Amiodarone and bradycardia anyone?

[Visigoth]

I’m wondering if anyone has had the same experience as me. I’ve been on amiodarone for four months now and after the first two weeks of weird feelings it felt like a wonder drug - I had no a fib and hardly any ectopics. After a while I noticed that my resting heart rate was going lower (as measured by my Fitbit) but I wasn’t too worried as it was only going into low 40s at night, but was still in the 50s during the day - perhaps a little lower than it used to be but not much. However, recently my RHR has been in the mid-40s during the day as well and I have found increasingly that if I get up from sitting or kneeling, or even if I just straighten up from bending forwards, I get unpleasant palpitations that make me feel lightheaded and I have to sit down again to let them pass. I know amiodarone is a rhythm control drug but I read in the Afib Cure that it does lower the rate somewhat as well. I am getting worried that the rate is just going to go lower and lower (it went down to 40 for the first time last night) or that there is something sinister going on. My QOL is definitely worse than it was in the first few weeks after going on amiodarone. I’m going to contact my EP but I’m freaking out a bit about what’s happening and wondered if anyone has had a similar experience?

[jeanjeannie50]

Lets hope that your solution may be to just reduce your dose of Amiodarone slightly. Please let us know what your EP suggests.

Wishing you well.

Jean

[Visigoth in reply to jeanjeannie50]

Thank you

[BobD Volunteer]

I do hope your EP is able to help. Amiodarone is generally a drug of last resort as it is so toxic. It has been said it does not have side effects, it has effects!

[Visigoth in reply to BobD]

Thank you. My Cardio did talk about the irritation of the skin so I’ve been very diligent with the sun cream but he seemed to indicate that any other side effects would only happen if I was on it for years.

[Bolander in reply to Visigoth]

I had the same attitude from my original cardiologist, and in my case it was definitely wrong. I was able to see a different cardiologist who accepted that I was suffering side effects, and changed me to Sotalol - this after only six months on the drug.

[Visigoth in reply to Bolander]

Thank you - that’s food for thought

[CDreamer]

My husband has been on Amiodarone for 2 years now and for him it has been a wonder drug but had a pacemaker inserted about 10 years ago when diagnosed with SSS - sick sinus syndrome. Many people are offered a pacemaker which solves the issues. It’s a day procedure & for me was the magic bullet as well as for him.

[Visigoth in reply to CDreamer]

Thank you - I would love to have a magic bullet! I’ll see what my EP says

[Visigoth]

Thank you - I’ll definitely see what my EP says about reducing the dose

[Cara95]

Hi Visigoth, I recall that when I asked about amiodarone a couple of months ago our experiences were much the same. I have also had the reduction in HR - also into the lower 40s during the day. My cardiologist reduced the dose a bit after 4 months and for 2 months the HR was slightly better but still in the mid 40s. It seemed to stabilise there.

Then came the time for the 6 months bloodtests check. Although kidney problems are not mentioned as a common side effect for amiodarone my GFR had gone down to 30. So we have stopped the amiodarone and I will have more tests in a couple of weeks to see if there is improvement.I also noted that the drug helped with the AF during the initial months but during the last 3 months my Kardia showed AF everyday despite the amiodarone.

I fear that if your EP reduces the dosage you may also have an improvement in HR but a deterioration with regard to AF.

Let us know how things develop.

Cara95

[Visigoth in reply to Cara95]

Thank you for replying. I am due for more blood tests soon and that will be interesting because the last ones showed my kidney function slightly out but not enough to take action. I fear you are right about the trade-off between reducing dosage and increasing symptoms.

[Rubymurray25]

Hi Visigoth, After 2 ablations the only drug that worked for me was Amiodarone and for 7 months all was good but it did bring eye issues so it was changed to Dronedarone and the last 5 months have been good. I have been on Sotalol, Bisoprolol, Flecainide and all 5 including the above have giving me a heart rate of mid 40's and often down to low 40's , my doctor really panics but my cardiologist really doesn't so I accept it. From memory I believe the only drug they had to adjust to light headiness was Bisoprolol from 2.5 to 1.25 mg.

[Visigoth in reply to Rubymurray25]

Thank you for replying- that does give me some encouragement that maybe I’m worrying too much about the low 40s! Waiting to see what the EP says.

[Redders]

I’ve been on Amiodarone for three months and I’m still in af or flutter. Waiting for a cardioversion but don’t hold out much hope that it will work as the Amiodarone hasn’t made any difference, in fact I feel worse. I would love to have a EP on my case but after three ablations he said there’s nothing more he can do and discharged me. Great.

I do hope you get sorted out, let us know please.

[Visigoth in reply to Redders]

Oh goodness, I’m so sorry you’re in that situation. But lots of people have more than three ablations - would it be worth finding another EP?

[Redders in reply to Visigoth]

Not many EP’s down here in Devon I’m afraid

[Mickey16 in reply to Redders]

Hi Redders, I have just seen this thread and your last comment. Are you able to ask your GP to be referred to another hospital, a bit further afield, for a second opinion?

[Redders in reply to Mickey16]

Thanks Mickey16, I’ve had my cardioversion on the 31st August and I’m back in rhythm at the moment thank goodness. Don’t know how long it will last as I’ve got a lot of stress going on at the moment

[Mickey16 in reply to Redders]

Hi Redders, glad you have had some good progress. I know how hard it can be to keep stress levels down when they are not of one owns making. Hoping things get better soon.

[Balearic]

I started Amiodarone 3 1/2 weeks ago following a failed cardio version for persistent asymptomatic afib. My resting heart rate at time of the cardio version was 57 and it has now gone down to about 48. Whilst sleeping it has, on occasions, dropped as low as 37 but mostly it is around 40. or just above. I was also taking 1.25 Bisoprolol but I have now been told to stop taking that. I am also taking Edoxaban. I am still in afib and due to have a 2nd cardio version at the end of the month. I don’t know what the outcome will be if this one doesn’t work! Fingers crossed all goes well for you.

[Visigoth in reply to Balearic]

Thank you - sounds like we have a similar experience with the heart rate. I do hope the cardioversion works next time for you.

[Balearic in reply to Visigoth]

Thank you.

[Glb1948]

I have the same problem with flecainide and nadalol. Nadalol is a beta blocker and lowers your heart rate also. It usually a last a couple of hours and my heart is out of rhythm during these times. Pretty scary. I’ve tried cutting back on the nadalol but have very bad withdrawals so end up back on then. My ep says I might have to have a pacemaker.

[Visigoth in reply to Glb1948]

I’m sorry you’re also having problems with your RHR. Nothing is simple with a fib is it?! But maybe a pacemaker is the answer…

[Glb1948 in reply to Visigoth]

I’m seriously considering it. I hate this , never knowing when it’s going to happen! I hope you get some answers and help. At least we know we are not alone.

[Ginshu]

I take 100mg for past year following a conversion..I take my vital sign and my heart rate is going..just finished 2 weeks on heart monitor and now. Dr wants to discuss to Pacer maker for me. I am taking 100 once a day and I still got Brandycardia. Also have developed Neuropathy in feet.

[Visigoth in reply to Ginshu]

Some time after I wrote my original post my dose was lowered to 100mg as well. It took several weeks before I began to feel better but now I do definitely feel an improvement. However, I still have bradycardia like you, though fortunately no neuropathy at present.

[Brent9]

Amiodarone does not leave the body quickly and it has a half life of 30 to 220 days. In my case I was given it after a heart ablation and on the third week I started to feel your affects. In modeling the concentration in the body even on the half dose the concentration can grow. It will take me three weeks at least to get down the concentration in my body.