Diuretics and A fib.

[pusillanimous]

Given the importance of hydration with A fib, I would appreciate the member's thoughts on the wisdom of the use of a diuretic in AFib sufferers. Thank you.

[etheral]

Generally diuretics would only be necessary if you had Congestive heart failure as well. What were the reason they were prescribed?

[pusillanimous in reply to etheral]

The tops of my feet were slightly swollen and discoloured (I walk around bare foot and I am always injuring my feet - dropping books on them etc. etc.I)They are extremely ugly so I plucked courage to show the worse one to my GP and she prescribed them. I had seen the cardio a couple of months previously and he had not suggested congestive heart failure, just a slight enlargement of the right side of my heart, I have asthma and mild COPD, which he considered the cause, He said he would see me in a year, He sent my GP a report and she said it mentioned I have a slightly leaky valve and a very high EF? (I think that's what it was called) rate. I have PAV, I take 120mg Verapamil , 10mg Lisinopril for BP. 5mg statin and 125mg Biso when my heart rate goes over 100BPM, Symbicort inhaler for my lungs and Alzam O.5 mg for anxiety and panic attacks as needed . I found the diuretic hard to take - it makes he light headed and jittery and elevates my heart rate. I was prescribed it 6 months ago and I has taken it spasmodically to try and accept it. It has made little difference to my feet which are fine in the morning - I suppose gravity during the day causes then swelling, I am due to see my GP next month and the cardio in Sept. so I'm not sure whether to persevere with them. I find if I take a large glass of water with the pill, it's not so bad. Sorry for the diatribe.

[pusillanimous in reply to pusillanimous]

Forgot to mention I take 20mg Xarelto!

[SuziElley in reply to pusillanimous]

When you take a diuretic you MUST take in extra fluids. Sounds strange I know, but it is so important to stay hydrated. The diuretic gets rid of unwanted fluid in the tissues. It’s easy to think because of this you don’t need the extra intake but you do! Also, could it be a form of lymphoedema requiring the diuretic? Maybe you should have an in depth conversation with your GP

[pusillanimous in reply to SuziElley]

Yes I intend to - I need to see her soon to renew my prescriptions, I think she may be jumping the gun assuming it's my heart when the cardio mentioned nothing about heart failure.

[etheral]

Sounds like the cause of slightly swollen and discolored feet I more likely local if your left ventricle is normal sized and the valves are OK. You didn't mention what diuretic you are taking but if your afib is mostly controlled and there is no fluid in your lungs, It sounds like the diuretic can cause more problems than it solves,in my opinion. Especially if you are getting obvious side effects. If you take it your potassium should be monitored closely. etheral

[pusillanimous in reply to etheral]

Thanks, I'm going to discuss it with my GP, I think it's more a circulation problem - I'm 79 !!!!

[Buffafly]

I had problems with swollen feet and was told diuretics aren’t very good for you. I was prescribed support stockings and told to put my feet up whenever possible and that worked well. Do be cautious about injuring your feet though because an ulcer on your foot is no fun!

[opal11uk in reply to Buffafly]

I am the same, post op after hip replacement due to a fall whilst playing table tennis, I will have to wear support stockings and keep feet up too, I am hoping that once I am back to 'normal' activity levels the swelling will subside......we can but hope lol.....I am 78 and had P/A/F now for over 20 years and wear a pacemaker. One thing I worry about is the side effects of all drugs, I read the information and find it a worry therefore I won't take anything that I think I can do without!

[pusillanimous in reply to opal11uk]

I've got a book I bought years ago - I'm not sure if I've still got it. It is called 'Cured to Death' and it really puts you off all drugs !

[pusillanimous in reply to Buffafly]

My feet have really been abused - living in a warm climate bare feet are so desirable !, trapped one between someone's unstable decking, none of the 26 bones broken, but very bruised and swollen, I squashed the other under the rocker on a chair, dropped a knife on it (slid from the cutlery when emptying the dish washer) Dropped the Complete Works of Shakespeare on one, and a frozen box of fish slip out of the deep freezer onto the other! I paint my toe nails to try and make them look better!!!!

