Asthmatic with P A F

Hi, I was diagnosed with paroxymal Afib last year. Only had 3 episodes lasting 1 hour each which have returned to normal sinus rhythm them self. My problem is that I am asthmatic, I was initially put on bisoprolol 1.25 mg and had the pill in the pocket if an episode occurred, Had to visit the E D department recently for a chest infection I was taken off my bisoprolol immediately and was told asthmatics should not take a beta blocker, they gave me adizem X L 120 mg, I seem fine on it but all this med stuff scares the he'll out of me, apart from asthma I don't have any health issues , I don't take tablets for anything and am very fit walking on average 40 mile a week . How do you get your head round taking meds for something that might happen and will the Adizem cause problems to a heart that is otherwise healthy, CONFUSED.

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  • Hi, it sounds like we're in similar situations. I had 3 episodes just before Christmas, the final one lasting about 6hrs, before returning to NSR. I also have asthma and I'm now on 60mg Tildiem (same active component as Adizem I believe) twice a day. It seems to be working well and I haven't had many problems since starting 3 months ago (other than the odd palpitations or lightheadedness). These drugs are calcium channel blockers, so they slow your heart down and stop it getting carried away with itself. This will be mean you may be more fatigued that usual or experience the odd headache as your body adjusts. They also relax the blood vessels, so increasing the flow to the heart. This can lead to a drop in blood pressure, which can be a problem if you have normal-to-low blood pressure anyway.

    I understand and share your concern about taking tablets every day, and I too am worried about the potential long-term effects, but I think Adizem is one of the drugs with fewer both short- and long-term side effects. It could be a lot worse.

    Read as much as you can, both of this forum and the AFA website (http://www.heartrhythmalliance.org/afa/uk). Knowledge is power!

  • I guess it makes you question things when you don't have any symptoms at all and my 3 episodes where 3 months apart each time, felt secure on bisoprolol , might ask the doc if I can go back on them and be monitored, he seems to think that some asthmatics can tolerate them at a low dose, you seem to b e coping really well which is very reassuring to hear, I'm the new kid on the block, I guess I need to get used to the idea. Cheers.

  • Hi I'm asthmatic and I was given Bisoplorol...could not function...breathing well I couldn't cardiologist took me off straight away and said you shouldn't be on these..but I was given them when I was first diagnosed..I'm on Slozem now...calcium channel blocker they have made a big change in me..they give you more oxygen too

  • Hi. Thanks for that. Gives me a bit more confidence . All this input helps a lot when it's all new to you.

  • Thank you for that, all of your comments help me to understand AF more, I guess accepting it is the stumbling block but I'm sure all of you out there where the same at the beginning, cheers

  • Your change of meds was correct Asthmatics should not be given beta blockers.

  • I realise that now Bob. Seem ok now on Adizem although a little wobbly at times. Will just have to give them time.

  • Hi, I am asthmatic and was never prescribed a beta blocker, told I could not have it, but I seem to remember somebody posting recently that the latest thinking is that a low dose is ok if you can tolerate it which you clearly can't. So I took Diltiazem which is what you have. I sympathise with your feelings about taking meds continuously for a condition which affects you rarely and for short spells. There is the possibility that you have episodes without noticing but it seems unlikely as you are so fit! I don't know if Diltiazem can be used as PIP (pill in pocket) but under the circumstances I would ask if you can have something suitable for that. All drugs have side effects (better not to read the list unless you have a very noticeable new symptom) but Diltiazem seems to be one of the good guys. I had to stop taking it because I don't have a healthy heart. You might have to try to get an appointment with an EP (Electrophysiologist) to discuss further. In the meantime look after your asthma well because chest complaints and AF go together!

  • Hi Buffafly I did tolerate it really well, felt very secure and confident taking it which is important. My 3 episodes have been 3 months apart each time, as well the 48hr monitor picked up only 2 episodes the longest lasting only 20 seconds , thank you for your comments I guess I have some thinking to do.

  • I am newly diagnosed with intermittent AF which is not always detectable by myself. I had an episode that lasted overnight in August and have only just been tested by the cardiology dept here. I was prescribed Slozem which is Diltiazem Hydrochloride I think which has had no side effects but I am anxious about being on this for a long time. I cannot take aspirin or warfarin as it could cause internal bleeding. I am 75 and not very active with a knee needing replacement. Reading the side effects of this drug is alarming especially as it states it should not be taken by the elderly and should be monitored by doctors which is not happening to me. It was reassuring to some extent to read that you thought it was one of the good guys. I am going to have tests with Nuclear medicine next week. I'd appreciate any help with what I should be asking the cardiologists next time I am seen.

  • I would have been happy to take Diltiazem forever at the dose I was on, 120 Slow Release daily because it did wonders for my 'IBS' (now diagnosed as diverticular disease) but had to stop because of pauses in my HB causing dizzy spells. So you are lucky if you have no side effects. I am afraid most of us have found that self monitoring is needed unless you have exceptional medics!

    I suggest you put your question with as much background detail as possible as a separate post and then you will get plenty of advice.

