Return to NSR?

[Polski]

I have PAF and take Nebivolol 5mg and Rivaroxiban. When a bout of AF starts I am mildly symptomatic for the first day, and then more or less assymptomatic after that, so can just get on with my life, albeit at a slower rate. After up to 5 days, sometimes more, I return to NSR, but only ever for about two days, which is frustrating as I get so much more done and feel generally better then.

Can anyone suggest why I stay in NSR for only two days (give or take a few hours), or what I might do to try to extend this? (I live in Poland and Flecainide does not seem to be an option here)

[Buffafly]

Hi, sorry you haven't had an answer and I'm afraid nothing much has come to me except that maybe in the two days 'break' you overdo the 'getting things done'? Apart from that maybe a change of meds to a calcium channel blocker such as Diltiazem if available might help. Best wishes 💜

[Polski in reply to Buffafly]

Thank you for your response. You may be right about the 'getting things done' bit!

I hadn't thought of a calcium blocker. What makes you think that might help?

[Buffafly in reply to Polski]

From the BNF: Calcium channel blockers 'influence the myocardial cells, the cells within the specialised conducting system of the heart, and the cells of vascular smooth muscle. Thus, myocardial contractility may be reduced, the formation and propagation of electrical impulses within the heart may be depressed, and coronary or systemic vascular tone may be diminished.'

So it seems that Diltiazem has a slightly antiarrhythmic effect (I read that somewhere else but this is the explanation.) Just thought as Flecainide is not available it might be worth a try?

I'm quite happy on it but I still get AF now and again and not allowed to raise the dose unfortunately.

If you do get to try it please let me know if it helps - or makes things worse 😬

[Polski in reply to Buffafly]

Thank you Buffafly, I will think about this carefully as I consider the way forward.

Best wishes, Polski