Question for Dr. Fett

[Oliviasmom]

My resting heart rate is often around 45- 50, I am on max. dosis off medicin, BB, ACE, SPIRON , my EF is 35- 40 %, is it too low and dangerous ?. My 2 ?; I was treated with SIMDAX at the Hospital but they never really told me what is was ? but it did make me fell much better :-)) can you tell me what it is ? and what it does ? Thank you Dr. Fett.
Rikke ( from Denmark )

[JAMESFETT]

It sounds like you are doing everything right, and hopefully, steady improvement of LVEF will follow/continue.

I am thinking your slow heart rate is related to your beta-blockade, and not due to any heart block (i.e. EKG otherwise normal). If that is the case, you certainly can tolerate the slow rate, so long as you continue to have good heart output, and do not have fainting, or rising serum creatinine indicating kidney function decreasing, so blood tests indicated to be sure about those things.

Sindex is levosimendan, a new class of inotropic (increases heart pumping force) medication, in a so-caled "calcium sensitizer" class. There are anecdotal reports of its benefit in PPCM patients. I have recently reviewed a journal manuscript in which half the ppcm patients were given levosimendan and half the ppcm patients (12 in each arm of the trial) were not, but all other medications the same, and the effects were neutral, neither beneficial nor harmful. Whether that trial has validity is uncertain, but more studies are needed to know the results. I assume that your LVEF is not lower than it was in the hospital when you were taking levosimendan. In brief, the final conclusion on the effectiveness of that medication has not yet been determined--and I'm sure we will be seeing other reports about its use in treating heart failure from a variety of conditions.

Wishing you continuing improvement, and good for you for progressing to maximum dosages of ACE-I and BB! Please let me have a follow-up.