I supposedly have Paroxysmal AF, and take Flecainide morning and night, and Metoprolol and Xarelto at night. My cardiologist is not good at explaining and seems impatient when I ask. Perhaps someone here can help?
When I try to go the PIP route with Flecainide, I find that by late afternoon I am getting palpitations and pre-ventricular contractions, which usually respond to a Flecainide PIP within an hour, though sometimes last longer. Might this point to Persistent AF rather than Paroxysmal? Does this mean that palpitations and PVCs are one and the same thing as AF? I ask because for years I understood that they are common and harmless and needed no treatment.
I was not diagnosed with Paroxysmal AF until 4 years ago, when, as caregiver for my husband during his last years with dementia, I had a frightening episode of high BP, rapid (155) and irregular heartbeat. But have been on the medications only 1 year. Since then I've had many hard-to-describe "brain" episodes which, after "normal" results with MRI, CAT scan, and EEGs, have been attributed to anxiety disorder. At the same time I can't help wondering if the episodes are medication side effects, but the cardio's almost casual response to that was to suggest switching to Amiodarone, and I don't feel I can face any more changes - especially after reading up on Amiodarone!
When I asked my cardiologist if the AF might be causing the palpitations, PVCs and anxiety attacks . . . or might the anxiety be causing the AF, palpitations, and PVCs? his answer was of the "who can tell?" variety.
Thanks to anyone who has plowed their way through all the above! I welcome any input, please!
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Nanfranz
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When I took Flecainide as a PIP I discovered I started getting more attacks of AF and tachycardia. I'm now on 2 x 100mg per day taken morning and night.
I too take Metoprolol, but only 12.5mg each morning and night as this drug has a powerful effect on me. I was told that that it only stayed in the system for 12 hours so needed to be taken twice a day whereas one dose of Bisoprolol (which a lot of people take) lasts for 24 hours.
It's not for me to suggest you change anything as I am not medically qualified, but I do wonder if you split your Metoprolol dose to morning and night whether that would help (i.e.half in morning and half at night). I would have a chat with your GP/EP or AF nurse and see what they say.
Is your cardiologist an EP? If not, I would advise you to get a referral to one. They are much better placed to advise you than general cardiologists.
With respect to anxiety, I had a number of anxiety attacks before realising what they were. They never set off an AF bout with me, just made it feel much worse!
I had paroxsysmal AF for 5 years, accompanied by various drug regimes, some more successful than others, before opting for a successful cryoablation. I do get ectopic runs but am drug free and have been AF free for 2½ years.
Mikey, I have to agree with your anxiety comment and I argued constantly with my Doctor that I was fully in tune with my anxiety issues and that they were not a trigger for PAF. I argued that my PAF was always triggered when I was completely relaxed (the complete opposite). I have to admit now that it does play a part when it comes to a delayed reaction. If I am going through a stressful period I am fine but I can expect a few weeks trouble with my heart once I am over it and totally relaxed. This is following 2 ablations and appears in the form of short tachy and ecptopic runs.
The point I make is that anxiety comes with a stigma and it is all too easy for it to be attached to anything and everything else. I believe I now have a greater understanding with my doctor given the 3 year delay in diagnosing PAF (we should be given more credit for understanding our anxiety)
My experience with Flecanide was not good. I was taking a single morning dose if I remember right for a period of about 2 months. Every evening I felt as if I had a severe case of indigestion along with some real weird arrhythmia. Believe me when I say that Amiodarone is not an alternative unless it is leading to an ablation and cessation of the drug.
I wish I had found this site during my years of enduring PAF and getting little information from the experts. In truth, I think they must get bored with trying to explain in layman's terms what is happening and instead go for a short medical description that means little to us. In truth, we go to them with a whole list of weird new feelings and concerns. We cannot relate the feelings to our heart in every case and we are bemused by the random unexplained triggers. The Doctors do little to convince us that they are all related and in my case I found they did the absolute opposite. It is only through reading the articles here that I realised I was not going mad back then. You absolutely can trigger PAF by moving slightly or laughing at a joke.
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