Your thoughts/experiences please about a change to a high dose of Sotalol (120mg twice a day).

[AFCyclist]

I have just had my 32nd bout of AF this year but could not shift this one myself (by cycling up a hill) so went to A+E. Sheffield A+E are always very accommodating, despite being very busy, and said that I had done the right thing to go in. The Cardiolology Depatment, where I am a patient, advised them to try giving me an increased dose of Sotalol of 120mg. I am normally on 40mg twice a day. After 90 mins I was still in AF so they prepared me for a cardioversion. Either the process of hooking me up, or the increased Sotalol, put me back in NSR so they did not have to give me a zap. Cardiology have advised that I stay on the high dose of 120gm twice a day and have me on the list for a tickle-up ablation. I had a cryoablation about 8 years ago. I am concerned about the high sotalol spacing me out particularly as I am going to France on a cycling holiday in 5 days time. I discussed this with them and they said that if I was not getting on with the sotalol to reduce it to 80mg. Your thoughts and experiences would be very welcome.

[rosyG]

I haven’t takenSotalol know it’s sometimes still used when other meds don’t work well it seems a short term plan until ablation so I wouldn’t get too stressed but talk to your cardiologist again about how much to increase by. They may say increase it slowly And see how you feel. worth a discussion??

[AFCyclist in reply to rosyG]

Thanks for your helpful reply.

[Az49]

I am on 120 twice a day, no problems

[AFCyclist in reply to Az49]

Thanks.

[Cat04]

I went into aflutter and afib 16 weeks ago. Initial loading of digoxin/bisoprol didn't work so replaced the bisoprolol with sotalol 2 weeks ago and titrating up to 320mg per day. So far I feel better on sotalol than bisoprolol although still in afib. Also having fortnightly ecgs to monitor QT interval.

[AFCyclist in reply to Cat04]

Thanks. That is encouraging.

[Hidden]

I know this will go down like a lead balloon and I also (think) I know what you are going to say. I know nothing about Sotalol but this fixation on fairly extreme exercise for any ordinary individual, let alone a 71 year old who had a pacemaker fitted two years ago cannot be helping your condition…………just a personal opinion as I’m not medically trained 😉

[AFCyclist in reply to Hidden]

73. Electric bike. PM is for low beats due to LBBB. Each to his own. Thank you for taking the time to comment.

[Hidden in reply to AFCyclist]

Take it easy but enjoy life 👍

[Gillybean123 in reply to Hidden]

I agree with you there.

[Jajarunner in reply to Hidden]

Most cardiologists recommend daily exercise which raises the GR to 70-80 percent of max. They tell me their main problem is getting people to do enough or at high enough intensity to keep the heart strong.

[Hidden in reply to Jajarunner]

I’m sure you are right Jaja, of course exercise is important but sometimes it does seem that folk who include their specialised sporting activity into their nickname are always trying to make a point or justify what and why they do what they do. Hopefully I’m not FJidler 😉 particularly as I’m a great believer in everything in moderation in the hope that everything keeps working for as long as possible (and I have an e bike too)…..👍

[Jajarunner in reply to Hidden]

Mmm, people like me, you mean? How rude. I only this nickname because my preferred one was taken. However, it allows people to make all sorts of erroneous generalisations about myself based on that nickname. I based my answer on my extensive training as a cardiac rehabilitation specialist instructor.

[Hidden in reply to Jajarunner]

Really wasn’t mean’t to be rude or directed at anyone, just a general observation of what I’ve seen here many times over the years. More than happy to delete if it offends……..

[dedeottie]

Personally I didn’t notice any difference between 80g and 120g in terms of how I felt but a jump from 40 might take a couple of weeks to get used to. It no longer works for me unfortunately so on my way down the tickle up ablation route and fingers crossed. X

[AFCyclist in reply to dedeottie]

Thanks. Useful information.

[Windlepoons]

I take 40mg 3 x a day. First thing ,just after lunch and 7.30pm. It doesn't space me out . But that's only half your dose. Maybe ask if it could be taken 3 x 80mg a day if twice a day affects you badly.

