New AF episode. Shall I take Adizem?

[FiveMilesSouth]

Hi all, I would appreciate some opinions or things to consider at this moment.

I haven’t had a persistent episode of AFib for 18months when I had first prolonged episode. At that time I was eventually put on Adizem which brought my fast heart beat down to 48-80 and seemed to allow my heart to re-regulate to normal within a few days. Was magic but also made me feel so tired it was not nice.

Currently I am experiencing an ongoing episode of AFib since two days. It’s not changing either worsening or improving. Heart rate 90-120 and moving around at home up to 150 I think. I have recently started using the Kardia gadget which flags AFib but this hasn’t initiated my noticing. It was very clear for me when the AFib episode started. I thought it would pass after a few seconds but it hasn’t. Previously resting rate 60 and moving 72-95 depending on activity. I have been fortunate in having an uneventful 18months - just brief 10-30 second AFib episodes on three or five occasions.

I’m feeling okay in myself. I can sense there are low key irregularities and I get a bit sweaty or hot at times. I get a bit more puffed on normal exertion. I have slept alright last two nights.

I take Apixaban twice a day since a year now. So my main question is what are the pros and cons of my starting with some Adizem for a while in the hope it corrects the AFib and stops my heart from overworking. Though I felt being on Adizem 18 months ago made my heart work hard as I was operating in slow motion like wading through treacle.

Thanks all.

Gail

[BobD Volunteer]

We are not medically trained here so I would suggest that you speak to your doctor before taking any steps . What I would say is that any and all treatmetn for AF is only ever about symptom control and thereby quality of life (QOL) "Normal " heart rate is 60 to 100 so your rate is not wildly out of control so you have some time to get best advise for you doctors. Your stroke risk is well managed by your Abixaban so don't worry about that.

[FiveMilesSouth in reply to BobD]

Hi Bob, well my GP said at the time of first taking it that I could take it again anything AFib came on. I guess I’m uncertain what difference it makes to be having a constantly raised heartbeat. Thanks for responding!

[Buffafly]

How much Adizem were you prescribed? I take 120 mg diltiazem and a bit extra when I have an episode so can speak from experience that it slows HR a bit and keeps BP down but it doesn’t seem to help terminate the AF. Probably you had a much higher dose? Were you supposed to keep taking it? Because if you were I can’t see the problem with starting again. Otherwise the only thing to do if you feel worse as time goes on is head for A&E 💜

[FiveMilesSouth in reply to Buffafly]

Hi Buffafly. Not I wasn’t meant to keep taking it. Just for as long as needed. My BP seems okay 100:80 or 110:90 (different readings with some failure to reads). I feel okay. That’s odd 😜. I remember feeling dire last time. Get puffed more easily though. Just wondering if it’s okay to let this just run.

[Buffafly in reply to FiveMilesSouth]

I would contact your GP when you can. They all have different opinions. My old GP told me I shouldn’t let it run because I would lose my little grey cells, very cheery! But he was unusual I think. One of our members was told to go to A&E if an episode lasted for over 20 minutes, now that is very unusual!

[KMRobbo]

Adizem is one on the brand's of Diltiazem I took for 10 months . It's a Calcium Channel Blocker. It was horrible for me , breathlessnes, exercise intolerance, poor memory, brain fog. Other people get on with It and some sing it's praises. We are all different! I took 200mg mod release most of time, 120 mg for a period which was better. Not medically trained but CCBS are rate control drugs. They do not control the rhythm so they do not stop afib, they just limit the max HR. It limited mine only to 137/140bpm max but kept it lower at resting except in the worst attacks.

HOWEVER It would have been 190 resting without it during AFIB. I took.it daily.

My understanding is also that from taking a pill it takes 4-5 hours to start having any effect, and I was advised CCB were not very good for PIP purposes. (I was on CCBs as I did not tolerate beta blockers, which acted much quicker) .

In order to control afib you would need a rhythm control drug, such as flecainide, which I also took for 10 months. If you think your afib is getting more frequent maybe you need to speak to an EP about

this.

I was also advised by my local hospital that if I was in afib consistently over 130 resting I should go to them to get help in stopping the afib .

If you do not like the adizem you could also get your medics to try other drugs. Verapamil is another CCB which I had for 20 months and had almost no side effects for me. Then there are many beta blockers of which I tried two but I did not tolerate. My GP was happy to switch my rate control drugs until I got one that worked for me. However a GP cannot prescribe the rhythm control drugs (my understanding).

Best wishes

[FiveMilesSouth]

Thanks for sharing your experience. It’s helpful hearing other people’s experiences. I think my resting pulse rate is going down a little so I’m going to wait and see. Thanks again.