Amiodarone

[lovetogarden]

My EP is suggesting that I try amiodarone. My history is of 3 ablations, 2016, 2018, 2020. Last one finally touched up the scars that had “failed” - so the afib seems to be gone. But they couldn’t trigger my tachycardia during the ablation. And annoyingly, the tachycardia is much more frequent (daily) than it was before the last ablation. Cardiac nurses have said that’s not uncommon. 🤬 I’ve been through sotalol, tikosyn, and currently dronedarone. Dronedarone has kept the events shorter and slower, but no less frequent. a bit of progress.

Now the EP wants to try amiodarone, recognizing that I’m really too young to be on it long term. (Gotta love a dr who is slightly older than you and says “but you’re only 66!”) He said he wants to make sure we try all the possible meds. As I think about it, it makes no sense to try it. If it works well, but has crazy side effects, I won’t be able to stay on it. And the likelihood of difficult side effects is pretty high.

I know some of you have had problems with it and some haven’t, I’ve read every post I could find mentions the drug. Would love to hear any updated experiences. And thought this article might be helpful to anyone else facing this decision. escardio.org/Journals/E-Jou...

The little chart that you’ll find at the bottom of the article is a fabulous summary of the risks. escardio.org/static-file/Es...

[mjames1]

Sorry. Were they able to identify the tachycardia from an ekg? Because if it's flutter or SVT, those are usually very minimal and highly successful right sided, let's say "touch up" ablations. Maybe get a second opinion from another ep to see if they can finish the job since you have gone so far already. If the ekg shows either flutter or ekg, many ep's will do an empirical ablation, meaning they will ablate what are most always the problem areas even if they can't trigger the tachycardia during the ep study. Other than that, I didn't see Flecainide on your "try" list. Works well for many like myself, if you qualify.

Jim

[lovetogarden in reply to mjames1]

Thanks Jim. Have been on flecainide, long ago. It worked well for a while. That’s been the story for all the meds, they work for a while, then don’t. I wish the tachycardia was on right atrial. But it’s in the left atria. And this is the 3rd EP over the last 8 years. The best one I’ve seen, totally trust him, unlike the 2 previous ones. But still, would happily go on to a bigger research type hospital if it seemed like that would help.

[mjames1 in reply to lovetogarden]

Left side tachycardia's, other than afib, are a little beyond my pay grade, but if you're willing to go a little farther, have you looked into the mini maze procedure? One of our members, "MummyLuv" just had one and possibly they can reach where the catheters can't? Might be worth a consult at least. The downside is if it doesn't work, it's more aggressive than a catheter ablation, not done out patient and has a longer recovery time.

Jim

[lovetogarden in reply to mjames1]

lol! Above my pay grade too! The various maze procedures are certainly something to consider.

[Ppiman]

I was reading about amiodarone just the other day. It was going to be the drug I was given before my ablation as I was unable to take others. With modern, lower dose usage, the report I read showed it to be exceptionally safe with few side effects. It's the widest used anti-arrhythmic drug in the world, I gather, and much favoured in the UK and parts of Europe.

ncbi.nlm.nih.gov/pmc/articl...

Steve

[lovetogarden in reply to Ppiman]

Thanks Steve, interesting article. There’s also a link in the article to a rebuttal of alerts in a subsequent issue of that journal . Seems it’s often used short term prior to ablation. Glad that it worked for you!

[CDreamer]

I suppose I’m struggling with why all the drugs you have tried were antiarrythmic drugs when you say you are struggling with Tachycardia? And at what sort of rates? And how symptomatic are you? Is the Tachycardia high enough to be dangerous or are you very symptomatic when you have these episodes?

If as MrJames suggests, there is another type of arrythmia going on which is causing the tachycardia, there may be other options? Has Pace and Ablate been suggested? Maybe revisit all of your available options and sometimes it is about picking the least risky option.

Amiodarone is a scary drug but it has worked well to keep my husband going for the last 3 years. He now takes as a 100mg daily. I do think proper assessment as to your suitability, baseline bloods especially with Thyroid & Inflammatory markers are essential and very close monitoring with regular bloods if you start taking it are important.

The trouble is that as with any drug, you will not know if it suits you or has affects until you try.