[Karendeena in reply to Windlepoons]

Windlespoons that is my dosage but I spa e them a bid wider

[Persevere99]

Hi

I am of course aware that AF is completely different to occasional missed beats.

However, the two may be linked?

I am a high level exerciser at running, trekking and swimming.

About 15 years ago I noticed the occasional missed beats, so looked everywhere for a solution.

Don’t like meds.

They have more side effects than benefit.

And found hawthorn berry. There are 2 versions - extract in 150 mgs and complete in 565 mgs.

Tried both which didn’t help on their own, so combined the 2

And, no more missed beats at all!

I occasionally get the missed beats again about once a year, so try the hawthorn again and sorted.

Where are you going on your cycling Hol?

All the best

Persevere99

[Dee5165 in reply to Persevere99]

You are the first person I have read on this site that used Hawthorne Berry. I had a Cardioversion in March 2021 which NSR lasted 12 days. I researched supplements in lieu of taking high doses of Sotalol which made me feel worse. After 7 weeks of taking Hawthorne Berry, Magnesium Taurate/glycinate, CoQ10, Wild Alaskan Fish Oil and Vitamin D3, C, and B12, I was back in NSR. I believe it was the Magnesium and Hawthorne Berry that kept me in NSR now for 15 months! I would prefer to increase vitamin supplements than pharmaceutical meds.

And by the way, when I visited my Cardiologist and explained the supplements I switched to, he quoted, "Whatever you are doing, keep on doing it!"

[Windlepoons in reply to Dee5165]

Wow. You have a cardiologist with an open mind! I take most of those supplements but didn't know about hawthorn berry. That will be next on my shopping list. Thank you to you and Persevere for the info.😁

[Persevere99 in reply to Dee5165]

Hi Dee

I read somewhere that hawthorn berry should not be taken with meds, as it does a similar job?

Yep, it’s always supps/food solutions for me!

Persevere99

[Dee5165 in reply to Persevere99]

I read the same and became concerned, however, I believe some of these reports were trying to sway people towards meds and not by natural alternatives. I took my chances, checked with my doctor, and was happy with my results.

[Gladstone001]

I take 80mg twice a day and I feel fine. I also have a 80mg tab as a pill in pocket for any AF event. I don’t use this very often. I prefer a 500mg of Magnesium.

[dunestar in reply to Gladstone001]

Interesting! I've got 60mg as pill in pocket which I've never used. I don't take it daily. Did you find the pip didn't work very well? Not heard before of high dose magnesium as pip. Do you find it effective?

[Gladstone001 in reply to dunestar]

Hi, I am unsure as to how effective a 80mg tab of Sotalol really is. I have used it many times a few years ago but it was difficult correlate success with timing of the PIP. Magnesium was my saviour 2 yrs ago. I take 500mg per day plus some CoQ10 and was able to dramatically reduce the no. of AF events. Recently I have had a few events and I have taken an additional 500mg magnesium immediately together with water and rehydration salts - it worked.

[Windlepoons in reply to Gladstone001]

I take two electrolyte tablets as part of my pip regime as they have both magnesium and .potassium .

[OzJames in reply to Gladstone001]

Hi Gladstone, I've just started taking Magnesium and noticed your post from a couple of months ago. I noticed Mg is measured two ways with Elemental being the amount to look for. Is your 500mg the Elemental content?

[Gladstone001 in reply to OzJames]

good question. Glycinate is 14% elemental magnesium but this is easily absorbed. As a comparison Mag Oxide is 60% elemental but very little is absorbed. You cannot take pure magnesium, so you have to take it in some form of salt or other compound. Best to experiment with what best suits you. I started with Mag Taurate, another salt, (9% elemental magnesium) but this is expensive. I moved to Mag Glycinate capsules which were cheaper and worked up from 100mg per day until I perceived that they had an impact (reducing or eliminating AF) - this was at 500mg per day, i. e 70mg of elemental Mag. However, please note that glycine and taurine may have other impacts on the body and I have not really studied these.

