Just diagnosed with AF

[DariaE]

I had my first episode of AF two weeks ago and was hospitalized for a day to bring my heart rate to NSR. Discharged after a day for further observation and prescribed dronedarone 400 mg twice daily. I had prior SVT and was on bisprolol. 2.5mg. I find that the medicines made me fall into depression and anxiety. Has anyone felt the same way? My BP has gone down to 109/68 whereas my normal used to be 120/80. Heart rate now resting is about 57-67. Is this normal? Will my body adjust in a few weeks time.?

[Goldfish_]

Hospitalised, goodness. Which country are you in? Unlikely that would happen in the uk due to the cost.

Not heard of dronaderone being used much before, but I gather it is safer than amiodarone but less effective although it's done the trick for you. Lower bp is common with it. These are the uk recommendations nice.org.uk/guidance/ta197?...

Also

ccjm.org/index.php?id=10793...

Do you have the other factors that make donaderone a choice for you?

If things remain settled it may be you could manage with pill in the pocket, just using medication if you get a recurrent episode.

[CDreamer in reply to Goldfish_]

Your second link is not accessible.

[DariaE in reply to Goldfish_]

Hello! Thank you for the link. Much appreciated. Yes I was already on BP medication and Concor 2.5mg. My cardiologist did say that she might take me off dronedarone in the future. Another Dr suggested anticoagulant eliquis for me but my cardio recommended that I do not take it as yet as my risk for stroke is low. Have been attended to by the cardio since 2007.

[Hidden in reply to Goldfish_]

I was hospitalized for 14 days with AF because they couldn't get my heart rate below 120 BPM.(in the UK)

Not seeing the right guy for 14 days didn't help. only so much a first year trainee doctor can do!

Sent home with Rivoroxiban, Amiodarone, Bisopralol, spironactalone ramipril.....

[Deeferdi]

When I was first diagnosed with SVT I was hospitalised and kept in for two nights to bring my heart rate down (197-242bpm) and yes I'm in the UK. I was then diagnosed with AFib and Flutter and was given Bisoprolol 2.5mg and it had the effect of making me very depressed too. I have now been on Dronedarone 400mg 1 tab twice daily and Diltiazem 120mg one daily for the last 18 months and I've been fine on it, no more depression and was glad to see the back of bisoprolol, as well as depression it was making me breathless and very tired. Have now been diagnosed around 6 months ago with Bradycardia, heart rate of 45-50bpm which my Arrythmia nurse said was probably the Diltazem so now just waiting for an appointment to see my EP. Hope you pick up soon.

[Hidden]

Hi I was kept in A&E for hours until my heart rate dropped. It's a scary thing isn't it having the first episode - and others can be scary too. Having control over medication and knowing how it works is a good move. I think the fact you feel depressed and anxious means you should have a chat with your doctor or call the hospital for advice. You should find someone professional to talk this through with to put your mind at rest. Everybody is different so if that's how the medication makes you feel then no matter how anyone else on here feels or if they had similar experience it's still best to seek professional medical advice. I'm sure you will feel better after a chat.

[CDreamer]

Hi Jules, welcome. AF can feel very scary and one of the worst symptoms to deal with is the anxiety and many people suffer low mood after diagnosis, so it may not be the meds.

Having said that, many people struggle with Bisoprolol, which is often the first choice and will lower your heart rate so a resting rate of 57-67 would not be a cause of concern. It can make you feel lethargic and breathless whilst exercising so for me (personal opinion) it is is matter of quality of life decision - are you better with it or without it? If without then ask for a review of your meds.

There was no mention of anti-coagulation, have you been assessed as to whether or not you should be anti-coagulated? AF itself is not a life threatening condition, however, it does increase your risk of stroke and therefore most people would take an anti-coagulant to lower the risk but this does need assessment.

Go to the AFA website and down load all the information regarding treatment and then ensure you have good specialist advice regarding on-going treatment - the usual heirarchy for drug treatment is:- anti-coagulant, rate control - and then rhythm control. You can take the rate & rhythm control drugs as a PIP - pill in the pocket, i.e. Only when you have an episode, and having had one the chances are you, although not inevitable, will have more.

Ask to see an appropriate specialist - which would be an EP - Electrophysiologist. They are the specialists in the electrics of the heart and the best people to advise you appropriately.

Many people live with AF, some cope better than others. Those that do well address the anxiety which accompanies AF which is physical not just psychological although worry will increase your stress, which AF thrives on. Lifestyle choices also are a huge factor - diet, exercise and alcohol consumption have a huge, direct effect and can eliminate AF for some people.

You will find a wealth of knowledge, experience and support on this forum, I couldn't have managed without it, so do ask questions and vent when you need to, there is always someone around.

