Norpace for vagal atrial fibrillation

[Choroba13]

I was prescribed today Norpace 100mg. I am very suprise because I hardly hear about this medication on this forum.

[Hidden]

I have just googled this and it appears to be a brand of Disopyramide. I'm on Disopyramide, which is a sodium channel blocker, as are and have been some others on the forum.

It has been the best drug so far. I've gone from a mess of a pulse to a nice steady thump, thump. I am not aware of any side effects at all. Been on it for a few years now.

Koll

[opal11uk in reply to Hidden]

I have been takin Disopyramide for years, its has suited me better than all the others and my cardio says it stays in the body for 12 hours only which I find unusual, now take 2 a day, one morning and one evening

[Hidden in reply to opal11uk]

Same here, I take it twice a day and it works great on me.

[secondtry]

That's interesting, I have never heard of it either. Did the cardiologist say it was particularly good for Vagal AF? Do yo take anything else with it? What rate is your pulse? I am sure lots here would be interested. Thanks for posting.

[opal11uk in reply to secondtry]

I have a pacemaker set at 60 revs, I take 2 x Disopyramide and 1 x 5mg Bisoporal per day

[Hidden]

I've been on this drug known as Disopyramide in UK for past 2 years. Was previously on it for 12 years before it became temporarily unavailable in UK. It's an older drug but as I understand it used mainly to treat vagally mediated AF.

It's the only drug which works for me but not 100%. I'm having problems st the moment.

Sandra

[rosyG]

must remember this in case offered- very useful

[GolfMyrtleBeach]

I was on Norpace for a very brief period. My EP advised that it was an older drug that was seldom prescribed these days ( at least here in the US), but since 3 other drugs and two ablations had failed to get my PAF under any kind of control it was worth a try. I had to stop it before I could really measure its effectiveness, because it was slowing my heart too much and lowering my BP to the point that I was feeling quite faint. I went back to Sotalol which was quite ineffective as usual ( this past June - 16 days with episodes totaling 61 hours). I have just started Tikosyn this month. I bit the bullet for the 3 days in the hospital of monitored dosing and I can stand the maximum dosage. Early to tell yet, but since the 5th of July I have had only 2 short episodes - 2 hours and 3 hours - and I few little blips that rectified within minutes., and no other side effects. So promising - but time will tell. I understand that this drug is not available in the UK, but I will keep the group posted anyway for general interest.

[Choroba13 in reply to GolfMyrtleBeach]

I really appreciate your responses to my email. This website is great and you are all very kind kind users.

I had cryoablation last year in September for a paroxysmal atrial fibrillation of vagal character. For almost six months after my cryoablation I had no afib, but I was taking Eliquis and flecainide. In December I dropped Flecainide and stayed just with Eliquis. Suddenly at the end of March I was getting afib attacks and I picked up again a small amount of Flecainide. Well, it didn’t help and slowly I increased the flecainide to the original dosage and no help. EP felt that it could come from flecainide because flecainide could induce a flutter. I was asked to stop the Flecainide. Again, there was a dispute if what I have is the atypical flutter or afib. Two EP doctors had two different opinions. We are dealing with top institutions in USA like Johns Hopkins or GW and Gerogetown etc. My attacks continued almost twice a week sometimes even more frequently and they changed after 4-6 hours to the normal rhythm. Then my EP who did the ablation concluded that cryoablation was not successful. Well, he decided to go with Norpace. Of course , I am afraid of it because I still hike , swim and being healthy otherwise. I have feeling that the research in Afib is going nowhere. I follow both sides US and Europe and see no new drugs, ablation is successful just 70% and it is unpredictable. I just have to decide going with the same doctor who was not successful or go to somebody else for the second ablation. My question is following: Do you change doctors if the first ablation is not successful?

I would appreciate feedback from some users here.

