After 3 days in hospital for drug loading, it looks as if Sotalol will be my rate and rhythm control drug. I chose this path over yet another ablation (my heart is pretty scared from the previous five ablations).
However, if (when) this drug fails we’ll weigh pros and cons of a sixth ablation or a pace & ablate. If you’re in exactly this same boat, let me know!
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DKBX
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Same here. It was hard. I convinced them to allow me to roam but there was one Bed Nazi tech who even put an alarm on the bed that went off when I stood up to pee in the container. His name was Osiris. So god of the underworld fit the arse perfectly. I told the main nurse that if I had to press the call button for permission to pee they had better run fast or expect to change the sheets. The alarm was removed and I went back to getting up whenever. But they were pretty miffed about it.
That was the toughest part. They are concerned about falls so be sure to emphasize that you are NOT a fall risk and you’ll be responsible even if it happens. But you may still be confined by some nutcase like Osiris.
exact position but won’t comment here as I am going to post the result of my private consultation to discuss all options, very shortly. Just need a day to let it all sink in first. X
Can I ask why you had to stay in hospital please? I am under a very well respected EP who changed me from Flecainide to Sotalol and I didn't even go to hospital (I see him privately). I have had the dosage raised from 40mg twice daily to 40mg three times daily. I do get breakthrough episodes though but generally the heart rate is lower when I get an attack
Here in the USA it is standard protocol for hospitalization for initial dosing. I believe due to the possible life threatening arrhythmias that are possible. Once they know you tolerate all is well.
That is correct. The threat of torsades de pointe (a ventricular arrhythmia) has to be minimized; they do this by following the QTc interval which must be kept below 500.
Can I ask please what dosage of sotalol you are on and do you get any breakthrough episodes? Also, does it lower your BP? I am on 40mg X3 daily but get episodes every few months. My BP is around 100/65. Is your afib paroxysmal? I am waiting on ablation but still not sure whether to go through with it.
I’m on 80mg 2x/day. I have persistent. I have been through five ablations. And I’ve tried the entire pharmacopoeia from Amiodarone to Tiazac. First ablation was cryoballoon; the last four radio frequency. They have all been a piece of cake and successful but progressively less effective over time. Each required cardioversion at some point. Recently I chose sotalol over a sixth ablation figuring metoprolol and diltiazem had failed and so I may as well switch to both rate & rhythm control with sotalol. However, if (when) sotalol fails, I’ll be happy to be first in line for the sixth ablation or even a pace & ablate.
Remember…this condition is progressive, it’s all about QOL (it won’t kill you); eventually ALL treatments fail; so, breathe deeply, meditate, do whatever it takes to mitigate anxiety, live your life to its fullest accepting whatever limitations you must. Relax, breathe life in, breathe love out, repeat the mantra, “it won’t kill me.” Good luck
DKBX. Just read your bio. I am almost 69. My last ten years have been 100% identical to what you described….just had Pace n Ablate here in Fla. so far so good. I appreciate your wisdom that you put into your posts!!!!!
That is great to hear. Finding one of those work to make it worthwhile with the risk is not easy. I was never able to find one because they could not get me in sync to begin with. That being said, I have a pacemaker now, and I have no regrets. Yes I get frustrated like we all do still. This past week has not been great but thanks to the pacemaker and AV node being ablated I don’t have to worry about further damage just the annoying feeling of my atypical flutter.
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