[lovetogarden in reply to CDreamer]

I have been on beta blockers and they knock me for a loop. Can barely move, even at very low doses. My understanding is that some of the antiarrythmics do also have a bit of rate control. Dronedarone has been pretty good at keeping my tachycardia much slower than it had been. All so dependent on one’s own metabolism isn’t it.

Do I recall that you said pace&ablate has worked for you?

[Wum1t1gs2s]

Hi, I ve been on Amiodarone since January this year. Like you, I am aware of the long term side effects, but, I have found it to be great, ATM none of the side effects have materialised and best of all no PAF at all.....

[lovetogarden in reply to Wum1t1gs2s]

Glad to hear it’s working well for you and no side effects. Is this short-term in anticipation of an ablation soon?

[Bluetonic]

I'll never take it again. As BobD has said in the past , it doesn't have side effects, it just has effects.For me it was sunburn if I was inside my house and stood too close to a window, in February, with factor 50.

That and it damaged my thyroid nd it was touch and go as to having to kill it completely but thankfully it came back to within normal range after 12 months.

I don't believe a report that it is exceptionally safe, it is a "dirty" drug with a half life measured in many months.

[lovetogarden in reply to Bluetonic]

Wow! Sun exposure problems is one of my concerns. I love to, garden and am already a bit restricted in how much I can do. The heat of the midday makes me very dizzy and lightheaded. Really don’t want a drug that can cause skin changes just being in the sun. The thyroid and corneal damage also worry me. Glad your thyroid recovered!

[pip_pip]

I was on amioderone for years. 2 + 2 + 2 . No problem. Worked wonders. I don't agree that it is a dirty drug. More objectivity please. Quite frankly I don't know what I would have done without it. Flec...and prop.. and digoxin...no go for me. Go for it.

Phil

[lovetogarden in reply to pip_pip]

I’m not sure what you meant by 2+2+2? Glad to hear that amiodarone worked well for you.

[pip_pip in reply to lovetogarden]

6 years (2 years at a time over a 10 year period). Phil

[SeanJax]

Why not try to send your medical records to Dr. Natale, Austin, Texas to see if he can take your case or not. I don’t know your medical background of your Afib or svt. Only him can make the decision if he can take your case or not. I am one member of his fans club, which has thousands and thousands members. When it comes to ablation, the skills set of the ep is 90 percents or more of its success and Dr Natale has done thousands and thousands ablations already. We call him the master of the masters ablationist. I talked thru experience . Good luck

[lovetogarden in reply to SeanJax]

Thank you for that suggestion. Sounds like he helped you out?

[SeanJax in reply to lovetogarden]

Please look at the web site of the author of the book beat your Afib. He is one of his patients as I am. It all depends of your heart structures. I did not say he will take every case but he is the master to resolve complexe refractory Afib cases.

[TracyAdmin Partner]

Hi there. Amiodarone is a widely prescribed medication, used to help keep the heart in its normal (sinus) rhythm. It is often used if previous cardioversions have failed and your doctor is attempting to get your heart back to normal rhythm with cardioversion. It can sometimes be used prior to an AF ablation to help increase the chances of success. It is also used whenthe heart has changed its rhythm to help it return to normal sinus rhythm.

Amiodarone has a low risk of pro-arrhythmia and is commonly used in patients

with structural heart disease. Sometimes it is necessary to ‘load’ amiodarone

with high doses initially and then reduce to a lower maintenance dose. It takes a

number of weeks before amiodarone is fully loaded into the body. Likewise it will

take a number of weeks for amiodarone to completely be out of the body. Doctors are carefully monitoring the medication for this reason.

[lovetogarden in reply to TracyAdmin]

Thanks Tracy, I have heard of being used short term before an ablation. Would not object to doing that.

[Visigoth]

I’ve been on amiodarone for about 16 months and no problems at all. I haven’t had an episode since I started it. I was really nervous about trying it because of all the possible side effects but I’m so glad I did. I’ve had no problem with sunburn - I just make sure I put plenty of factor 50 on before I go out. I do have some corneal deposits but my eye consultant says they are nothing to worry about at all.

[lovetogarden in reply to Visigoth]

Thanks for sharing your experience. So glad to hear you’re doing well on it.