Bradycardia and Amiodarone : I’ve had AF for... - AF Association

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Bradycardia and Amiodarone

BigDunc profile image
BigDunc

I’ve had AF for around 15 years and it has been well controlled after an Ablation and Flecainide. Unfortunately I have had to come off Flecainide due to moderate stenosis in one of my arteries and I have been flipping in and out AF every 4-5 days.

I have been very fit cycling/running and exercising all of my life and hence have a low resting heart rate around 52bpm. I am on Ramipril 1.25mg and Bisoprolol 1.25mg and I finding it hard to tolerate the latter as my heart rate is dropping into the low 40’s and 30’s sleeping and along with Hiatus Hernia seems to trigger the AF particularly when asleep. I only use Bisoprolol now as a PIP when in AF

The strategy was to see if I could tolerate staying in AF until another Ablation I seem to be ok until I take the Bisoprolol to control the rate and then I feel awful.

My Arrhythmia Nurse has suggested taking a small dose of Amiodarone (planned for Friday) which the EP has okayed with caution. My question is has anyone with Bradycardia tried Amiodarone as I have some trepidation with the possible side effects?

15 Replies

Hi BigDunc,

I took Amiodarone when I had a history of Bradycardia. Did me no good at all.... Take a look at the information leaflet about Amiodarone.... It used to say not to take with a history of Bradycardia.... Wish I had had the chance to read the pamphlet before I was given it...

Hope all goes well for you.

BigDunc profile image
BigDunc in reply to Mickey16

Hi Mickey thanks for the reply what dose did they have you on? I’ve read that myself and I struggled with Bisoprolol so I’m getting anxious about taking it

Mickey16 profile image
Mickey16 in reply to BigDunc

Hi BigDunc, I was put on the usual 2 week loading dosage and then reduced. About the Bisoprolol, that does reduce your heart rate as you know....

What I found with the Amiodarone; because it was the wrong medication for me, I developed severe reactions over the time, bit by bit but exponentially over time . I took it for almost 3 months and at first did not connect the symptoms with Amiodarone. Eventually it stopped keeping my heart in rhythm and at that point the clinicians realised it was doing more harm than good.

Hi Dunc, I was 60, fit with no comorbidities and had a low HR under 60; contrary to the usual action to partner Flecainide with another drug, my cardiologist said that I should go on just Flecainide as anything else 'would make me feel unwell'. I think this ideais relatively safe only if you are in your 60's, fit & no comorbidities. I have done this for 6years and so far it has been fine.

BigDunc profile image
BigDunc in reply to secondtry

Thanks for your reply I’ve got a private consultation being arranged hopefully he may have a similar view

I was happy using flecainide, it was controlling my paf just fine. Then I ran out. I live in Shenzhen China and use a HK cardiologist. I also buy meds in HK. But the border has been closed since February so I went to a local hospital to get more flec a few weeks ago after running low. Turns out it’s not available in China. They offer Amiodarone instead. I have been in afib every day since making the switch. Interestingly (and thankfully) the tachycardia that usually accompanies it is at a lower rate, 90-120 rather than 120-150, Correspondingly I see my resting heart rate is occasionally lower now. It’s usually in the low 60’s but I’ve recorded it in the low 50’s since the switch. Seems like there is something there to think about.

BigDunc profile image
BigDunc in reply to Jfbould1

Thanks for your reply that’s useful Clear link there to lowering the heart rate

Not medically trained but for me bisoprol was terrible. There are many other beta blockers you could try as an alternative. I tried Atenolol and this was not good for me either but it was a lot better than bisoprolol! I ended up at the time on verapamil a calcium channel blocker and this had no adverse effects on me . However CCBs are no use as a PIP as they take too long to effect. I tried verapamil as a PIP, it took over 5 hours before it appeared to limit my hr.

BigDunc profile image
BigDunc in reply to KMRobbo

Hi Robbo thanks for the reply I’ve been thinking overnight about trying an alternative to control the rate and Living with AF before embarking on Amiodarone

Hi, my resting heart rate was about 44 at its lowest pre ablation and meds. I was put on amiadarone, digoxin plus a betablocker while in afib. Jeez, I was a zombie. The EP cut out the digoxin straight away the over the next few weeks cut out the betablocker and the halved the amiadarone to 100 mcg. After the ablation I am still on amiadarone 100 with no issues. It's scary stuff for sure, but as the arrythmia nurse said it is brilliant for controlling arrythmia if you dont get the side effects. Initially I was completely paranoid but now I quite li,e the 'safety net' of being on it. If only they could invent a version without the side effects.

Good luck and good health

BigDunc profile image
BigDunc in reply to Jajarunner

That’s really reassuring as they are thinking of only using a low dose once a day did you have side effects?

Jajarunner profile image
Jajarunner in reply to BigDunc

Not really. To begin with u blamed everything on the amiadarone which was probably aftereffects of AFib and cardioversion. But I've relaxed now. I feel tons better than when I used to be on 1.25 mcg of bisoprolol which made me tired and drained.

In between cardioversion and ablation (4 wks) I got back up to cycling 12 and walking 3.5 and felt great.

Ablation has totally knocked me back, I'm only walking and struggling to do two miles.

But it'll be worth if it stops the Afib and i can get back to running and cycling.

I've posted about my slow recovery on here before if it is helpful to you.

Good luck and good health

That’s interesting as I live for being outdoors cycling and walking etc and will go out for hours

Have you ever tried exercising whilst in AF?

I tried last Friday whilst in AF with no rate control drug and only managed 3 mins on a stationary bike before my heart rate shot up and I had to stop

I have been similar to you Bigdunc. I used to do triathlons, had a resting pulse of 39 in my 40's. Now have AF with flecanide and pulse 43. It was 53 before the flec. I am convinced that it was all the exercise that led to my AF.

Yeh I agree it’s a well known fact that endurance athletes are prone to Vagal AF. Sanjay Gupta a York Cardiologist has a YouTube channel he enlightens on all aspects of AF and has a couple of episodes on Vagal AF

I’m convinced I have Vagal AF as I almost always go into AF when I’m asleep or gastric problems

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