Best wishes CD,

[CDreamer]

From Orchardworker on another recent thread:-

"With the benefit of hindsight, as soon as you have any AF symptoms your first action should be take your pick of relaxation exercises and persevere with a daily programme. This action should help protect yourself from depression/anxiety as you go through hospital tests/interventions and all the other knowledge you need to glean to take those important individual decisions with your medical and Alternative practitioners."

Excellent advice!

[Rellim296]

Hello JulesE, and welcome to the world of AF that we all belong to.

I hope some of the replies you are getting will reassure you a bit. The anxiety is something most of us encounter, but we get a bit more blasé after a while and your mood may lift when you find that AF can be well managed. Having AF tends also to make us behave in healthy ways, and that's no bad thing.

I can't really comment on the medication but I think optimum BP varies according to your age and personally I'd rather have /68 than /80. We had a discussion yesterday about heart rate and quite a few of us have a resting rate much like yours.

[Annekw]

Hi JulesE like you I came home on Amioderone, Bisoprapol and an anticoagulant- Apixaban . The Bisoprapol 2-5mgs made me feel very lethargic, my GP lowered the dose to 1-25mgs and that did the trick! Still on that regime,except for the Amioderone .good luck!

[DariaE]

OMG! It is such a relieved to hear from you guys. It means so much to me to get all the encouraging words from people who share the same experience. Thank you so much guys.

[fifitb]

I am from the UK and was rushed in to A&E 4 times in a month, over Christmas and then New Year and beyond - staying a week in the cardiology department in the end and finally I had a pacemaker. But, the pacemaker only kicks in when my heart goes too slowly. Sotalol was the beta blocker that finally seemed to help but lately I've been having more and more AF episodes and was then prescribed bisoprolol - but - after 2 days, I have had yet another AF episode and went to my GP (luckily it was during working hours, for a change!) I was advised to have bisoprolol for a week and then start Flecainide (as well, I think). The GP said to go back on Sotalol. His advice is taken from my cardiologist, who I have been trying to see, but on the NHS, I seem to be at the end of the long list - but I think I am an urgent case!

Anyway, I am phoning the cardiology secretaries at the hospital tomorrow. I have not seen my cardiologist for months and have been requesting an appointment. I can't live like this, nothing is working and the thought of an ablation scares me - that doesn't always work! I think I need a pacemaker that kicks in when my heart goes to quickly as well. Pills don't seem to work and can have such awful side effects, as you have described!

I hope you get your treatment sorted - AF is a scary thing.

[Beta44 in reply to fifitb]

I was given to understand that Flecainide and Sotalol are a risky combination as they can both have pro arrythmic effects and the sum of the two is greater than the sum of the parts. That is why Sotalol is not usually recommended and Bisoprolol is so often used. Important to check as many GPs do not understand this.

Peter

[countrygirl1]

Hi, sorry to hear of your anxiety and depression. I am also on Dronedarone 400mg twice a day and Bisoprolol and I did feel very low physically and mentally at the beginning. I reduced my Bisoprolol from 2.5mg to 1.25mg, which I take in the evening, and I manage very well now and feel much better. I'd been fine on 2.5 Bisoprolol before the Dronedarone, but taken together was too tiring for me so I needed the reduction. I think a few weeks are necessary for the body to adjust to Dronedarone, I remember that weeks 2 to 4 were worse for me, then it all improved! Hope you improve soon, best wishes, Jane

[DariaE in reply to countrygirl1]

Hi country girl. It's nice to know that someone shares the same experience. Thank you for taking the time to respond too. I hope to feel better soon when the body adjusts to the Dronedarone. Just curious do you have side effect like headache or nausea?

[DariaE in reply to DariaE]

Hi Jane 😀

[countrygirl1 in reply to DariaE]

I don't get headaches but I do get nausea if I don't take food with the Dronedarone. I read somewhere online that prescribing recommendations for it are to take it with a meal including fat, so I'm careful to do that (although yesterday I didn't so I suffered!) Good luck, Jane

[DariaE in reply to countrygirl1]

Hi Jane! Another question .. Do you sometimes feel nervous for no reason and your HR is actually 'normal'.

[countrygirl1 in reply to DariaE]

Yes definitely, I have no idea why this happens but I deal with it by taking a few sips of water with a little magnesium powder in it. I usually have a glass ready mixed and sip it through the day anyway and if travelling I have some in a water bottle. I find it has been very beneficial for my heart and is also very relaxing. It helps me sleep better too. The brand I use is Natural Calm, I first read about it on here and I buy from Amazon. This is just a personal recommendation; I think I may have been magnesium deficient, it's certainly helping me a lot. If you search for Magnesium on this site you'll see there are lots of posts about the benefits, Jane

[DariaE in reply to countrygirl1]

Thanks Jane. 😊