  • Hi Buflatly. Been on the Diltiazam for 3 weeks now . Have a naturally low BP so was alarmed yesterday when I checked it myself. It was 120/46. I only checked it as I was so tired. Seems far too low to me. I know I am recovering from Pneumonia and maybe the wrong time to be overanxious . I was only diagnosed with P AF 7 months ago but I feel so alone in this ( apart from you guys ) nobody in the medical profession seemso to have time to listen to me. Still confused .

  • Diltiazem lowers blood pressure and heart rate but as you see is not selective! Please do not worry yet, your body adjusts in time but if not you do not have to take it. Some people concentrate on lifestyle changes and take no meds, most prefer a quick fix. The hospital docs will have assumed you should be taking something and Diltiazem is the alternative to Bisoprolol. Sooner or later someone will suggest this so it may as well be me, if you can afford it see an EP privately so you can have a proper discussion, but actually I would say stay calm and carry on for now because it is very early days - if you still feel anxious on Diltiazem I wouldn't stop 😃 Read lots on here and British Heart Foundation website, NOWHERE ELSE! and that will help.

  • You really are a help and talk a lot of sense. I will look into the E P suggestion. Thanks for that.

  • Buffafly,

    I am concerned as I have had diverticulitis myself and am worried now that the drug I Am taking will exacerbate the condition. Thank you for your reply.

  • Diltiazem is one of the few drugs helpful for diverticular disease (at a low dose) which is why I am gutted (sorry) I can't take it.

  • Thank you for this information. It is reassuring.

  • Thank you for this information. I do have bouts of diverticulitis from time to time and informed the cardiologist of this and was then prescribed Slozem lowest dose. Seems I might be on it for ever. I do feel tired however and am breathless when walking out of doors. At home things are ok except climbing stairs! The Slozem has not made any difference for that.

  • Sharer a. Same as you. New to it all. Scary isn't it. Still not sure about Diltiazam. Good luck to you. Hope you get your answers.

  • Stivvy

    Thank you for your reply. Glad to find I am not alone in this. Hopefully things may improve.

  • Good luck to you too. Keep in touch if needed. If I learn anything new when I see the consultant next I will keep n touch.

  • I understand your concerns and have been there myself. When I was first diagnosed with my arrythmias (yes I'm lucky enough to get THREE types), I was put onto preventative meds. I've always been tablet phobic so was stressed off my bean. My cardiologist was amazing. As he said "we can manage any side effects of medication so take them and enjoy your life". I found it oddly reassuring and have done just that. I have no effects of a negative type from them either. I still have episodes that land me in hospital, but since being on meds they are now reduced to far between. Take my doctors advice and simply enjoy life. Try not to worry about the medications, as the stress from worrying is far more likely to worsen your heart than the pills will.

  • Hi Vonski. Thanks for that. Your comments are very reassuring. This is all new to me and I'm sure that all of you lovely people had the same fears when first diagnosed. I have found the forum to have helped a lot. I was told to recognise my triggers and work round that. Believe it or not it's medication . Decongestants kicked me off last time .

  • Decongestants usually contain pseodoephedrine which is in the same class as amphetamine and a nono for anyone with AF, SVT etc. Also beware of painkilling injections with adrenaline.

  • All I have to do is walk too fast or vomit and mines triggered

  • Poor you. My lovely Mum died last week peacefully in her sleep of natural causes ( old age) she had AF and was asthmatic. She led a full and healthy life . Her motto was. Shut up and get on with it ! Wise woman.

  • A wise lady. Sorry for your loss. No wonder you're worrying

  • Stivvy,

    I went skiing with an old friend. We are both 61. He was diagnosed with PAF a few years ago. He only had one or two episodes and was put on Sotolol (a beta blocker). After that he has had about 6 episodes whenever he has missed a dose. I had PAF episodes for 20 years before being prescribed PIP Flecainide. The progression of the disease was very slow. I was not prescribed any drugs due to incompetent practitioners. My condition deteriorated quickly in 2014 and I had an ablation a year ago. My friend takes the daily medication. I am medication free.

    But the message is that it's hard to know the right strategy. My friend is now "addicted" to the beta blockers because he WILL get PAF even if he misses one dose. Is that because he should have been prescribed PIP Flecainide instead of a daily beta blocker? Who knows?

    We can both still ski hard and fast, but I am medication free and I don't have a beta blocker slowing me down. I used to take 25mg metoprolol (beta blocker) with 100mg Flecainide as PIP, but I really didn't like the feeling of the beta blocker slowing me down. Again that is just my individual reaction to the drug.

  • Ms4444. I think P AF is somehow harder to deal with as far as medication goes , because episodes a few and far between and because I have a healthy heart you tend to forget you have it until boom it's off again, the chest infection that I mentioned in my first post was actually pnuemonia and I was admitted to hospital for 6 days, docs thought that the nebuliser and meds would induce AF but it didn't, which again gives you a false since of security, I guess I haven't come to terms with it yet but do realise I am one of the lucky ones, I am a similar age to you and like you very fit and healthy , thanks for your comments it all helps a lot,

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