AMIODARONE - FAINTING

[Ruza2020]

Hello Everybody. I hope someone is able to help me figure out if Amidarone is the cause of my fainting.

I have been taking Amiodarone for my paroxysmal Afib for three years now. I take 100 mg each day.

About ten days ago I passed out. I am not sure how long I was unconscious. When I regained my consciousness I tried to get up, but I could not. Any attempt to lift my head up would cause me to faint. Somehow I dragged myself to the phone and called an ambulance. By then my entire body was limp - I hardly had strength to hold the phone.

I spent seven days in the hospital. They performed numerous bloodwork, X-ray and ultrasound of my abdomen, and MRI of my neck and head.

All the test results, according to the doctors, came negative. In hospital, I was bedridden for six days.

Right now I am at home. I have not lost my consciousness for the past four days. However, it feels as if I would. I hold on to furniture or a walls when I get up.

So, question is: Has anyone who takes Amiodarone had similar experience?

By the way, I also take Apixaban - five mg a day. I do not take any other medications.

Thank you so much for listening, and for responding to my enquiries.

[CDreamer]

Presumably you were on monitoring machines whilst in hospital? What was your HR and BP? Did the hospital give you any suggestions as to what could cause this reaction?

I had similar although I have never taken Amiodarone, every time I raised my head off the pillow my HR went sky high (180+) whilst my BP dropped making me pass out. I had various forms of this Autonomic Dysfunction over a number of years, until I got a pacemaker, this steadied both HR and BP and not had a problem since.

[Ruza2020 in reply to CDreamer]

Thanks CDreamer. Yes, I was on a monitor. Blood pressure and heart rate were ok but not perfect. I do have very low resting heart rate though. During sleep it goes as low as 42 BPM. When I get up jumps to around 95 BPM. The doctors were not certain of the cause of my fainting. I have seen four different doctors during my stay at the hospital. They had different opinion. One believed that I have orthostatic hypotension. One doctor recommended pacemaker.

I, like you think, I may have an Autonomic Dysfunction - namely, Vagus Nerve not functioning properly.

Question, did the pacemaker reduce your Afib Episodes?

Wow, 180 BPM, that is scary.

[CDreamer in reply to Ruza2020]

Since implant of Pacemaker (I was scheduled for Pace & Ablate) I have had very few episodes of AF - for the first few years none at all - then I got COVID and had pneumonia several times so AF kicked off again and was problematic for a while but as soon as I recovered from infection, NSR returned. PoTS - Postural Orthostatic Tachycardia Syndrone can be a pain. Have you had a Tilt Table test? Do you know about the STARS site run by AA? heartrhythmalliance.org/aa/...

I didn’t worry too much about temporary high heart rate as long as I was prone, standing was not a good idea as I would pass out, and yes it’s a concern if it exceeds 200 or is sustained for any length of time as there is a danger of VTach but that never happened thankfully. I learned a lot from STARS Patient Day on how to manage PoTS and met many people who suffered far worse than I because it affected them all day, every day which was very humbling whereas I only had occasional episodes.

I’ve just re-read what you wrote about Amiodarone and I believe that Amiodarone can cause fainting when taken long term or with a higher dose, it can lower BP and HR. May I ask why it was recommended to you if your AF was Paroxysmal? My understanding is that Amiodarone is normally a drug of last resort or for persistent AF prior and following carioversion. Where in the world do you live?

[Ruza2020 in reply to CDreamer]

Although my Afib was paroxysmal, I was having too frequent episodes (one every 7 to 8 days). Mind you, even with Amiodarone, I get at least 2-3 episodes per month.

And yes, I did try many less toxic medications, none helped at all. My electrophysiologist (EP) recommended Ablation. I did consider and almost went through. But when I was told that the procedure will take around 6 hours, I got major anxiety attack, and thus unable to go through it.

I live in Canada.