[Buffafly in reply to pusillanimous]

😱 Hot weather is often what affects my feet/ankles so yes, I think circulatory problem. I am very careful because my mother cut her leg on a child’s toy, got an ulcer and you don’t want to hear the rest 😢

[Barb1]

I am on a diuretic to control swelling in ankles - cause unknown. I was on Bumetanide for years and then a routine blood test in Cyprus found that I had dangerously low potassium level and was immediately admitted to hospital. Lost a stone in fluid in there and was changed to Spironlactone. So far,ok. The potassium level was not picked up in UK as then they did not have the blood phials for my annual check!

[opal11uk]

Agree, I think we take far too many and regularly look at what I am taking, I am lucky in as much as my grandson is a clinical scientist and makes drugs so I can go to him for advice. I query every drug that I am advised to take, what it is for and contra indications then I make informed choices as to whether or not I take them and for how long.

[Silvasava]

Im another one who gets slight ankle swelling and purple feet. I don't have COPD but I do have Afib and DCM. I was originally on Furosemide as I had a bout of pulmonary oedema not long after I was diagnosed. Over the last 2 years my meds have been tweaked and I take half a tab of Spironolactone daily. I take Furosemide only when needed (rarely) The balance seems about right for me at the moment.

[Hatten28]

I was diagnosed with fluid around the heart and prescribed Furesemide which certainly eased my breathing, however my skin became extremely dry and still is.After another problem I was prescribed another tablet, which brought me out in a rash, taken off that and replaced with another which caused an even worse rash which affected my hands and feet. Now I have been taken off Furesmide , the rash has gone from my hands but is still lingering on my feet which have been discoloured because of poor circulation. The advice to wear support socks is a good idea as it improves the blood flow.

I have A/F heart failure plus a pacemaker

All these tablets were added to reduce my blood pressure, which now they are gone my blood pressure is still just above average, think they did more harm than good.

Not a good idea to wear nothing on your feet, they don’t heal very well, wear shoes and socks.

Good luck to you

[likestosing]

I find that a diuretic helps avoid afib for me. When I feel bloated I assume my blood volume has increased, putting a strain on my heart and often activating the afib. I regularly take a potassium sparing diuretic and I think it helps. So far I have maintained a potassium level at about 4.5 on average. I have never gone over the limit for high potassium. Or under the low . But I think the higher side of normal is best to avoid afib episodes. And avoid any bloating as well.

[Ewloe]

I’m on a cardio specific diruretic. A low dose. After a STEMI 10 months ago. After a cardio version in November I now have PAF as well as other cardiac arrhythmia’s. I’ve never had any problems with the diruretic. X

[Belle11]

Thanks for this question and your experience pusillanimous. It's helping me, reading the answers too, as I was prescribed a diuretic recently by a locum GP, when my feet and ankles had swollen up so much I couldn't get my usual shoes on, and had to use a pair I bought when I had cellulitis. Because I was also getting breathless on walking more than a short distance, he also ordered a chest X-ray to see if I had fluid on my lungs, and ordered a BNP blood test, which would be diagnostic for heart failure. I've had the X ray, but don't get the blood test till next week.

I don't like taking drugs if I can avoid it, and reading all the possible side effects of furosemide I decided to wait for the results before taking it. I've changed what I eat, and have lost the few pounds that I put on last winter, and my feet are already swelling much less ( maybe as a result?). I've also managed to walk further without getting a bit short of breath.

[Dr-Gohan]

Thank you pisillanimous for posting this. I agree with you; I thought the whole thing was not logical and weaned myself off of the water pill! I felt fine for about 3 weeks and then I noticed my swollen ankle on the left side was now showing up on the right side as well. I called my cardiologist's assistant and confessed that I had been trying to be my own doctor and she laughed and explained that the water pill helped my blood pressure by causing my kidneys to excrete more water and sodium with it. And, I was to continue drinking fluids normally (1-to 11/2 liters per day) and my ankles would be much happier.

Thus, i have returned to following doctors orders. It also reminded me that 3 weeks prior to my afib showing up, I had weaned myself off of my BP medication(10mg of Linsinopril daily)

I didn't bother to discuss this idea with anyone. By the time the subject of my BP came up, I was already in ER and I left "against doctors advice", with a whole lot more medication and an appointment to see a cardiologist. I have surrendered humbled by my own foolishness.