I’m still in hospital, where they have decided not to do a dccv and instead give me Digoxin over 24 hours. I’ve had two doses and it isn’t working yet. My heart rate is still around 120 bpm. I’m also taking flecainide 200mg and bisoprolol 5mg. The dr has said I won’t take digoxin at home.
A) If the digoxin works in hospital, as my heart is in AF, what is to stop it increasing pace once I am up and about again.
B) what are the likely next steps if the digoxin doesn’t work?
Thanks
Difficult to say and probably questions to ask your medical team as to next steps but as far as I am aware you could be assessed as to suitability for ablation but if they decided against DCCV & Digoxin didn’t work that would probably be unlikely?
Further drug treatment options could be other anti arrhythmic drugs such as - Amiodarone- which is the only treatment that worked for my husband or Pace & Ablate.
Digoxin is part rate control with some anti arrhythmic qualities but evidently it’s a really difficult drug to get the dose correct.
The other option is to stop trying to convert to NSR and focus on rate control which many in persistent or permanent AF decide to do.
I found Pacemaker worked for me after all else failed.
Link to info nhs.uk/medicines/digoxin/
Sorry but I can't quite understand your medical team's approach so really no idea. Have they discounted DCCV due to lack of anticoagulation (not on it or missed doses? ) Why not increase flecainide to 300mg 24hour limit?.
Hi Bob. I spoke to 4 cardio doctors. 2 said I was having dccv, 1 said there was no dccv because of Covid and the last one said because my last episode was only a month ago it was too much of a risk. The nurses said there was no theatre capacity that day because of staff shortages and that the drs would say whatever was expedient. Who knows? I awoke at home this morning still in sinus rhythm but my memory of yesterday is hazy. I don’t remember being discharged or leaving hospital. I remember being home and speaking to a friend but that is it. The digoxin made me absolutely loopy. I wrote down that they gave me a sedative - I don’t do well with sedatives either. I am shocked that they discharged me tbh, but I must have appeared normal and my heart was working ok.
I don’t know how it works but when I went in to A&E feeling very poorly after several days in fast AF I was given a large dose of digoxin and told if it didn’t work in six hours it wasn’t going to. So six hours came and went and my heart was slowing now and again but still AF so I was admitted and on the way to the ward I reverted and managed to fit in half a sandwich before being kicked out. I was told not suitable for use at home though.
I hope they come up with something useful soon ❤️🩹
Thank you all. I have reverted to sinus rhythm 5 hours after the digoxin dose. Thrilled. Unfortunately I had a bad reaction to Digoxin and after 2 hours started to hallucinate and be very fuzzy headed. This only lasted 30 minutes but was very strange.
The last episode of AF i had they gave me two lots of 500 mcb of digoxin and i hallucinated seeing fleur de lille all over the walls. It was quite frightening. Eventually i returned to NSR.
Wife was admitted to hospital after her PAF went beyond 7 days and she was experiencing chest pains. A&E attempted a cardioversion which failed. A week on the cardio ward and they tried various combinations of Digoxin and Bisoprolol to no avail but they got her rate down to 90. She was discharged and told to continue Bisoprolol + Digoxin. GP was happy to continue prescribing that combination.
She self reverted on leaving hospital but medication was continued for a further 3 months at home till follow up at hospital said Digoxin should not be taken as she was in NSR.
So all in all a totally different experience and medical advise from what you are getting.
On the up side, this was over 2 years ago and no prolonged PAF episode since.
Your doctors are the only ones with the information you need as they know the parameters of your heart. Digoxin worked for me, and I called it a wonder drug at the time. I couldn't take flecainide or sotalol for some reason connected with my heart's electrical activity. Perhaps that's why they haven't increased your flecainide? The next stage for me was amiodarone or ablation. Thankfully, the latter came my way quickly and worked well to stop my atrial flutter.
Steve
Been on Digoxin tabs for over a year, rate is in low 60's but my aF is rythm not rate perhaps that makes a difference?
How are you feeling today? Digoxin is a well used medication in the treatment of AF. It is often prescribed on a twice daily basis to boost its effectiveness in the body, but then can be altered to a once daily dose. It is a medication that can be taken safely over a long period of time, but you should receive regular check-ups as with all long term medications. If you have any specific questions or concerns, it is best to speak to the care team around you for their medical advice. Good luck and I hope you are on the road to recovery soon!
Digoxin vs Pace & Ablate?
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