Confused

[Spinbiker]

Visited GP complaining of extreme tiredness - subsequent ECG discovered AF - put on diltiazem 180mg & eliquis 2x 5mg and I feel even more tired and “ running on empty “ all the time plus heavy in the head - quite awful really and strangely enough I don’t experience any AF symptoms palpitations heart thumping etc etc just this awful lethargy - a cardiologist confirms that I have AF and recommends cardioversion and change of medication - but I am still puzzled as to why I don’t ger usual symptoms and these tablets making me feel even worse - I did feel better without them

[MarkS]

I often think we're given tablets as a bit of a sop - here, take this and don't come back and bother me. Calcium channel blockers like diltiazem don't work for everyone. You could try beta blockers, though dilt worked better for me than them. You need to be on something if your HR goes over 100 when you have an AF episode, but if it's not that fast then there's not a lot of point.

You may need to go through the drugs to check if any happen to work, before you get offered an ablation, which is the best long term option.

[jeanjeannie50]

Prescribed tablets can sometimes make people feel a lot worse and it may take a bit of time to find out which ones's and what dosage suits you. Please don't put up with how you are feeling right now and seek medical advice. Saying that, we have to make sure we give our bodies fair time to adjust to new medication. I don't think I would give longer than two weeks for that. The most important of all your tablets are the anticoagulants

Jean

[KMRobbo]

I was on diltiazem 200mg modified or extended release for 10 months until after a succesful ablation. I had tiredness, some breathlessness , exercise intolerance (max HR 137 and painful at that) ,poor memory and brain fog. Possibly the latter 2 are what you are describing as heavy head. I think the problem got cumulatively worse the time I was taking the drug. When I stopped the diltiazem it was 4 to 6 weeks before the symptoms went away (which was a surprise as i thought diltiazem has a short half life ). Then it was a magical improvement. I only put up with the drug as I knew I was having an ablation and I had tried 2 beta blockers previously which were far worse than the diltiazem for me. If i were you i would ask for a change in rate control drug or a reduction to 120mg. Diltiazem has a multitude of different suppliers/formulations which I am aware has caused problems for other people when they have been switched brands.

[Dodie117]

Some people are asymptotic and do not feel the AF. It might be useful to check your pulse rate as if your heartbeat is not very fast and the meds are reducing it further it could be too slow and making you tired. Some people have slow AF.

Also the AF itself will make you tired. The blood is not being pumped properly around the body when you are in AF. Do you know how often you get episodes/how long they last?

There is a device called Kardia which can tell you if you are in AF and what your heart rate is. Costs about £100.

It will get easier when you know more and get some control over it. Get information. Knowledge is power!!

God luck 🍀

[Spinbiker in reply to Dodie117]

Thanks for reply- I will take what you say onboard- I have the kardia already and it repeatedly tells me I have possible AF - but as previously mentioned I do not feel ant attacks, palpitations or movements in my chest

Absolutely nothing - I have the feeling to lower my medication dosage or even change from diltiazem 180mg say to 120 msg OR try out lebivolo

Thanks again. Michael

[Dodie117]

Have you seen an EP (electrophysiologist). They would be able to help you with medication and also look at ablation as a possible way forward. I had ablation in 2013 and got my life back. So far no more AF and able to walk, garden etc.

[Spinbiker in reply to Dodie117]

No but recently saw cardiologist and he recommended cardioversion - thanks again michael

[Hidden]

While you are experimenting with different meds, remember that if one makes you feel bad - see your doc and try something else. Remember that doctors are largely guessing what will work for you - they probably know only 5% of how the body works. Until you find the right mix, you might try reducing your intake of sugar and salt. See the research I did below:

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After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt??

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

[Mrsvemb]

I agree with what you are saying about sugar. It is definitely a trigger for my PAF and my tolerance level has reduced as I have got older. Even a year ago I could eat a dessert occasionally or some chocolate. Now I can’t get away with it.