[Jock68]

I experienced problems when I was on Amiodarone as it caused me to have an even lower heart rate down to 43 during the day. After my second ablation I got a Pacemaker installed and has a third Ablation, now waiting for my 4th Ablation. Speak to the doctor he may recommend a Pacemaker and Beta Blockers.

[Ruza2020 in reply to Jock68]

Thanks Jock68. 4th ablation? Oh my goodness - you are so brave!

Beta Blocker did not work for me at all. Plus, I had major side effects.

[Espeegee]

Was your B12 checked? A big deficiency can cause fainting.

[Ruza2020 in reply to Espeegee]

Thanks Espeegee. My B12 should be fine - I take supplements - plus, I started (sadly) eating beef😔😔😔

[Espeegee in reply to Ruza2020]

Should be doesn't mean it is. Always worth getting it checked.

[Nannysue1]

I was on 100mg daily of amioderone for just over 6yrs and never experienced this.

[Ruza2020 in reply to Nannysue1]

Good to know. Thanks Nannysuel.

[Angusdon]

Yes, I fully understand your situation I also used to be taking almost fainting turns while on Amiodarone. Since coming off Amiodarone I feel fine, although very effective it’s a very toxic drug.

[Ruza2020 in reply to Angusdon]

Thanks Angusdon. No doubt, very toxic indeed.

[1Golf]

My Cardiologist called this drive g a Dirty Drug. Many terrible side effects and to be avoided at all costs. Helpful for a short period but beware.

[Ruza2020]

Thanks 1Golf. Dirty Drug? It sure is. Unfortunately, nothing else even remotely worked for me - well, even Amiodarone is all that effective - still get Afibs two to three a month. However, Afib episodes are shorter with Amiodarone.

[Ducky2003]

I've been on 200mg Amiodarone for a while and never had that happen (on Apixaban too). May be some kind of syncope if your blood pressure drops.

[Ruza2020 in reply to Ducky2003]

Thanks Duccky2003. 200mg a day - that is a lot. For how long have you been on Amio. ?

[Ducky2003 in reply to Ruza2020]

Oooh, about 6 years on and off, usually as a build up to a cardioversion but they've kept me on it continuously after my last DCCV 16 months ago as I'm incredibly symptomatic with AF. It's keeping me in rhythm so far, which is what I need as I'm on the list for a mitral valve repair and Cox IV Maze.

[Ruza2020 in reply to Ducky2003]

Thanks for sharing. Afib has stollen my freedom, my life...so sad....

I could never comprehend the medical research, or lack of it...with such a advanced technology one would expect better solution to our health problems...

[Ducky2003 in reply to Ruza2020]

I think there are a few new procedures emerging now, such as the Hybrid Convergent Ablation, QDot Micro ablation and the pulsed field ablation.I was offered the Hybrid until the pre op checks revealed the valve issue.

You don't say whether you've had an ablation or whether you've been offered one. May be worth a chat with your EP if you haven't.

[Ruza2020 in reply to Ducky2003]

Oh yes, I have been offered ablation - I fear of the possible risks...

My EP said that risk are a lot greater in my case, because I am a thin petite woman. He wanted me to gain at least 35 pounds before the ablation😊😳...I tried - it didn't work...

I'll look into the other procedures you mentioned here...

[kocoach]

I've been amiodarone 200mg a day for 5 years but haven't experienced fainting episodes, but I'm always wary with this drug. Like you my EP says I have to be on it and he refuses to take me off of it. I have done a little research and 200mg or under of amiodarone is considered a safe dosage and that problems occur in doses above that. I would love to be on only 100mg daily as you are. One poster replied to one of my posts regarding amiodarone and said her 84 year old ( I believe, maybe older) has been on amiodarone 100mg for 25 years with no problems. Main thing is keep being monitored for liver, kidney, eye and lung function as well as thyroid. Best of Luck to you.

[Ruza2020 in reply to kocoach]

Thanks kocoach. Good to know that lower dose of Amio may not be as detrimental as we fear...