Morning arrhythmia for a few hours

[TreasureCay]

I had a second ablation for AF and flutter in May 2021 which was deemed a success. After the first six months things settled and did not record any more AF on my Kardia. Was on Flecainide then. I have low bp, am 65 and am currently taking only Bisoprolol 1.25mg on waking. I have chronic nausea since possible covid infection in 2020, or could be reaction to one of my meds. I recently upped my dose of Amitriptyline for nerve pain to 15mg which coincided with morning palpitations (recorded as unclassified@ 150 on my Kardia)particularly whilst showering or brushing teeth or even just walking to the bathroom. My EP wants me to change bisoprolol to Sotalol bd.

Any thoughts would be appreciated.

[jeanjeannie50]

Hi Cay

I feel you must already know that taking Amitriptyline is a known cause for palpitations? If after upping the dose of it your AF/Flutter grew worse then that medication could possibly be the cause. Have you read the information sheet that came with them?

As with most medications, Sotalol will have good and bad reports. It is a rhythm and rate control pill combined. I took it briefly, first just when I had an AF attack and then a few years later daily, unfortunately it didn't stop my AF at all. I've had 3 ablations and am now in constant AF. Flecainide, the beta blocker Metoprolol and a healthier diet is what has helped reduce my AF and my pulse now stays between 60-90bpm. I can now walk our hilly coastline and mostly forget about what my heart is doing and to be honest the less I think about my heart rate the better it is.

Jean

[TreasureCay in reply to jeanjeannie50]

Thanks for your input, Jean. My EP told me ami at a low dose ie. 15mg was unlikely to cause arrhythmia but I guess in my case it probably did as it started a day or two after upping the dose.I will try the Sotalol too 🤞. Maybe one day I will be able to go hill walking again or even a round of golf.

[jeanjeannie50 in reply to TreasureCay]

Uncontrolled AF is such a hateful condition! It took 3 ablations (first 2 made my AF worse) and lots of cardioversions to get where I am now - 17 years since my first attack. I've discovered that the mind has a big part in AF too. If anyone had told me that when I was having a bad attack I think I would have hit them! The truth is, the more I ignore what my heart is doing the better I am and I always do my best to make sure that I don't get so engrossed in something that I forget to breathe.

[bassets in reply to jeanjeannie50]

you're right about what the mind can do. The less I think about af the better I feel but it's a long road to get to this stage isn't it?

[bassets]

It seems that it's worth trying the Solatola as your Ep suggests. It can take a while to find the right medication. Best of luck.

[Ppiman]

My only thought, like Jean's, is regarding the amitriptyline which affects the conductivity of the heart - but your doctor will have accounted for this. It's a question that I would be asking, however.

Steve

[TreasureCay]

Thanks for your replies. I will speak to the cardiologist and pain clinic again this week. Have dropped my ami dose back to 10 mg to see what happens.

[das1234]

I was on Bisoprolol 2.5 mg for 3 years , 2016 to 2019. From June 2019 I am on Ivabradine 5 mg twice daily. Bisoprolol was good but unable to put down my HR, as it remained around 90-95 bpm at that time. Once my BP fell to 90/60 . i also passsed an episode of 190 BPM, but within 15 minutes ECG showed Sinus Rhythym with 85 bpm. So that my Bisoprolol story. Still I am on Ivabradine, it is keeping my HR below 70 BPM. But the main problem has not been solved. I sometimes feel weird sensation in my mid chest , it's like a knocking sensation, feels like that my heart is stopped. This episodes come after food particularly. I never found irregular heart beats in a bp monitor. I have stopped Coffee drink, curtailed my Tea dring also. HOLTER monitoring for 48 hours recently did not show any AF episode, but it showed many Supra Ventricular Events. Doctor told that these are common. Sought a second opinion, all are saying nothing to worry. MY ECHO report is normal, ECG is also normal. In spite of all these I am facing these episodes. These are not occurring daily, but when it strikes I become very much worried. Blood parameters are also normal.

[TreasureCay]

I hope you get to the root cause of your arrhythmia, it is very frustrating. I have started the sotalol on Monday and have had many runs of palpitations since then. I am going to give it a week to settle but each time I feel like passing out.