Rate Control or Arrhythmia control?

I was diagnosed with paroxysmal a few months ago and Doc has me on Metoporol 25 mg twice a day and a daily aspirin. A previous Doc had me on Digoxin and Flecannaide and those 2 caused me lots of problems so went for a second opinion and I am doing much better now. I was taking Lisinopril 25 mg twice a day along with the Digoxin and flecannaide and blood pressure would spike almost every night. Now the Metoporol is working so well that I am not even taking the Lisinopril. I am scheduled for a sleep study to check for sleep apnea as a possible cause of my A Fib. Just curious how many people believe that rate control only is the best care for A Fib and is this something that I will have to take for the rest of my life. I am a very active female age 65 and never even knew I had A Fib until I had food poisoning one night and was up all night vomiting and diaherra and pulse rate was 165 so wound up in emergency room. Was referred to Cardiologist and after taking all these drugs I wonder if they have helped or made things worse.

5 Replies

  • HI Flaka and welcome. From your reference to Emergency room I assume you to be in USA rather than England . My point being that here in UK we no longer approve of aspirin for stroke prevention in AF as it is of no use. Sure it has some uses in cardiac care but not as a prophylactic against stroke. At the same time it can still cause stomach irritation and bleeding. If you are taking it on your own without doctors' instructions then go and ask and if your doctor has prescribed it ask them why. At age 65 and female you should possibly be on a proper anticoagulant.

    Regarding your original question most general doctors try rate control first whilst electrophysiologists who are rhythm specialists will usually try rhythm control. It all depends on what works for each individual although personally I found rhythm better before I had my ablation and got rid of the AF.

  • Oh wow, that is kind of scary. The doc asked me questions and I told him that I thought that being female and 65 that would add to my risk but he seemed to think daily aspirin would work. I will have to ask him again if he thinks I should be back on Pradaxa. My previous doc had me on that and I don't know which of the meds was messing me up but once I got off those and got on the Metoporol I felt much better. I have thought about the abalation procedure but scared of possible complications.

  • I agree with Bob. If you are 65 and female and have atrial fibrillation, you already have 2 points on the CHADS2VAS2 system. I'd request anticoagulation, and go off aspirin.

  • Look at CAREAF website and download where necessary.

  • Absolutely agree that asprin is going to be useless to prevent a stroke. If you have stomach problems taking Pradaxa I found you need to take it only with food, NEVER without and never if you eat any carbohydrate. It needs an acid environment to work so never take an ant acid, even though the docs will prescribe it if you get heartburn and indigestion and acid reflux after taking which I did until I researched it and found this solution,

    Ablation was the only answer long term and the earlier you have it the better the chance of success, Flecainide worked for me for about 5 years but eventually most meds cease to be effective over the long term and a majority of people end up on stronger drugs.

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