hi all. Went to see my ep this morning at uchw lovely chap
He’s put me on the list for a touch up 2nd ablation
Rf this time he said. Meanwhile he’s asked me to start a new medicine diltiazem. 60mg twice a day
Anyone else in this regularly ?
mans also 50mg flecanide twice a day.
Not had experience of that but glad ypu got somewhere. Mine is Proff Osman,but Proff Dhanjal did ablation.Good luck xx
Hi
I take 120mg Diltiazem am to control my raoid persistent AF H/R.
On 180mg to start with it dropped down to 51 H/R Day. Too much.
I take 1.25mg pm. You must separate the CCB and the BB.
Calcium Channel Blocker and Beta Blocker.
So BP 123/70 with Day H/R 77-88.
Night H/R 47 doesn't change
CONTROLLED makes me happier.
cheers JOY. 73. (NZ)
thank you.
If the Diltiazem is replacing the Bisoprolol it should be fine. I'm on that dose except I take 120mg once a day with Flecainide 50mg x2. Although I only need 25mg in the evening these days as agreed with my EP. The Diltiazem is acting as a partner to the Flecainide and is also effective in controlling your BP as it's a vasodilator. You might find that you prefer the Diltiazem to the beta blockers which can slow down your system. See how you get on. There can be issues with Diltiazem buy it's an individual thing, same as any drug. Makes you photo sensitive btw bit not an issue here in the UK at present.
cheers. Yes the ep said try this instead of bisoprolol and take 50mg flecanide twice a day till ablation date
Singwell Has Diltiazem caused ankle swelling or any other issues ?
As you say, it is dependent on the person. I am on Metoprolol but always considering Diltiazem.
Not for me. The main side effects for me were weird skin flushes - I'd suddenly get hot and go red - and the tendency to widen the oesophagal sphincters causing heartburn when I first started using it, and acid reflux. Apparently ENTs recommend not using it for that reason. But since I'm not performing nowadays it doesn't matter. I think I was on.too high a dose at the beginning as I don't get the flushing now.
I was on Diltiazem for 10 months ( with flecainde) ,200Mg modified release 1 per day. I did not really like it, tiredness, slight breathlessness on commencemeng of exertion, excercise intolerance and brainfog. I am sure 200mg was too much for me, I tried 120mg for a while , but the medics at my local hospital put it back up again ( long story).
However when I developed reentrant Atrial flutter it did its rate control job at keeping my HR down at 140bpm whilst I waited for an urgent ablation!
sorry to hear. I’ll give this a go. See what happens roll on ablation 2.
The 10 months I was on it was 6 months waiting for an ablation for AFib, and then I developed flutter , a month waiting for an ablation for that, and then 3 months blanking period, then off all drugs inc the diltiazem.Best wishes for yours!
Do you have heart failure, or similar? I hope not. Just checking. Hospital doctors did not check to see if I had reduced ejection fraction (though I could have told them it was low/borderline). They prescribed diltiazem, which worsened my heart failure until stopped.
"Non-dihydropyridine calcium-channel blockers [such as diltiazem] are negative inotropes and are therefore contraindicated in patients with heart failure and reduced ejection fraction."
I’m on Diltiazem twice a day as well as Flecainide twice daily. I take the Diltiazem because I can’t tolerate beta blockers. No issues at all with this regime
As Singwell mentioned there can be issues with Diltiazam. I'm one that had a (rare) severe reaction to it. It was given to me through IV while waiting to be further assessed in the ER, and within a couple minutes my blood pressure rapidly plummeted to the point I was starting to pass out. The doctor rushed back into the room and quickly stabilized me. I would recommend taking the first dose at the hospital where you can be observed for any adverse reaction to it.
cheers. Even a small 60mg dose ?
I'd say unlikely to be problematic. In my case the initial 200mg slow release was too high. But the pandemic had just hit and I was left to manage on my own. I only had big problems with it twice - and that was following long episodes of AF. The cardiologist explained that pur BP fluctuates a lot during an AF episode and that slow release Diltiazem has a rise time of around 2 hours, when it peaks. Both times I had BP hypos was after the long episodes and 2 hours after taking the Diltiazem. A BP hypo isn't nice, gotta say. But you're on a low dose so unless it's a drug that doesn't suit your system hopefully you'll be fine.
I have read that Diltiazem is the choice of ER doctors because it has proven to reduce heart rate faster than Metoprolol. However, that is when given intravenously.
I take Diltiazem 120 in am and 120 pm.I felt dreadful for the 3 months I took Bisoprolol.
Only issues I have with Diltiazem is occasionally puffy ankle and I now hyperplasia of my gums which the hygienist keeps an eye on.
I was told to switch from bisprolol to diltiazem but am too scared to do this. I want to talk to my cardiologist first.
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