just a thought, I say my pip works fine to sort an af episode. However this last one, it was 8 hours from when I took it to now not showing af on my Kardia.
my question is, how quickly would a a pill in the pocket be expected to work, on average?
Mine is verapamil and so far I have only ever taken one, at the start of an episode.
Verapamil is a calcium channel blocker to slow your heart when in AF. It is NOT an anti-arhythmic drug to stop events.
that is why I have been referred back to the cardiologist, to ‘re-evaluate’. This was prescribed in a & e last June after they consulted with the cardio team . Thank you for the info.
I'm on Verapamil. I was told it would take two weeks for the Verapamil to take full effect.... So for me it's definately twice daily not a PIP.
But I was given Flecainide, initially as a PIP and now taken regularly and I thought that it is a “calcium channel blocker”. It does stop the irregularity as well as the speed at which the heart beats in my case. Of course we are all different and must discover what works for us as individuals. On the rare occasions I have an AF episode now an extra Flecainide 100mg always ends it within a couple of hours.
Fecainide is an anti arrhythmic drug to stop arrhythmias like AF not to slow the heart.
Yes I know but I thought it was called a calcium channel blocker which was what was said about the other drug. Sorry about my error about the speed though must say I rarely have had to take a lowest dose bisoprolol which was advised on the rare occasions my heart rate was over 140, twenty minutes after taking the PIP .
I would say that a PIP should work within 1-2hrs.
Sometimes I wonder if our heart reverts back to sinus rhythm naturally. To me it sounds like that's what yours did and perhaps no credit goes to the PIP.
Jean
possibly, although previous episodes prior to having a pip to take lasted a lot longer, but then, who knows what this condition behaves like. 🤪 it’s a law unto itself
It certainly is. Has the attack left you worn out today?
always does. I have had 10 episodes since the start of March - way too many. My pip starts to calm the range down pretty quickly - but I think I need to learn to understand more about these different meds and how they operate, so I am more aware of what’s being prescribed - and ask a ton of questions 🤣🤣🤣 Just off out for a late breakfast/early lunch with grandchildren - nice and relaxing x
Perhaps you need to take a tablet daily rather than as a PIP? Enjoy your breakfast.
If you go to our main website ( Atrial Fibrillation Association) under patient resources there is a booklet/fact sheet on all drugs used to treat AF.
10 episodes since March ... you may do better with a daily anti-arrythmic, like Flecainide, which helps prevent episodes, as opposed to just converting from afib to normal rhythm. Speak to your ep.
Hi Tilly
There are many 'blocker' type meds.
I understand that a BB Beta Blocker blocks ADRENALINE. If you are an uptight individual a BB could suit you either mildly on low dosage or drastically on a higher dose.
I understand that a CCB Calcium Channel Blocker blocks CALCIUM. It relaxes muscles etc of the heart.
Remaining UNCONTROLLED with BB Metoprolol (Los..... is in that family) and gave me pauses, and Bisoprolol it took 2 years 3 months and visit to a private heart specialist who was interested, to introduce CCB Diltiazem to CONTROL.
Go on google and read up on BBs and CCBs. Go to library if you have only a Smart Phone. I enjoy my Apple old NoteBook Air which I have upgraded x twice.
But my specialist was wrong in that I was reduced from 1/2 dose of Diltiazem to 120mg when he said in his report that I could have my dose increased up to 360mg !
120mg suits me but already after 1 year my H/R is now 62 at 7am to 69 at 7pm when I take 2.5mg Bisoprolol.
I hope this helps.
cheers JOY. 74. (NZ).
It depends on what type of PIP you are taking. There are basically two types.
First, there's a rate control PIP like Verapamil, Diltiazem or Bisoprolol. While they have some weak anti-arrythmic properties, their function is basically to lower your rate. Once you rate is lower, conversion is easier for some. It could take a couple of hours. A couple of days. Or, you might not convert at all. I used rate control PIP for many years with Diltiazem and generally converted within 12-48 hours.
The other type of PIP are anti-arrythmic drugs like Flecainide. You take them at the onset of an episode. Conversion is usually 1-4 hours.
Neither type of PIP is better than the other. Just different. One type might be suitable for one person, the other type for another.
Jim
thank you. I take verapamil
So with Verapamil, a calcium channel blocker, it basically just lowers your rate so that you will be safe and more comfortable until you naturally convert. That could be hours, days, or not at all. Once it gets to the point where you think it's taking too long to convert, then time to discuss an anti-arrythmic PIP like Flecainide. What is "too long" is an individual decision, but you don't really want to go on for more than three days. If I had it to do over, I probably would have used Flecainide as PIP earlier on. There is also daily Flecainide (or another anti-arrythmic) that is used to prevent episodes, rather than convert an episode. You start taking these when your episodes become very frequent, like every week, etc.
