Should I Continue Anti-arrithmics

[macdongr]

If meds, like Propafenone, don't work anymore to control AFib is there any point in continuing to take them? I take Xarelto and Diltiazem, thats all. No other physical problems: 78 years old. At this point, few symptoms I can't live with. Trying to control rate only, not rhythm. Has anyone been in a similar situation?

[Hidden]

If rhythm control is not a goal, I see no point in taking a rhythm drug. Most of these drugs one has to wean off do dont suddenly stop it without speaking to your doc

[macdongr in reply to Hidden]

Thanks for the answer.

[Hidden]

On the face of it, agree with Hoski but we are not medically trained so really is best to seek the advice of your Doctor.....

[macdongr in reply to Hidden]

Thanks for your reply. I agree with the doctor advice.

It seems difficult, at times, communicating that controlling rhythm with the elderly is a fools errand, as long as anticoagulants are taken ; rate, on the other hand is another subject--and, of some debate.

But again, thanks.

[Hidden in reply to macdongr]

Your not elderly, just mature!....😉

[macdongr in reply to Hidden]

I appreciate that. Mature is it!

[jan-ran in reply to macdongr]

Hi, it’s me again. I am interested that you say that controlling rhythm with the elderly is a fools errand? I am 78, and rhythm is the only thing I need to address, as my life is very much affected by it. When my gp said I could stop taking flec as I was probably going into permanent af, I was appalled. I actually begged him to let me keep taking it. I am seriously contemplating ablation now, in spite of my age. I’m afraid anxiety is now ramping up and I’m beginning to panic☹️

[cuore in reply to jan-ran]

I thought GPs were not licensed to deal with rhythm drugs. At least, that's what my GP said when I asked about rhythm drugs and the rate control drugs were not working to get me back to sinus ( of course not, rate control drugs address rate not rhythm.). My GP' dabbling with rate only got me to persistent for which I have had to have three ablations. So much for GPs and some cardiologists focusing only on rate without giving any emphasis to a return to sinus.

I am appalled that your GP, like mine, is comfortable to let you slide into permanent. You can still have an ablation, even at 78. By-pass that GP and get professional advice from an EP.

[macdongr in reply to cuore]

There is recent research from Johns Hopkins that suggests before anyone can anticipate improving their own unique experience of Afib, and gain from treatment: they should (1) lose weight to a BMI of 25 and (2) have a sleep study to see if the suffer from sleep apnea, a real culprit in AF; otherwise, in thousands of patients any treatment is short lived and AF returns in most of the patients. Tough to do.

[macdongr in reply to jan-ran]

You aren't helping it, is the point he was making I guess. Permanent means permanent. All AFib remedies just buy time. No cure is available--you just move from one treatment to the next.

[cuore in reply to macdongr]

I disagree that "controlling rhythm with the elderly is a fools (sic) errand." I am almost 77 having had three ablations to get and keep me in sinus. At present I am almost 8 months AF free and taking the rhythm drug Propafenone. I am not taking anything for rate, but I do take meds for high blood pressure. I guess it boils down to whether one wants to remain in AF or not. I didn't, plus I earned my age.

[Buffafly in reply to cuore]

I used to take propafenone but I hated it and wouldn't take it again, so if I had had three ablations and still needed it I'd be very upset 😬

[cuore in reply to Buffafly]

Compared to Amiodarone, Propafenone is fine for me. I was one of the most complicated cases at the six month persistent stage, so I am assuming this is why I was prescribed the drug. However, at the six months sinus stage I did ask my EP about continuing to take it at that dosage. He didn't offer me a reduction. I am almost at 8 months sinus and will ask again. Thank you for your story because it gives me hope that I can get off it. Are you saying you are off drugs except for an anti-coagulant?

[macdongr in reply to cuore]

No. I have not had the guts to do it, yet. I have reduced the dose by one half and I feel about 50% better :]

[macdongr in reply to Buffafly]

Terrible stuff. I could not agree more. Thanks for the reply

[macdongr in reply to cuore]

I misspoke. What I mean is that treatment buys quality of life in some people, not in others who are less bothered by not having NSR. Each person is different. Essentially, you are are correct in your own experience of AF treatment

[jan-ran]

Hi macdongr, I am asking myself the same question. My af is very troublesome regarding rhythm. I am now struggling with an escalation of paroxysmal af, episodes coming nearly every night. Flecainide does seem to control length of episodes to a couple of hours, but it’s not stopping the frequency. Yet I dread stopping flec as it is the only thing I have to cling to. The dosage of bisoprolol has been increased to 5mg, and now my heart rate drops to 48 at night, my fitbit tells me. I am intrigued that you seem not to be bothered by rhythm symptoms, and I wonder how this happens. I am acutely aware of my heart rhythm when it goes into af. Can you really not feel anything? And in the past, did propafenone work for you?

[Buffafly in reply to jan-ran]

Only going on info from health websites and experience from posters, but the low HR at night might be the cause of your episodes. Maybe that needs checking/adjusting. Also reported from those in permanent AF that they don't notice the rhythm so much if at all. So there is some hope there. Another option is pace and ablate should an ablation be unsuccessful so please don't panic 💜

[macdongr in reply to jan-ran]

Propafenone worked for about 5 years.

It is hard to make the decision to stop taking it. Rhythm is dependent on the person. At my age, especially. They say the real risk is stroke not heart problems; therefore, I let rhythm do its own thing. I stopped worrying about. Does no good anyway.

[Bambi65]

I was in the same boat as you 2 yrs ago. The meds have side effects, the meds dont cure, and some meds can slow down the HR, but none of them really stop it for me.

Personally I look at this the same way as birth control pills many years ago. Since Im not "risking" pregnancy everyday, I dont want or need these chemicals in my body 24 hours a day 7 days a week for years,. I only have AFIB 2-3x a week and for those that are 150+ HR, I use Diltiazem as a pill in the pocket. I manage well with most HR under 130 without much difficulty.

Just my 2cents worth.

[Hidden]

Try this and see if it works for you:

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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 (this is why all doctors agree that afib gets worse as you get older). 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 (afternoon) 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?? I also found that strenuous exercise does no good – perhaps you make yourself dehydrated??

I'm pretty sure that Afib is caused by a gland(s) - like the Pancreas, Thyroid (sends signals to the heart to increase speed or strength of beat), Adrenal Gland (sends signals to increase heart rate), Sympathetic Nerve (increases heart rate) or Vagus Nerve (decreases heart rate), Hypothalamus Gland or others - or an organ that, in our old age, is not working well anymore and excess sugar or dehydration is causing them to send mixed signals to the heart - for example telling the heart to beat fast and slow at the same time - which causes it to skip beats, etc. I can't prove that (and neither can my doctors), but I have a very strong suspicion that that is the root cause of our Afib problems. I am working on this with a Nutritionist and hope to get some definitive proof in a few months.

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

PS – there is a study backing up this data you can view at:

https//cardiab.biomedcentral.com/a...