My heart rate is fast – rarely below 100 beats per minute, even after a good night’s sleep. I have atrial fibrillation and have been prescribed bisoprolol, but still not cured. Does firing help?
Alan Pirie, Livingstone, Scotland.
Your fast heart rate is probably a symptom of atrial fibrillation (AF), the most common abnormal heart rhythm disorder that affects 1.4 million people in the UK.
AF is triggered by faulty electrical impulses firing into the walls of the upper chambers (known as the atria).
Your fast heart rate may be a symptom of atrial fibrillation (AF), the most common abnormal heart rhythm that affects 1.4 million people in the UK.
As a result, these parts beat randomly rather than at a steady rate, which means that sometimes the heart beats faster than normal – and I guess that’s why your heart rate goes up.
In your long letter, your cardiologist has determined that cardioversion – a controlled electrical shock – may help restore the heart’s rhythm. But it didn’t work.
Bisoprolol is a type of beta-blocker drug that helps slow down the heart rate.
But your question is whether abortion can help you.
AF is triggered by faulty electrical impulses fired into the walls of the upper chambers (known as the atria) of the heart.
This technique uses heat to target heart tissue, creating tiny scars to block abnormal electrical signals.
Especially when atrial fibrillation has been going on for a long time like you have, it’s not always effective to explain why it wasn’t given to you. (Over time, atrial muscle tissue undergoes ‘re-modelling’, which means it no longer functions.)
But if you don’t have other symptoms — shortness of breath, severe fatigue — that could indicate heart disease or failure, even if your heart rate is elevated, it’s acceptable. It is important that you are taking an anticoagulant (such as warfarin, apixaban or rivaroxaban) as well as the beta-blocker, bisoprolol.
This is because when the heart beats irregularly, it leads to slower blood flow, which can promote blood clots. These can block arteries and cut off blood supply to the brain or heart, leading to a stroke or heart attack.
When the heart rhythm is disturbed, it can lead to poor blood flow, which promotes the formation of blood clots.
Another thing you should pay attention to is your blood pressure and keeping it in the normal range.
I suggest reviews with your doctor or cardiologist every three to six months to monitor your Bisoprolol dosage: A beta-blocker can lower your blood pressure too much, but an insufficient dose can cause your heart to beat faster. The recommended dose is 1.25 mg to 15 mg daily and regular evaluation allows for adjustment.
After emergency hernia surgery, I had a urinary catheter inserted. But now it’s gone I have embarrassing breakouts and have to wear pads without confidence, plus take water tablets to ease the problem. Is there anything else I can do?
Name and address provided.
I’m sorry to hear about this, it must be stressful for you – and it’s a problem shared by other readers. Older patients who struggle to urinate after surgery (they are 84 years old in your long letter) – this can be a side effect of anesthetics, and painkillers after surgery – and need a temporary catheter.
I suspect that there is an underlying problem, benign prostatic hyperplasia (BPH) – or an enlarged prostate – pressing on the duct that carries your urine out of the body. It is believed that more than 90 percent of men over 80 have the disease.
Treatment for BPH includes medication and surgery. In some cases, the recommendation may be permanent bladder catheterization, where a catheter is inserted through the abdominal wall under anesthesia. [File image]
Struggling to urinate after surgery in elderly patients (you say you are 84 in your long letter)
You may have some symptoms during your surgery, including a weak stream, hesitancy (difficulty starting to urinate) and nocturia (having to empty your bladder more than once during the night), and you may need catheterization afterward. The operation worsened the situation.
Treatment for BPH includes medication and surgery. In some cases, the recommendation may be permanent bladder catheterization, where a catheter is inserted through the abdominal wall under anesthesia.
I think this is a better solution than an indwelling catheter in your urine which is more prone to recurrent infections.
If you are not under the care of a urologist, I would ask that you discuss the possibility of a referral with your GP.
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In my view… don’t underestimate the dangers of horse riding
Motorcycles are dangerous, we know that. As a lifelong cyclist, I was horrified that a US study published last month found that motorcycle rally areas had 21% more organ donors per day than four weeks before and after.
Parents usually don’t let their kids ride motorcycles, but let them join the local pony club on a whim.
I have developed my GP practice for 44 years in the UK, where there are strict laws regarding training for motorcyclists. In all those years I have seen a few accidents happen, but not one death among patients on my list.
The contrast is horse riding: five of my patients have died during that time and one member of my staff.
But parents often don’t let their kids ride motorcycles, but rather enthusiastically let them attend the local pony club.