From the everyday health website :“The benefits of these drugs [anti- arrhythmic drugs] diminish with time, says Gopi Dandamudi, MD, cardiologist and assistant professor of clinical medicine at Indiana University School of Medicine's Krannert Institute of Cardiology in Indianapolis. “Less than 20 percent of patients truly maintain sinus [normal] rhythm on anti-arrhythmic medication,” he adds.”
I did not know that this was the case. Does anyone know any more about this?
No. But it's depressing reading.
We need to be very careful when analysing statistics. What was the age group of the sample data sets, what sex, what type of arrhythmia, the list goes on. I have done a little research on side affects for Amiodarone and also came across some stats re efficacy. Amio came out head and shoulders above the rest but an interesting fact was that around 50% failed during the first year. A high proportion of this 50% failing during the first 6 months. The decline is even quicker if you on a "very very" low dose of 100mg daily. In fact, and wearing rose coloured spectacles, if you are still in normal rhythm after 6 months then you're on a winner. After 12 months the rate of decline(back into AF) is very slow, both for 200mg and 100mg dose rates. " 40% of participants taking part were still in NSR after 5 years". Now for my money that aint bad odds.
I am not a AF specialist (a person who learns more and more about less and less until eventually knows everything about nothing!) so usual caveats and good luck!!
This is technically incorrect as the drugs do not become ineffective. There are no receptors in our bodies for the anti arrhythmic drugs so unlike opiates for example the body does not get used to them and need more to be effective.
AF is a progressive condition as I am sure you will have been told so it will often get worse regardless of treatment, the possible exception being ablation. .I say possible as there is little really long term data available. In my own case. three ablations (the last in 2008)has left me AF free for ten years but I am under no illusion that I am cured as it may return some day hopefully long in the future.
My suggestion would be to use the drug to buy some time to work on lifestyle changes.
Background info: I was given 100mgs Flecainide and got 9 episodes in a month, not sure whether the drug exacerbated the episodes but was then offered an ablation but discussed with cardio upping the Flec to 200mgs, which stopped it for 4+ years and counting with the help of many lifestyle improvements.
Certainly my experience, works for a while & then you get break through as AF progresses. But not everyone’s AF progresses and if you have been in AF consistently for months/years you may very well stay in NSR, even when you come off the drugs.
I fought against daily rhythm meds for the last 2 1/2 yr and finally gave in early summer. I was a PIP advocate , unaware that we can have silent afib we are unaware of. After a lot of research, I’m now agreeable to taking my flecainide and metoprolol daily. I expected big side effects and have had minimal. No apparent afib in 5 months now, fingers crossed.
Side affects from Amiodarone show in recent reports see: Amiodarone guidelines for use and monitoring. Routine screening for respiratory distress syndrome is of limited value because pulmonary toxicity can develop rapidly with no antecedent abnormalities on chest radiographs or pulmonary function tests. High-resolution computed tomographic scanning can be helpful in making a diagnosis. The primary treatment for pulmonary toxicity is withdrawal of amiodarone. Because of its iodine content thyroid toxicity is another complication that requires intervention. Was on this drug for a very short time started on a high dose in hospital then on 200mg which caused liver toxicity stopped straight away.
Anti -inflammatories
New anti- coagulation drugs 
Flecainide and Diltiazem 
Drugs
NHS restrictions on new drugs.
