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QTC and Tikosyn
My husband, age 62, had quadruple bypass @ age 50--never had an MI. AF began 18 mos ago. He was hospitalized 4/20 for AF and started on 500 mg Tikosyn bid on 4/21. It's not working. His hospital EKG tracings show QTC before Tikosyn of 496 on 4/20 & 391 on 4/21. After beginning Tikosyn, QTC's were 490 on 4/23 & 469 on 4/24. I detected a bradycardia-tachycardia arrhythmia about 3 days ago. His EP is out of town & Steve's scheduled to see him on 5/20. I'm really concerned that he shouldn't be on the Tikosyn with such QTC readings. Your opinion, please. Thank you!
Concerned wife
Concerned wife
Please keep me posted! Good for you for doing what you know is right. I had to fight for my family and I don't regret one moment of it.
Tell hubby to try and relax and keep his fluids and electrolytes in order.
Take care
Tell hubby to try and relax and keep his fluids and electrolytes in order.
Take care
Doctor's office called me back--nurse reviewed Holter results with another doctor while I was on hold--said Steve had had a "pause" and therefore should not leave town, should "lie low" until this Wednesday when his EP returns and if he gets light-headed or dizzy, I'm to take him directly to the ER. I'm glad I called them!
Hi,
I thought it was odd he had a QTC of 496 on 4/20, dropped to 391 on 4/21 and then 490 on 4/23! Right before we went home on 4/24 he developed rapid ventricular response, I raised *$^@)% and they put him on 25 mg. of Toprol. I didn't think he should've gone home, and neither did one of the EP's nurses, who used to work where I did. (I am not a nurse.) He did have an in-office EKG last week; no one called to say anything was abnormal; he wore a Holter last weekend--results unknown to us. I detected a change in his pulse on 5/6--pauses between some beats were noticeably longer; on 5/7 I detected bradycardia-tachycardia rhythm. I have a call into the EP's nurse as I write this. We are gathering his records to go to Mayo. I am like you--the EP poo-poohed the possible VF--said it was rare. We're supposed to go from Des Moines to Omaha (120 miles) tomorrow for a college graduation, and I'm just really leery of getting so far from home. I've seen some of your replies to people and respect your opinions....I am trying to be his patient advocate, not his wife here.
I thought it was odd he had a QTC of 496 on 4/20, dropped to 391 on 4/21 and then 490 on 4/23! Right before we went home on 4/24 he developed rapid ventricular response, I raised *$^@)% and they put him on 25 mg. of Toprol. I didn't think he should've gone home, and neither did one of the EP's nurses, who used to work where I did. (I am not a nurse.) He did have an in-office EKG last week; no one called to say anything was abnormal; he wore a Holter last weekend--results unknown to us. I detected a change in his pulse on 5/6--pauses between some beats were noticeably longer; on 5/7 I detected bradycardia-tachycardia rhythm. I have a call into the EP's nurse as I write this. We are gathering his records to go to Mayo. I am like you--the EP poo-poohed the possible VF--said it was rare. We're supposed to go from Des Moines to Omaha (120 miles) tomorrow for a college graduation, and I'm just really leery of getting so far from home. I've seen some of your replies to people and respect your opinions....I am trying to be his patient advocate, not his wife here.
Hi,
Is your husband on any other medications that could be on the QT list? www.qtdrugs.org. Tikosyn is known to cause Torsades de Pointe VT. It seems funny that his QTc was 496 even before starting the Tikosyn. Some people after an MI will have prolonged QTs. One thing to know is that the ECG machines can be very wrong in interpretting QTc especially if the heart rhythm is irregular as it can be with AF.
Has he experienced an increased in PVCs or had dizzy or faint episodes? If he has, I would try to contact another doctor right away.
If it is really bothering you, I would get a second opinion soon. Torsades comes on very quickly with little or no warning and can lead to VF.
Doctors are famous for down-playing a prolonged QT.
Good luck
Is your husband on any other medications that could be on the QT list? www.qtdrugs.org. Tikosyn is known to cause Torsades de Pointe VT. It seems funny that his QTc was 496 even before starting the Tikosyn. Some people after an MI will have prolonged QTs. One thing to know is that the ECG machines can be very wrong in interpretting QTc especially if the heart rhythm is irregular as it can be with AF.
Has he experienced an increased in PVCs or had dizzy or faint episodes? If he has, I would try to contact another doctor right away.
If it is really bothering you, I would get a second opinion soon. Torsades comes on very quickly with little or no warning and can lead to VF.
Doctors are famous for down-playing a prolonged QT.
Good luck
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