Change of Meds

[hollymae]

I have just had my meds changed from Flecainide to Adizem my paroxysmal has changed to persistent and I now need a rate control. I have felt quite agitated and wondered if it was the adizem or the withdrawal from the flecainide I have been on it about 15years. Has anyone had the experience of changing to a rate control or starting Adizem

[cuore]

Another name is diltiazem hydrochloride. It is a calcium channel blocker.

"Inhibits calcium from entering myocardial and vascular smooth-muscle cells, thereby depressing myocardial and smooth-muscle contraction and decreasing impulse formation and conduction velocity. As a result, systolic and diastolic pressures decrease."

If you are persistent and are changing from rhythm to rate control, it appears that you and your doctor have made the decision to live in afib and not have an ablation.

Calcium channel blockers are easier to tolerate than beta blockers (also rate). A lot of people tolerate diltiazem quite well. I took a similar drug, verapamil, and had no problems with it.

Out of curiosity, who is your doctor-- a GP or an EP?

[Hawkie147 in reply to cuore]

Hi Hollymae,

Like you I was for 15 years paroxysmal, and for most of those years took Flecainide. When 2 years ago I became persistent my consultant took me of flecainide.and put me on bisiprolol, deciding to concentrate on 'rate control'.

Apart from tiredness which is pretty much all the time I have been reasonably OK bearing in mind that I am 78. I must say that I was more than happy to get off flecainide which thinking back often made me feel lousy.

I don't know anything about Adizem which you are taking. Bisoprolol which I take is a beta blocker (I think). And it does keep my blood pressure down but is known to make you tired. Hey ho! You can't win really can you.

Anyway chin up life in 'persistent' isn't that bad.

Jean

[cuore in reply to Hawkie147]

Hawkie 147, you went from rhythm control (Flecainide) to rate control (Bisoprolol); was an ablation not an option? You refer to consultant: was he an EP?

[hollymae in reply to cuore]

not an EP, a cardiologist I shied away from invasive treatment when I was paroxysmal I am now 71 with other health issues so I wouldn't really contemplate it

[cuore in reply to hollymae]

Okay, wish you the best. I am 74 and I did have an ablation on July 3, 2017.

[Spoiler in reply to cuore]

Was your ablation successful? Just curious, I have been considering it as a option.

[cuore in reply to Spoiler]

I would say "Yes," but I do need another one because the heart gets inflamed during the procedure so that the EP cannot ablate all of the rogue signals. I was offered an October 24 date but am trying to schedule mid-November. I was six months persistent, so it's pretty common that two ablations are needed when you are that far gone. I went to Bordeaux, France -- tops in the world, and used the cardio-insight vest. Age is not a deterrent to ablation.

[Coco51 in reply to cuore]

Did you go to Bordeaux privately or was it possible to arrange through the NHS?

[cuore in reply to Coco51]

I am from Canada and had to pay for it privately because had I waited for the Canadian system to get to me, I would have been in at least long-standing persistent atrial fibrillation.

As it was I reached 6 months persistent by the time I found the Bordeaux group. The Bordeaux group is worth every penny. I am returning there for my second ablation on Nov. 20th because I was so far gone (due to our "waiting time" Canadian system) that they couldn't get it all the first time round.

[Coco51 in reply to cuore]

Good move! I too was in persistent for 4 months before my first ablation through waiting times. It worked well enough then after 6 months I got more longer episodes and was in persistent for 3 months before the 2nd ablation 5 weeks ago. So what you say about getting it all first time round applied to me. The second 16 months later was pretty comprehensive with a full anterior wall and " box" but who knows? Bordeaux has a brilliant pioneering reputation but what is the cardio insight vest?

Sorry for all the questions.

Good luck in November.

[cuore in reply to Coco51]

The cardio-insight vest is a 252 lead vest that wraps around the torso of your body to map with very good precision where the rogue signals of your body are coming from. Compare that to a 12 lead when you get an ECG done. The mapping procedure is more accurate than a 3D one using catheters. You can Google cardio-insight vest by Medtronic and you'll get a lot of information on it.

The Bordeaux group knew exactly where to ablate and Dr. Jais (tops in the world) did ablate the four targeted areas (developed during the six months persistent atrial fibrillation) as well as the pulmonary veins. However, due to acute edema, there could not be a complete blockage after a roof dependent macro-reentry. The good news is that if the arhythmia comes back, "it will be most likely amendable to catheter ablation." That is why I am going back.

[Coco51 in reply to cuore]

Very impressive. No doubt our NHS will have them in about 25 years time! Hope it goes well for you.

Janet