Jim
that all makes sense, thank you .i think my longest bout I have been aware of has been about 12hours. I think I will research flecainide just in case …… ah, just looked, it has an ingredient I may be allergic to in it (pre-geletanized starch )
Hi
I was diagnosed with Rapid and Persistent AF.
I was never offered Flec... or had Cardioversion.
Now told no Ablation due to enlarged chamber found on ECHO. Xray of spine says top measurements of normal.
Or perhaps because the stroke with aF was due to Thyroid Cancer found on 4th day in hospital on a Carotid Arteries Scan, when Cancer removedmy heart might revert itself.
3 years since my Thyroidectomy in Feb 2020 I'm still holding out on self conversion.
Interesting since Dec 2022 my H/R controlled with Diltiazem @ 90s has dropped and at 7am - 7pm my H/R is 62 and climbs to 69.
cheri JOY. 74. (NZ)
I tried to use Verapamil as a PIP to control high HR when first diagnoses. The cardiologist was happy for me to try it but said it was not fast acting unlike bisoprolol ( which I could not tolerate) . He was not wrong in my case.I also obtained a supply of 40mg normal release pills for the purpose.
Eventually I took 120mg extended release daily, but used the extra 40mg pils to try to control the AFib if I went into high rate.
I had limited success..
Depends on the medication. I was on bisoprolol and it took 2 weeks in my case to leave and a good 10 days to arrive , consequently took q0 days or so to quell episodes. It is long acting and have now changed to propranolol which is short acting and needs 2 doses daily and acts in hours. That's fine
Hi Tilly. Tablets like verapamil and bisoprolol, which work by reducing the pulse or heart rate, can work well for some people as "PIP" but they do take a while to have any effect, maybe an hour or a little more. I used to take bisoprolol in this way until recently and it worked well.
The true anti-arrhythmic drugs, such as flecainide, are more often used as PIP, I suppose, but they are more potent and work more quickly. I'm unable to take this.
Steve
thank you. Yes, I think the verapamil takes about 40mins to work for me . I can’t take bisoprolol and woukdbt be able to take flecainide either. I can remember saying to the gp can’t I take the verapamil daily instead of the beta blockers and he said no - without an explanation.
I used to take 1.25mg bisoprolol as needed but began taking it daily just before a small procedure I had two months ago (to try to be sure I didn't get AF at the time of the op). It did the trick and also calmed my daily palpitations, so I asked my GP if I could keep it up, and he agreed. The one negative is that it does reduce my resting heart rate to below 50 most evenings. If I do develop AF again, which I guess is likely, I was wondering what I would then do - I ought to ask!
Steve
That's nonsense. There are lots of people who take a CCB daily because they cannot tolerate beta blockers. I take Nebivolol daily and my cardiologist told me to double the dose during an attack but I find it does not work as well or as quickly to lower the heartrate as Bisoprolol does. I found there were more side effects with Bisoprolol so I did not want to take it everyday.
Hi
I tried to take Bisoprolol without CCB Diltiazem and CCB without Bisoprolol.
Both don't work holistically for me.
It showed that I needed Bisoprolol for BP control
and
Diltiazem for H/R control
Both controlled helps my rate of AF and therefore symptoms of AF.
Now 123/69. avge day. H/R 62 - 69 avge day. 47 at night.
cheri JOY. 74. (NZ)
We have the original Diltiazem back.
excellent! X
I had a small dose of Verapamil as part of my BP medication. The Cardio took it away and put me on Biso as a HR lowering drug, I have never had any drug for the rhythm. The Verapamil may have helped with my BP but it started to cause my feet to swell. I have asymptomatic AF, but although the Cardio said I could use the 1.25mg Biso as required (if my heart rate goes up), I prefer to take it every day and it keeps my HR between 60 and 70 (It goes up when I get cross which I am at the moment about a lying courier delivery man ) !!!!!!!!
I can’t take bisoprolol x
Hi
I take Diltiazem. Another CCB Calcium Channel Blocker.
I was not controlled H/R and therefore AF - the rapid H/R it took 2 hours to drop my H/R to 51.
I could see that in Rapid H/R and worse AF it could work as a PIP.
In AF it is important to CONTROL the H/R and therefore the symptoms.
I hear what Bob says but he means AF does not stop on your med.
My symptoms of sweating profusely and any exertion ability unable with pounding heart.
I take Diltiazem 120mg (adjusted from 180mg) AM but I take Bisoprolol 2.5PM both daily with PRADAXA 110mg twice a day.
Mine is RAPID and Persistent AF so daily platform of meds a must have.
CONTROLLed CCB works mainly on H/R and BB Bisoprolol works on B
and both for rythmn.
It is the need of a HOLISTIC plan to help each individual.
It may be that you have V... in your meds daily plan eventually.
Interestingly at night my H/R stays at 47 regardless of taking Bisoprolol at 7pm.
Diltiazem doesn't cover 24 hr even though slow release.
Separation os a CCB and a BB a must.
cheri JOY. 74. (NZ)
thank you to everyone for all your replies. 🤗
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