[OzJames in reply to Gladstone001]

thanks that helps understand it, I think a lot of people get confused about it. As you quite rightly suggest, that each person is different and one might need less or more depending on the individual variables of their own body. I remember going into ED at local hospital a few years back and they gave me IV Magnesium a Beta Blocker and Apixaban to settle the AF, that afternoon I went for a brisk walk and got back in Sinus. The important caveat here is what works for one may not work for another. I’ve learnt that on this Forum and appreciate everyone’s comments.

[Gladstone001]

Aggressive exercise can be a cause of AF, rather than a remedy although I am aware that some folk have reported that walking can help sometimes in a reversion back to NSR. I am also aware that the simple act of going to an A&E dept can be enough to revert some folk back to NSR - this has happened to me in the past!

[Dee5165 in reply to Gladstone001]

You are correct. For some people who can't find the cause of their Afib if no other heart issues exist, aggressive exercise was my trigger to Afib as well. I also reverted to NSR near Emergency Room.

I had a Cardioversion in March 2021 which NSR lasted 12 days. I should have rested my heart for 6 weeks but felt great after a Cardioversion, so I went back to my normal routine not understanding the heart needs to remodel itself and rest after Afib.

I researched supplements in lieu of taking high doses of Sotalol which made me feel worse. After 7 weeks of taking Hawthorne Berry, Magnesium Taurate/glycinate, CoQ10, Wild Alaskan Fish Oil and Vitamin D3, C, and B12, I was back in NSR. I believe it was the Magnesium and Hawthorne Berry that kept me in NSR now for 15 months! I would prefer to increase vitamin supplements than pharmaceutical meds.

And by the way, when I visited my Cardiologist and explained the supplements I switched to, he quoted, "Whatever you are doing, keep on doing it!" I thank God every day for being Afib free!

[KMRobbo in reply to Gladstone001]

Prior to ablation to used to go running to stop the AFib. 7 to 10 minutes did it. Unfortunately after 12 AFib attacks that stopped working and I went for an ablation. Incidentally my EP was in favour of me keeping up the running/excercise .

[AFCyclist in reply to KMRobbo]

The short burst of exercise to stop AF trick has worked for me for at least 100 times over the past 10 years. Perhaps that is coming to an end now and I need another ablation. Thanks for your input.

[Karendeena]

Hi AFCyclist, I had my sotolol increased 3 months ago by my EP who is trying to get my AF episodes reduced (at the moment they occur around every 4 months but heart goes into tachycardia for up to 48 hours). I have been asked to take one extra 40mg in the middle of the day, so I take 40mg around 8.30am, 40mg around 2.30pm and the last 40mg around 9pm. 120mg daily instead of my normal dose of 40mg two e daily. So far so good but seeing EP in September. He said there was room for further increase but I don't want to take more of this powerful drug.

[Jmarina]

I have been on 120mg 2X day..lasted 9 months... back in afib. See cardio end of the month. Not sure if they will raise the dose or just do a cardioversion? Have not had any issues on my current dosage. Good luck!

[AFCyclist in reply to Jmarina]

Thanks. I think an ablation is the longer term solution.

[Bob002]

Watch that your pulse rate doesn't go to low. My pulse rate was in the 40 bpm which made me very sick I had to reduce mine due to low a heart rate. But at the right dose Sotalol was a great help to me, but now I am in permanent afib. No more sotalol or any kind except blood thinner Xarelto. But feel good now. Go to France how fun don't stress, that is the best medicine.

[AFCyclist in reply to Bob002]

Sound advice. My pacemaker kicks in if my heart rate drops below 50bpm so I have an "insurance policy".

[Clarrie]

I was put on 120mg twice a day after having a pacemaker fitted. I still get AF every 7-8 days lasting from 48-72 hours.

[AFCyclist in reply to Clarrie]

👍

[Pump]

have a great ride in France. I'm on 160 twice a day and that seems to have worked. Not spaced out at sall, though. Sadly. 😆

[AFCyclist in reply to Pump]

👍

[AFCyclist]

👍