Can Afib drugs shorten your life?

[Slattery]

I read an article written by a cardiologist that said people with Afib are put on to many meds tha can shorten their life. He believes that life style changes that effect our health is a better way to live with Afib. Please tell me what you think.

[BobD Volunteer]

Don't tempt me! Seriously I do wonder about articles such as that which generalise.

Lets us look at how AF is treated. There is no magic cure although ablation for some of us can give huge improvements for many years. Most treatment is about improvement in quality of life and reduction of symptoms since the greater majority of patients will never be offered ablation if drugs can hold things to a manageable level. Many sufferers have no symptoms and many are in permanent AF and for those treatment is about preventing the AF from doing long term damage to the heart. . We know that AF is not life ending but it can if untreated be life limiting by causing cardiomyopathy which could lead to heart failure.

OK but what about changes to life style. It has been said that many people with AF actually live longer than their peers due to changes which they make to improve their life styles. Loosing weight, stopping smoking, stopping or reducing alcohol consumption, eating less meat, reducing stress etc have all been shown to be beneficial in the control of AF but what about those who already lived exemplary lives! What can they do I hear you ask. Take drugs basically since they have already done (or not done ) the above.

My personal opinion is that we all need to do or at least try to do everything possible to help ourselves as well as anything the doctors feel will help us. I know that there are plenty of people who are anti pharma and feel that only natural methods are acceptable and will defend anybody's right to an opinion. I do not share those views with the caveat that not all drugs suit all people so it may take time and many trials to find one which works for you.

None of this of course relates to anticoagulation which I feel is not an option if risk assessments point in that direction.

Bob

[SRMGrandma Volunteer]

Hi Slattery, I am a believer (and this will be no surprise to anyone here who reads my posts) that lifestyle changes, make a healthy heart, and while that may not "cure" the electrical havoc of A.F., it certainly helps to keep other things from going awry and increases the likelihood that you will have a healthier life. While medications are wonderful when needed, there can be a lot of payback involved....for instance, drugs like the PPI's (proton pump inhibitors) for GERD; simple pain relief meds like acetaminophen; Bisphosophantes (for osteopenia and osteoporosis); and even blood pressure meds in the ACE Inhibitor category like captopril, have all now proven to be pro-arrhythmic, meaning they can aggravate AF in some who has the substrate for A.F

I took all of those at one time or another and was on all of them when my AF was diagnosed....who knew??? But when you know better, you do better, so it would be ludicrous not to try for the healthiest lifestyle, but it is also ludicrous to not take something like an anticoagulant when that is what you need to stay safe with A.F.

Obviously the best thing to do is eat well, exercise well, sleep well, and manage stress well....AF is a reflection of one's general health. But it is key to have a partnership with an EP/Cardiologist who can help you make choices about what drugs will help you live your best life when that is what is needed. Be well.

[Finvola]

My short answer - and cynical reaction - is that the cardiologist probably doesn't have to live with the various miseries of AF himself.

I do not agree that life style changes are a better way to live with AF. For a start, they may not be enough on their own to suppress established episodes, leaving the condition to progress uninhibited. Some of us who have AF already had good, healthy lifestyles but had a predisposition to the illness. For me the best is a combination of any lifestyle changes which are necessary plus minimum optimal drug therapy and/or ablation therapy when needed.

It could be argued that any drug will shorten somebody's life some time but I have seen no competent research data from medical trials which supports the assertion that AF drugs shorten lives. There was a trial some years ago into Flecainide which was stopped because some of the patients in the trial had previous heart conditions and this research led to Flecainide being prescribed only for those with no other cardiac ailment.

I am very wary of grains of truth which get magnified into global truths, scaring people and promoting someone's opinions. For me, Flecainide has been a friend over the last two years, suppressing my horrible symptoms and enabling me to enjoy my healthy lifestyle.

[Hidden]

You wouldn't live with my AF without drugs (or an ablation). I already have a good diet and healthy life-style but that isn't enough in my case, although obviously it may be with others.

PS. [edited] But if I drank, drunk loads of caffeine and put on more weight etc etc, then things would be worse clearly. Guess I'd have to take more drugs, or maybe then they wouldn't cope, which they are at the moment 😀.

[PeterWh in reply to Hidden]

Agree.

