I was diagnosed with paroxysmal AFIB 11years ago and was prescribed diltiazem and a regular size Aspirin . I was AFIB free for five years then I had my second episode followed couple more episodes months apart. Then on the seventh year of diagnosis with AFIB my episodes became more frequent at which time I was prescribed Multaq and Eliquis. My episodes lasted between 2 hours and 6 hours with variable heart rate with the top rate less than 140. Last night I had an episode lasting 11 hours with variable heart rate topping at 152. My questions are:
1- are permanent and/or persistent heart rates variable topping at 152 or higher and if so how are they tolerated ?
2- if some of you on Multaq , have you attempted to get off it and if yes have your frequency and severity of episodes increased ? This medication helped stay episodes free for one year so it was worth it to put with visible side effects of back and abdomen pain but now with episodes every month to 2 months I am not to sure if I would no worse without it.
Thank you all for reading my post and for your sharing your experience and thoughts.
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execz1
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Sorry but I have never taken dronedarone (multaq) so can't answer your question regarding that but wonder why you are on aspirin rather than a proper anticoagulant? Aspirin has little benefit in stroke prevention for people with AF.
1- are permanent and/or persistent heart rates variable topping at 152 or higher and if so how are they tolerated ?
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Long term they are not very well tolerated by the heart and that's why years (or possibly less) of uncontrolled afib can lead to heart failure. The question is how much uncontrolled afib does it take and we don't know. However, given what we do know, the idea is to control the rate in afib as quickly as possible if we are not able to convert to normal rhythm. There are several drugs on the market that are prescribed as PIP (as needed) to get your rate down and you should have a discussion with your doctor about it. In my case, I was prescribed fast acting Diltiazem tabs to take as soon as an episode started and to keep taking "x" mg at discussed intervals until my HR was around 100. At that point, I could go about my business, with a controlled HR until I converted. Many use a beta blocker like bioprolol instead of Diltiazem, or even a combination of the two. Later, my strategy was changed to PIP Flecainide and anti-arrythmic.
2- if some of you on Multaq , have you attempted to get off it and if yes have your frequency and severity of episodes increased ? This medication helped stay episodes free for one year so it was worth it to put with visible side effects of back and abdomen pain but now with episodes every month to 2 months I am not to sure if I would no worse without it.
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Not Multaq, but another anti-arrythmic, Flecainde. When I attempted to go off of it, or reduce my dose, my afib burden increased. This is not to say one shouldn't try to come off these drugs after say a long period of being afib free -- you probably should -- but don't expect just because you haven't had afib for a year on Multaq that it's gone. Odds are it will come back. Different story after an ablation, of course.
Wife is in persistent AF since March and both GP and then consultant altered her meds so her HR was under 100 most of the time. She is waiting on a cardioversion as her QoL is much worse than when she was in NSR.
I was on dronedarone previously (for ablations) and came off it under direction from cardiologist, who directed to just stop taking it. I also came off digoxin and apixaban. That was 5 months after 3rd ablation. I was due to go on heart failure meds and rate control as was then classed permanent AF, no further procedures until pacemaker appropriate (they won't do at my age, 48). It was sounding a bit gloomy but once off all meds I went into NSR, and have stayed that way. Now 10 weeks. Cardiologist more surprised that me!But I was not paroxysmal, was persistent. However, no issues at all coming off dronedarone.
And I guess in part this may answer your other question... I was 18 years in uncontrolled AF before the (borderline) heart failure diagnosis. 10 years of persistent. I am told that trying to keep the HR below 100 is good practice to avoid that scenario. I wasn't medicated at that point, only last 2 years.
I gather that AF, in and of itself, can be safely endured but that extended tachycardia cannot. I think one course for your doctor will be to, perhaps, stop the Multaq, as it doesn't seem to be working any longer, and add in a beta blocker to prevent the racing heart.
My elderly friend, 90 this year, takes only warfarin for his permanent AF and copes admirably well, but he rarely gets a racing heart with it.
Aspirin used to be given for stroke prevention, especially in the USA, but it has been replaced first by warfarin and now by other "DOAC" anticoagulants, so you are better protected now.
I was on Multaq/dronadone but it did nothing to stop my af but it did lower my heart rate. My cardiologist told me to stop it. Now I just take apixaban and bisoprolol I am in AF most of the time.
Hello, I am currently on dronedarone following a cardioversion back in October and so far it is keeping me in lovely sinus rhythm . I have had it previously to replace amiodarone when that gave me visual side effects , but when the AF broke though again I was told to stop it . I was then on rate control only whilst waiting for ablation no 2 . When I have been in AF it has been persistent with heart rate bouncing from the 50’s to well over 160 and it is not tolerable at all , hence the need for quite high rate control meds that have made me feel like a zombie !!
To put my reply in perspective I was diagnosed with Paroxysmal AF & when I didn't self convert to normal rhythm I was started on Multaq which did convert my rhythm. But a few days later my rate was escalating again & back into Afib. I was started on Ranolazine (Ranexa) and in 20 mins I was in NSR again. And stayed that way for 2 years at which point I asked the EP cardio if I could try using the PIP protocol where I will take the Multaq & Ranexa back to back if I have an Afib episode. Thank God I have not needed it but I keep it with me & track the Kardia app daily.
If I understand your situation correctly you are still taking Multaq but doubt it's helping. Perhaps you need a dose change or the addition of rate control adjusted. That Ranexa made a difference in the rate in 20 mins of taking the first dose.
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