Diltiazem question

[Slattery]

I have paroxysmal Afib and I have been taking a Diltiazem for a few months. My question is how do you know if your Afib is changing to persistent if you are on this medication?

[BobD Volunteer]

Persistent AFis defined as AF that last longer than seven days and or requires intervention to revert to NSR. Any treatment is only to control symptoms so if symptoms remain then that treatment is not working. If the diltiazem is controlling the symptoms and your heart rate then why do you think you may become persistent?

[Slattery in reply to BobD]

Hi Bob,

I thought that this medication could also control persistent Afib and you would not know what type of Afib you have. For now this medication is working.

[Buffafly in reply to Slattery]

The terms used for AF are based on symptoms. I think you are asking if Diltiazem is masking the symptoms but if you aren’t having symptoms it is preventing AF, hope it continues 💜

[Coco51]

I have had both types of AF. But you can tell if you take your pulse. If it's always irregular then AF is persistent. If you have periods of regular rhythm then the AF is paroxysmal.

Paroxysmal for me is characterised by a heart rate that shoots up and feels as if my heart is jumping about uncomfortably. There's a sense of panic, some breathlessness and also fatigue while the attack lasts plus loads of peeing. Gallons of clear pee! A few hours later - 2 up to 12 hours usually - it stops. After it I feel drained - literally! Not everyone experiences it the same way.

Persistent was less dramatic but unpleasant in other ways. My heart felt as as if it was too fast all the time, as if I had a lot of adrenalin - like I felt when I was preparing for exams or a big event or meeting a deadline. But not as fast as with paroxysmal AF. This was 24/7. It was hard to find a position in bed at night where I wasn't aware of it, but on my tummy was best. Then exercise like going up hills sent the pulse sky high, and I literally had to stop.

I found Flecainide helped by evening out the irregularity and masking the symptoms but it didn't stop it altogether til I had two ablations which have helped a lot.

[Outtheresinger in reply to Coco51]

This is the best description of how I feel when in AF. I have never been able to put into words that feeling of being unsettled and butterflies as if I was about to take an exam. I have always felt so frustrated at being unable to put these horrible symptoms into words. What I was saying was such an inadequate version of how bad I felt. Thank you so much for your clarity. I have also had an Ablation and felt immediately different afterwards all that low level nervousness had disappeared and I felt myself again. I have printed out your description so I can show it to my EP next time she asks how my symptoms make me feel! Thank you !

[Coco51 in reply to Outtheresinger]

Thank you! I have spent too long thinking about it, but I am glad it helps you. I also read on here once someone described the irregular heartbeat as being like having a box of frogs jumping about in their chest. Colourful! There's one thing I forgot to mention about the paroxysmal AF and that is the lurching feeling like going over a humpback bridge in a car, when the heart pauses as it tries to slow down and get back to normal. Thankfully I don't get AF so much since the ablations. And I'm glad you feel better since yours.

[MarkS]

Diltiazem was very effective for me in masking symptoms. I did not notice when I was in AF. It was only when I had a 24 hour monitor that I was told I was in AF 80% of the time! I then had an ablation which had eliminated AF for the last 10 years, until just recently!

[Madscientist16]

When I was on diltiazem, it did not mask how I felt my heart. It just reduced my heart rate. I could tell when I went into AF just the same as before I was on the medication. Everyone is different on whether they can tell if they are in AF or not. The best way to tell is by checking your own pulse.