Yesterday morning for some reason I forgot to take my tablets. By yesterday afternoon I wasn't feeling too good and then my resting heart rate (excellent idea Kardia) in bed this morning was 85. Hate to think what it would be after a few days of no medicines.

[PeterWh]

Firstly I would love to have the link to the article and to do an analytical review and read in between the lines.

Secondly I will quote a favourite saying of my dad's which was you are at where you are at regardless as to where you thought you'd be!!! You can't turn the clock back.

There are a plethora of possibilities many can never be proved one way or another.

If you don't take any medicines then many patients will end up dying (see BobD's reply) and / or having a poor quality of life. So even if your life was THEORETICALLY shortened you'd be better off taking meds!!!

Yes lifestyle changes should and must be made by all sufferers but will that solve it for everyone? I do not believe so. How would that stop all the rogue signals for someone who may have been in persist AF for years and have loads of signals firing off in veins? Other scenarios for people with paroxysmal AF.

On the other end of spectrum there is no doubt in my mind that lifestyle changes will extend the life of sufferers from that that they would have had because bad lifestyle / habits would have curtailed their life.

In summary once you have AF a lot of the theoretical values have no meaning. Furthermore statistic s are not absolute nor a certainty.

At the end of the day I believe that people must make lifestyle changes, take the medicines that suit them and have ablations if that suits. Personally. As BobD says, Anticoagulation is very important (though not for absolutely everyone).

[Slattery in reply to PeterWh]

Peter, the website is drjohnm.org. The article Is The best tool for treating Afib.

[BobD Volunteer in reply to Slattery]

Yes we know of him.

[Musetta]

I have faith in pharma drugs - many years of research goes into the making of meds ok, sometimes they get it wrong but pharma drugs have helped milions worldwide - that's quite impressive. Pharma drugs have kept me free of pain and improved my quality of life. They certainly have managed to keep my AF at bay so far.

Cheers,

Musetta

[Kodaska in reply to Musetta]

If you were male with an enlarged prostate, and you were prescribed finasteride, you might think otherwise. It's the only pharma drug that's given to shrink the prostate. A good thing, no? Maybe not if you get its side effects of impotence and incontinence - even after going off the drug - for the rest of your life.

Pharma drugs are made (in part) to create profits for the pharma industry. Be wary of what you're given.

[Barb1]

I did and do have a healthy lifestyle. My AF is inherited. I hate it when people and drs especially say that. It's as if AF could always be avoided

[Jimppy in reply to Barb1]

Absolutely Barb, it really grinds my gears when some sanctimonious non sufferer infers that all our troubles are caused through lifestyle choices and if we eat well and meditate then all our troubles will be solved. I was a healthy, active super fit 24 year old when I was first struck with af and my episodes are always VERY symptomatic. I don't know what I'd have done over the years without the meds. The misery of putting up with symptomatic af would have killed me long before any drug did!!!

[bassets in reply to Barb1]

I agree. I,m vegetarian, don’t smoke, drink or take caffeine but high blood pressure and af are both in my family.

[Barb1]

Totally agree but I suppose you have to stand in our shoes to understand. My EP is totally supportive understanding, thank goodness. Others look at the now fat me (Bisoprolol really buggers up the ability to exercise) and jump to their own wrong conclusions.

[dmac4646]

I would rather have life in my years rather than years on my life putting up with AF.

[Vony]

What about when it is vagally mediated AF then? Even when i live an impeccable lifestyle, when i lie down or sit on a low chair, i go into Arrythmias. And also just before my period (sorry for information overshare). Those are honestly the only consistent triggers i have identified. And i can't avoid lying down and sitting down!!! Or being female! So is there any lifestyle change i could make to control my vagal nerve? This is a serious question by the way. I have wondered if i could get a vagotomy like in the olden days...didn't they used to cut the vagal nerve for people with severe reflux and things? Or is that a myth??!!! X

[mincde in reply to Vony]

I read somewhere that flecainide had anti-Vagal properties (vagolytic).

[dedeottie in reply to Vony]

Gosh , I remember my friend had that done. It ruined his life and he still suffers terribly today. No reflux though but all sorts of other problems. Shortly afterwards they stopped doing that op. X

[Vony in reply to dedeottie]

Oh really?? Perhaps not then!!! Lol