Amiodarone & Electrical Cardiovesion - does it work

[AbbyTabby]

Hi would appreciate comments from ppl with my condition. Recently diagnosed with persistent AF. Due to start Amiodarone for 5 months and elec catdioversion in 2 months 💔 also have mitral prolapse. I feel treatment is routine and not specific to the individual. Is this just the way it is? Thanks

[BobD Volunteer]

Neither treatment will cure AF but either may reduce symptoms. By combining the two you may have a better chance of a good result and if it returns you to normal rhythm (NSR) and it makes you feel better then this may signpost other treatments. Any and All treatment with AF is only for quality of life. These treatments are typical for AF regardless of individuals and any additional issues they may have although eschaemic heart disease may preclude some drug treatments.

[Aurealis in reply to BobD]

So are these treatments given routinely even in cases where quality of life is not impaired at all?

[BobD Volunteer in reply to Aurealis]

DCCV along with possible pre treatment with amiodarone are often used to see if a patient's QOL is improved by getting them back into NSR. If so then other treatments may be signposted.

Sorry but there is nothing routine about AF treatment as we are all so dfferent with different levels of acceptance and symptoms. For example a person may have permanent AF and be quite ignorant of it unless discovered by routine pulse check. For those, so long as they are protecetd from stroke by anticoagulant and theie heart rate is controlled by suitable rate control drugs there is no need to try and return NSR.

[Offcut]

I have been on Amiodarone and many others besides. I will add I am not your usual AF'er I have a lot of other complicated conditions so not the best to base my experience as the norm? What I have deemed from my treatments is that it is finding what best suits you?

Be well

[ILowe]

As I understand it from memory of the time when I researched this in medical journals, what you have been offered is pretty standard.

1/ It takes several weeks to fully load you with amiodarone

2/ I have seen at least one piece of research showing that the chances of success for a DCCV are (marginally??) better under amiodarone than under flecainide or other meds

3/ There is some evidence that success is best maintained if you stay on amiodarone for another three months or so, bearing in mind that most cases of reversion of NSR to AF happen in the early months after the shocks it makes sense to stay on it a while

4/ Keeping amiodarone to less than six months is a popular tradeoff to avoid the other effects.

[AbbyTabby in reply to ILowe]

That’s great, thank you

[Wasp1954]

Not like you I suffer from Paroxysmal AF and due to the increasing frequency of episodes had a ablation last December. A month later and as a result of the ablation had a pretty bad AF experience that required hospitalisation. I was ‘loaded’ up with Amioderone over a 5 day period and continued on a steady dose for three months. I experienced side effects (nightmares, loss of appetite, taste etc). I saw the Cardiologist last month having had no more AF or any other symptoms for 6 months. He will see me again in March 2020 when the amioderone should be out of my system! That stuff is potent and you need to swat up on it.

[AbbyTabby in reply to Wasp1954]

Good to hear you are off Amiodarone, I am dreading it, and find it hard to believe this is the best there is for AFib treatment. Sorry to hear your ablation had an adverse effect. It’s serious stuff isn’t it?

[Jes59]

I was on Amiodarone for about nine months with the last three months reducing the dose. About a month after starting I had no more AF episodes. I was lucky and had no side effects though I was careful with sun getting to my skin in the summer! I had a couple of blood tests during that time to check for other side effects. I have suffered a few bouts of ectopics coming to the end of the course and also recently, Six weeks after finishing. It takes a while to fully leave your body so fingers crossed that my AF takes its time coming back! For me Amiodarone was brilliant, though for others it can be the complete opposite. Good luck with your treatment.

[Aurealis]

Yes I feel the same, I feel like I’ve been placed on a conveyor belt leading to cardio version with hardly any individual focus. How do you feel? I feel well

[AbbyTabby in reply to Aurealis]

Hi thanks for your comment. I feel ok, well I did before being diagnosed. Now I m on apixaban forever and have a heart problem. The comments on here on very interesting and certainly helpful. I am trying to understand how I have gone from being very active to getting breathless when I go upstairs. It was only when the doc routinely took my pulse (I had gone to doc for bump on head) and then ECG confirmed AF. I realise there is no quick fix and perhaps I’m lucky to be alive💔. Are you on Amiodarone and when do u have your cardioversion? Regards AbbyT

[bennie06]

I started a similar journey nearly two years ago and yes it does work!.

It takes around six weeks for Amio to become fully functional on a maintenance dose of 200mg daily. You just might be very lucky and convert to normal rhythm without the need for an electrical intervention, but don't count on it! Note that when you have your successful conversion you may notice the difference and think of climbing a mountain or doing an extreme marathon. Don't do it, take it easy for a couple of days. As mentioned by ILowe, the risk of the conversion failing is in the early days, after the first month the failure risk becomes significantly reduced. With the help of Amio helps to reduce this risk.

The side effects of Amio are well documented and if your interested follow the link below for the largest study which may provide some reassurance.

Ignore the post by RayHrdlicka, he is a mischief maker. This is an excellent forum comprised of people who have real world experience of AF. Unfortunately you cannot always prevent the darker side of social media raising its ugly head.

Stay positive, trust your medical professionals and Good Luck!

doi.org/10.3904/kjim.2014.2...

[AbbyTabby in reply to bennie06]

Thanks I really appreciate all that you’ve said. How are you now? Are you AF free?

[bennie06 in reply to AbbyTabby]

See Below!!

[bennie06]

Well my heart is good with an EF of 73% so a happy bunny! I have had a few AF episodes although all have been short lived (converted naturally within 48 hours and all at reasonably low heart rates. <100). So this is "work in progress" as i am pretty sure this is Vagal AF. i.e the episodes have always been postprandial(after a meal) and have been preceded with a "rumbling stomach " and a fluttering sensation in my stomach area. (this is a vagus nerve reaction). So i have identified the triggers! For info: Vagal AF characteristics are; After exercise(with at least a 30 minute rest period. After food/alcohol. It is also possible to have a mixture of Vagal and non Vagal (e.g. Emotion) triggers.

Stay strong, you will get better and Good Luck.