AF and Digoxin

[Earledavis]

Yesterday I saw a different cardiologist as my normal one has left the hospital. He said he said he thought I had moved from Paroxysmal AF to Permanent AF. He also said I now have to take Digoxin as well as the Sotolol 80 mg x 2 daily and 150mg Dabigatran twice daily. He informed me I may have to go back on Warfarin which I found alarming but give no explanation as to why. I know I should have asked but I was so taken aback. Anyone else on similar medication or have been told they may have to go back on Warfarin. I find it very worrying. Thanks.

[Hidden]

I assume you recognise the need to take anti-coagulants but it's the fact that he wants you to go back to Warfarin that is concerning you. Generally DOAC's are not suitable for patients with replacement heart valves or if their kidneys are not functioning correctly. Age and being under normal weight can also have a bearing. The other reason can be cost and if that's the reason, you will have to fight your corner!!

[Kaz747]

At one point last year I was on 320mg of Sotalol per day and was put on Digoxin as well. That still didn’t control things so I was taken off Sotalol and ended up being on a cocktail of Digoxin, Amiodarone and Atenolol which slowed the rate down but didn’t stop the AF. Thankfully my last ablation has made a big difference and I’m now only on 1/2 a tablet a day (25mg of Atenolol). I’m not sure about the Warfarin.

[DevonHubby1]

Hi,

My wife is also diagnosed with paroxysmal AF treated with Bisoprolol. A recent AF episode went on for over 5 days and we ended up in A&E and from there onto the cardio ward. They added Digoxin to her meds and after a lot of experiments on different doses of both Bisoprolol and Digoxin they got her HR down to below 80 resting and telling us she was now permanent AF and to get used to life in the condition. A week later she self reverted back to normal rhythm. She was discharged on those 2 meds plus her regular modern blood thinner and is still on them.

As your worried I would suggest you contact your GP or cardiologist/EP and have them explain the meds to you and the reasoning behind prescribing them to you. My experience is that generally consultants in hospital assume an underling will explain in detail why things are being done after the ward round but quite often these junior doctors forget or are diverted to something else. Before being discharged you should ask for someone to explain things if you have any concerns.

[Earledavis]

Thanks to all who give me their experience of the meds I am now on. As always it is greatly appreciated.

[Hidden]

The first 10 years of having AFib, I was on a cocktail of Digoxin and Quinidine. It gave me a pounding heart beat, but my heart rate dropped from its normal 68-70 down to the high 40's and never recovered to more than 50. Suddenly at a visit the doctor said they were terrible drugs and took me off of both of them. He put me on high doses of Vitamin C and Fish Oil after reading studies that said they helped. Frankly, my episodes of AFib were no worse and about the same frequency on the natural stuff than they had been on the Digoxin and Quinidine. About 3 years later I ended up in his office in A Fib and he gave me Verapamil, which converted me quite quickly. That was my pill in the pocket for the next 6 years until it stopped working. At that point, I was given Flecainide as my pill in the pocket and I have carried it with me for the past 14 years. Thankfully, I haven't had to take any in months since I became mindful of my eating and studiously avoid carbs.

[Aorticklapper]

Hi, if you have AF it's normal to be prescribed warfarin to reduce risk of having a Stroke. Due to the heart beating out of normal rhythm there is a risk of a clot forming.

It will probably be a low doseage however you will be more prone to bruising and perhaps nosebleeds if it's a higher dose. Also if you participate in sports such as contact ones you will have to take care.

Warfarin interacts with some foods especially some green vegetables which can make blood thicker. Alcohol conversely can make your blood thinner. Full details about warfarin interactions online.

You may have to attend a clinic for check ups to measure your warfarin INR (clotting ratios). Check with your doctor if you have to do this.

I recommend the following:

Always have a supply of Kaltostat. This is great for stopping nosebleeds and any other external bleeds.

If you are having to visit a clinic to measure your INR ratio and are a person who will worry a bit etc then Roche Diagnostics have a small self tester. The test strips can be prescribed by your GP or bought online ( not cheap). Tester by Roche costs around £300.

I have been on a high dose of warfarin for 26 years and the info given is based in my personal experience.

Regards

Will

[Mira265]

I have been on Warfarin for 10 years and keep it in check by not having dark greens broccoli and Brussels. Alcohol in moderation but normally abstain. No cranberry at all. I have a test at my local chemist every two and a half months and have had no problems at all.

[billllly]

I've been on Warfarin for years and have had no problems but I couldn't tolerate Sotolol and stopped taking it.

[supergranny]

Ask him to put you on a new drug Apixaban or similar if he insists on Warfarin.

[LPE44]

I am on Eliqus (apixaban). As supergranny suggested above, you might ask for this instead as it does not require frequent monitoring. It also leaves your system fairly quickly - three days - so if you need any other kind of surgery, you won't need to wait long.

On the other hand, Eliqus does not have a generic yet, so it's extremely expensive - at least here in the US.

[Lock5000]

Hi hope your ok i have afibb and not sure if its permenent yet but i am on ribaroxaban think i spelt it correct. You dont need blood tests every so often you just take one every evening with your dinner i been on them for a year with no side affects