[GolfMyrtleBeach in reply to Choroba13]

I returned to the original EP for my second ablation. I also went to a top-notch ( I believe) facility - the Duke University Heart Center. I am currently seeing an EP in Wilmington, NC, where I live, who sends all his difficult cases and redos to the Cardiac Center at Chapel Hill, NC. Without being critical of Duke he implied the success rate is greater at Chapel Hill. He has suggested a 3rd ablation there and I am contemplating it . He assures me Medicare will approve the procedure ( I am an active 68 yo). I am particularly interested in the HYBRID procedure where a cardiologist ( through a small puncture) ablates the outer surface of the heart muscle and the EP simultaneously ablates from the inside via catheter. This is apparently done at Chapel Hill, so I may go this route if the Tikosyn fails completely.

[Choroba13 in reply to GolfMyrtleBeach]

This is a very interesting procedure. I never heard about it. Are you talking about ablating some of the ganglia that are imbedded in the fat pads on the surface of the heart. I just have to find out about this " HYBRID" procedure. It could be called also " convergent."Probably I would google it. My doctor at Johns Hopkins who did the cryoablation suggested the second ablation would be done by using the traditional way using RF ablation doing it in a point by point fashion. I am just wondering if that would be helpful. He must have missed some parts and AFIB came back. Again , I will try to get a second opinion in this case. Thank you for sharing your next step.

[GolfMyrtleBeach in reply to Choroba13]

I am not really sure what they abate externally. I do believe "convergent" is the same procedure I was thinking about. Looks like we might be on the reverse course. Both my ablations ( 2011 and 2012) were RF. This EP initially suggested cryo for the 3rd one. If I do a 3rd I may have to settle for that, because I am doubtful medicare would cough up for the obviously more expensive "hybrid/convergent" variety.

[Choroba13 in reply to GolfMyrtleBeach]

Thank you for writing about it. I am so disappointed about the progress of the afib research not only in this country, but in Europe too. Especially there is no research in the vagal character of the paroxysmal afib. I am talking about real research and not only identifying triggers. We have here in the Northern Virginia so many electrophysiologists and everyone is eager to do ablation. I don’t know anybody who is happy and got out of just one ablation without medications and afib attacks. This would be a great miracle. My EP suggested going for another ablation and this time he would not go through cryoablation as he did last time, but he would use the classic RF. Right now I returned to Flecainide 100mg twice a day and 25mg Metoprolol. My head is heavy like a stone and I am just waiting that it would at least stop my paroxysmal, vagal afib. I have no other structural heart problems and I am basically healthy, but this afib came back after cryoablation last year with vengeance. I heard that in Prague they started the ablations with a laser. It would be interesting to see it here.

[cuore in reply to Choroba13]

Choroba13, you imply you have vegal AF and you are taking 25mg of Metoprolol? I have read on this site and elsewhere that Metoprolol is contraindicated with vegal AF. I had a severe reaction to 25mg Metoprolol especially getting palpitations that I never had before. And, I had atrial flutter that had not progressed to AF yet. I have wondered if Metoprolol was a contributing factor to my progression to AF.

[Choroba13 in reply to cuore]

Yes, you are right. Metoprolol is a beta blocker and what it does it slows the high palpitation during an afib event. Beta blockers are not helpful for vagal Afib. That time I had occasionally high palpitation. When I took just 25 mg of Metoprolol I felt overwhelmed with fatigue and pressure in my head. I cut it in half and took it only in the evening. That helped. I will talk to my EP in one month if I have to take it and what is the reason for it in my current situation. Right now I have been helped by taking 100Mg of Flecainide twice a day. I don't think Metoprolol would be a contributing factor to the progression to AF. I know that when I got a flutter for a short time that my EP asked me to stop Flecainide and prescribed Metoprolol to slow down the palpitation. Flecainide could introduce Atrial Flutter. Again there was a dispute between two electrophysiologists if the EKG is just an atrial flutter or some kind of mixture of atrial flutter and afib. As you see you just must ask lots of questions when you go to see an EP. The unpredictability of this illness and lack of research in it make it hard for us as the patients.