per minute) the doctor should add a beta-blocker to slow the heart down. This is known as rate control. The heart is still in atrial fibrillation, but it is beating at a regular rate.
You can also try to rhythm control with medications like amiodarone, procaineamide, propafenone or ibutilide, but these carry a certain amount of toxicity and can actually make the fibrillation worse.
So....that said...has your father been put on any medications?
You mentioned they shocked your father, but it doesn't sound like his heart was stopped or anything. Did they have him on any medications before they shocked him? The shocking they did for him is different than the shocking you see on a show like ER. This is a "cardioversion" shock rather than a "defibrillating" shock. It attempts to get the heart out of atrial fibrillation and back in to normal sinus rhythm. Usually, they only do this if they know the person has been in atrial fibrillation for less than 48 hrs. Otherwise, they have to put the patient on coumadin for about 3 weeks before doing the shock or they can cause the stroke.
In terms of the management of atrial fibrillation, it doesn't sound like your doctor explained it very well to you. I'm sorry for that. Anyway, he's right that your father will likely have this irregular rhythm for the rest of his life, but that doesn't mean that it's not treated. The first thing for treatment is to put your father on a blood thinner to reduce his chances of having a stroke. If he's on coumadin, then that has been done.
The second thing is, an irregular heartbeat in terms of atrial fibrilation can be fine as long as the heart isn't beating really fast. If the heart is beating at a regular rate, just coumadin is fine. If however the heart is beating really fast (like more then 120 beats per minute) the doctor should add a beta-blocker to slow the heart down. This is known as rate control. The heart is still in atrial fibrillation, but it is beating at a regular rate.
You can also try to rhythm control with medications like amiodarone, procaineamide, propafenone or ibutilide, but these carry a certain amount of toxicity and can actually make the fibrillation worse.
So....that said...has your father been put on any medications?