3rd Episode of AF, since ablation in July and thinking ? Triggers. Possibly Amlodipine?

[Turquoise19]

Hi all,

I was in persistent AF before my ablation. Had 2 episodes since the 10th July ablation in August and October, then last week 18th Feb.

The first 2 I was anaemic, but not this time. Had recently started Amlodipine tho, for BP that had been increasingly rising - up to 150/160 over 90-110, when 2 weeks after my ablation BP was good, just taking Ramipril 10mg and Indapamide while in AF as heart wasn't pumping off water well enough pre ablation.

My theory now is maybe the Amlodipine caused the episode ?? No proof, so just wanting to hear others thoughts n experiences .

I had so much water retention/bloating and weight gain all over, so stopped it. Have increased my intake of potassium instead, BP now steadyish around 140/50 over 90-95. GP wasn't concerned, tho I'd still like it better, but not liking the Amlodipine, and don't know if I needed it, as a calcium channel inhibitor, re my AF profile ? So could it be that t gf at triggered the AF X 3hrs. NSR since Weds. Took one beta blocker to help bring it back and the deep breathing.

Any Thoughts ??

[Padayn01]

Be interesting to get peoples take on this, not sure why the amlodipine would have caused it

[cuore]

I am not sure if I got this straight. You were taking Rampril 10mg (an ACE inhibitor) plus Indapamide ( diuretics/"water pills) , plus recently added Amlodipine (a calcium channel blocker) although you don't give the dose of the last two. It seems you are taking these drugs for your blood pressure.

The recent literature, that I have read , is that it is better to use combo theory where one combines drugs but at low dosage compared to monotherapy where one just uses one drug but increases the dose. You might want to evaluate the dosage of your drugs.

My experience with Amlodipine was that I was on monotherapy taking 5mg Amlodipine. But, when my GP increased it to 10 mg, I went into a 6 day AF episode and that was right after my second ablation. Granted, I was also taking Amiodarone ( a rhythm control) which could also have something to do with it. A past post stated that a cardiologist said that Amlodipine should not be increased if taking a rhythmic drug.

Our cases are different but I think we can both argue that Amlodipine can be a catalyst for an episode.

[cuore]

You might want to read this article:

escardio.org/Journals/E-Jou...

[Mister_K]

A drug that lowers BP may concomitantly increase heart rate, in order to keep the blood pumping. Amlodipine dilates the vessels, which helps reduce the force of blood. Your body may need a few days to balance the two. For me, the BP meds that have consistently worked throughout a 24-hour period have been Telmisartan, 80 mg, and 5 mg amlodipine, daily. I also take 100 mg daily of metoprolol. Some people with AFib combined with bradycardia should use extreme caution before taking beta blockers. A cardiologist had once prescribed a beta blocker to my wife, and her heart rate dropped so low, she wound up hospitalized. He should have known better. I recommend that anyone with AFib find an EP (electrophysiologist) who actually specializes in heart rhythm disorders, and then let both cardiologists confer with each other. If push comes to shove, go with the EP.

[Turquoise19]

Thx very much yes I have been on Ramipril (Ace inhibitor) for over 2 years , since before the AF started. Then put on Indapamide diuretic, when in persistent AF due to water on lungs / inefficient heart pump function in persistent AF. Then after successful ablation in July, as I started getting back into exercise, I noticed my BP kept creeping up. Went to GP, who just said maybe it's no longer working (Indapamide)and put me on Amlodipine. And still took the Ramipril.

3 weeks in and loads of bloating and sudden weight gain, I stopped the Amlodipine. 2 days later I got an episode, last Tuesday night. None since and j have stayed off the Amlodipine .

BP now is 140-45 over 90/95. Better than it was before the Amlodipine. So staying off the Amlodipine.

Have increased potassium in diet and supplements, hope this is helping.

Thx for the article attached, will look through, looks v helpful. Seems I may be on the right track re Amlodipine as trigger for last episode, from what you've said. Be good to hear other experiences too if others are similar.

[Lilibet1937]

I had a reaction to amlopodine. Lower legs, ankles and feet swelled dramatically and caused a rash in these areas. I took myself off them. Now on ramipril and just this week started taking indapamide as BP was not reducing.

[Turquoise19]

Thx for replying Lilliput yes I am on Ramipril as well. Went back on Amlodipine as seen the only thing my GP will prescribe. But when I was away just before lockdown I met a guy who's in zanidip. Same group as Amlodipine calcium channel blocker, but supposed to be better. Gp hadn't heard of it. So does pay to ask around.

I haven't had any more episodes of AF, apart from a v brief one, with heavy menstrual blood loss last month, my other saga . And the Amlodipine swelling finally stopped, but not massively good for my BP. So here goes with zanidip!