I would like to reach out to see if anybody has ever had similar experience as I do at present.After 7 cardioversions and 2 ablations I was eventually and surprisingly converted to sinus 7months ago with Sotalol(amiodarone and flecainide failed to do so) and remained in sinus since. I am very active guy loving hikes,walks,swims and biking,but since starting Sotalol,these activities became less enjoyable.What happens is that when I start my exercise my breathing is quite labored and feels like I cannot perform deep breaths,interestingly however,later on,after 20-30 minutes warm up it gets much better and actually can even get better while going up the hill.Despite having medical background I am having hard time to explain this.Since it all started after Sotalol I am blaming this drug for the symptoms.
My question,should I push my EP to change my meds or should I count my blessings and live with it enjoying regular heartbeat?I know my decision at the end but would love to hear some insights with similar symptoms on Sotalol or other betablockers.
THANKS JERRYCZECH
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55zuzanka61
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SOB with smaller tasks involving bending, but ok on the treadmill and walking up hills. Saw Pulmonologist and passed the Pulmonary Function tests, ruling out athsma, COPD, etc. Can't say we've figured it out yet, but the suspects are GERD, abdominal distension from SIBO, which can affect the diaphragm when compressed and long Covid. And, sure, it could be the drugs I'm taking, plus some de-conditioning. The heart is always a suspect with SOB but then I probably wouldn't be ok doing hill work.
So for now, just decided to treat it symptomatically. Doing breathing exercises with the intent to strengthen diaphragm and increase capacity, including boxed breathing, breath holding and yoga type breathing. Also core stretching and pelvic floor exercises. Thinking of getting a home spirometer for further exercise and looking into seeing a respiratory therapist for additional guidance. At some point may have Chest CT scan and a more updated echo.
You might try similar, but always best to check with your doctor before embarking on a home program like this. You could also ask for a trial off Soltalol to rule it in or out, or switch to a different anti-arrythmic like Flecainide.
Please let me know if you end up finding out more on your condition and what helps and what doesn't
I was on sotalol for 2 years when I had Afib. It was a horrid experience. I got really puffed out cycling up hills I used to be able to take in my stride. When I finally came off sotalol, I had so much more energy and go. I went on to diltiazem which I got on very well with and hardly noticed the AF.
"High‐certainty evidence from five studies found that deaths from any cause were twice as high in people taking sotalol compared with people taking a placebo (dummy treatment) or no treatment. We calculated that one extra person would die for every 102 people taking sotalol for one year"
I started taking Sotalol 18 months ago and reported similar experience with breathlessness when walking up short inclines or starting out on a ride. Low heart rate initially then over time breathing and heart align and I feel ok. I having spoken to a number of Consultants over this time and they all seem to rule out Sotalol being the cause.
I had persistent Afib. My Cardiologist kept increasing the Sotalol because it did not keep me in NSR. 80 mgs. twice a day. The more I took the worse I felt. 120 mgs. twice per day.
I was being cared for by a Cardiologist and a Electrophysiologist. After the Cardioversion, and being in NSR, the Sotalol was reduced to 80 mgs. again by Cardiologist, but not taken off those meds. I started a supplement routine and had a visit with Electrophysiologist. He was pleased with my test results and told me to keep doing what I am doing. My other doctor was not pleased with his advice, however, I had too many side effects from meds, especially beta blockers. It is now 2 1/2 years later and I am still Afib free with only 40 mgs of Sotalol 2X which supposedly has no effects on heart rate but at least I have no ill side effects!!! My son's doctor told him to stay on Sotalol to avoid ever going back into Afib. He is Afib free now for 4 -5 years.
I took supplements recommended from a website, for example, Dr. Frank Shallenberger in a newsletter, Real Cures, in addition to For Afib patients, 7 supplements for a healthy heart. I cannot recall all the research notes, but it was information regarding natural alternatives for Afib.
I take Magnesium Chelated Glycinate and Magnesium Taurate (taurine the most important amino acid in the heart), CoQ10, Vitamin D3, Wild Alaskan Fish Oil, Vitamin B12, Vitamin C, Hawthorne Berry and half a banana.
The Vitamin B12 and Vitamin C was for my personal health. Chelated Magnesium was for calming effects on my stomach, sleep, anxiety and inflammation and the Hawthorn Berry may have some blood thinning qualities so I wouldn't require the Eliquis.
I am still Afib free, taking supplements today, however, not at the higher doses I took after going back into Afib. I believe the Magnesium Taurate and Glycinate with the CoQ10 and Fish Oil were the cures to my Afib. The body only absorbs about 40% of magnesium and the rest is lost in urine, therefore most people may have a magnesium deficiency which throws off the body's nerve function which in turn could cause Afib in those with no other heart issues.
Taurine along with magnesium and potassium are known as the "essential trio" for treating nutritional deficiencies relating to Afib. It is important to note that these supplements take about 8-10 weeks to show benefits. I went into NSR after 7 weeks of taking them.
Hi there, I too take 40mg Sotalol twice daily. It has kept my afib at bay for over 5 years. I do experience more fatigue etc about two to three hours after taking it, so I try to time my dosage to compensate for this. I may exercise before my next dose is due or exercise about 6 hours after the last dose. Yes, sometimes when I start exercising I feel fatigued but better after about 10 minutes or so. I think this is due to the beta blocker that is in the Sotalol. It just takes my heart a few minutes to catch up with my movements. Hope this helps.
As a physician, could you please review the above study posted by MarkS and give your thoughts ? Thanks to Mark for posting.
The average age of participants was 65 years. The most frequent diseases were hypertension (high blood pressure) and diseases of the arteries and valves of the heart.
I assume this means they had afib/arrythmia in addition to the mentioned diseases. Seems like that would contribute to the mortality rate.
We found high‐certainty evidence that people taking quinidine or metoprolol had a higher risk of proarrhythmia than people taking no treatment
I suppose this means that metoprolol is for rate control but has a higher risk of proarrhythmia ?
Also noted is that antiarrythmics reduces recurrence of afib, but reoccurred in 43-67% of the participants. And do the benefits outweigh the risks for that group.
Appreciate your thoughts on the above and the article as a whole. Thanks !
All those studies are so called retrospective,retroactive and they are known to be full of multiple biases and usually they elicit sleuth of different conclusions from well-seasoned experts in the field.
Generally Sotalol is dangerous only at the moment of its introduction,thus it’s recommended to start in hospital and then in people with all kinds of coronary artery disease and its overt or salient presentations.
General US EPS panel consensus does not agree with above mentioned study conclusion.
Again,nothing is ever foolproof in the field of medicine
I have been on Sotalol since 2016. I was in NSR for almost 6 years after starting it and having a cardioversion (my 3rd at the time). I went back into a fib.
After a trial of a new med and a failed cardioversion (my 5th by that time) I had an ablation a year ago. They tried taking me off the Sotalol after that but my heart began acting up. I’m on half the dose I used to be on and I’m still in NSR. I also still have a degree of shortness of breath, but I can deal with it. I’m happy to be in NSR.
Hi . After reading what you had said about soltalol I was glad to know it wasn’t just me I actually thought am I imagining this . I am definitely not as active as you but I do like to walk, but when I first start like you, I struggle to breathe easily, but once I’ve been going for 15/20 minutes, I’m absolutely fine. I had the most horrendous two years constantly in and out of AF having procedures done three or four different types of medication, which literally had me housebound I was so breathless just walking to the end of my street felt like I had done the marathon but once I was put on soltalol I finally got my life back, so I will put up with the struggle when I first start walking to have this. “ normal “ life that I’m living right now.
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