Diagnosed a little over a week ago with Afib. On Diltazem and Eloquis. I am 58 years old and always been healthy until now. They have given me Flecainide to start taking daily if I have another episode.
My question is about being so tired all the time. I sleep a lot but have to work full time. Is this from the meds and does it get better as your body adapts to them?
I have atrial flutter/fibrilation. Diagnosed a year ago and also take Eliquis (apixaban) as well as diltiazem. The diltiazem is the 120 mg extended release form of the medication once a day and after a few hours of taking it, if I sit around, I feel worn out. Diltiazem sometimes will lower my blood pressure dramatically which contributes to my feeling tired. But I also workout and ironically it doesn't affect my exercising. My doctor said not everyone will have the symptom of feeling tired but it is common and your body may adjust over time. He did say that after a few months if the side effects are interfering with with day-to-day life to look at other medications instead. So far it's keeping my flutter/afib stable for now.
Hi, for me first days were difficult in terms of being tired. Then it has improved even though I always feel a bit more tired than before taking flecainide.
I think it is normal to feel tired with AF, yes. And Diltiazem takes a while to adjust to as its quite a powerful drug. It will slow your heart rate down and that might maje you feel tired. Do you have an Apple watch or Kardiamobile (mini EKG device that connects with a phone app)? These would allow you to see if your heart is in normal Sinus rhythm or in AF and check your rate generally. It's possible you might need to adjust your dose if the tiredness doesn't go away. Mention it to your practitioner so they have a heads up.
You don't need Apple watches or Kardias. Simply feel your pulse. I've had AF for about twenty nine years. I was in Flecainide daily for 12 years without side effects.. I have never taken Diltiazem nor Elequis. I take Warfarin instead.The tiredness is probably from the Diltiazem which is a Calcium Channel blocker, aiming to reduce the rate of your heart beats.
Hi Jeep, did you have the tiredness before you ever started on meds, i have paf approx 34 years but only diagnosed around 6-7 years approx , tiredness has been an issue for me before meds and now with meds, actually extreme fatigue, in between i get bursts of energy.
I’ve read of this same thing so often but being a very poor sleeper my tiredness is not caused by AF. Two possibilities come to mind in your case: the diltiazem is slowing your heart down a little too effectively and causing the tiredness or the naturally heightened levels of anxiety of having AF are causing it.
Steve
I didn’t get paroxysmal AF until well into my 70s so fortunate to have had more fit active days for longer than you. My surgery couldn’t come up with anything after the lowest dose of Bisoprolol proved too much for me so we found a private EP through the AFA and after he had introduced me to the wonders of a smartphone and a Kardia and I’d sent him a reading of one of my AF episodes, he sent a prescription for Flecainide to my surgery for me to be taken as a PIP when episodes occurred. When they became more frequent I started taking it daily first 50mgx2 and now 100mgx2 and only have very occasional episodes like when I was infected with covid which can be stopped with an extra flec! I developed chronic fatigue around the same time, no doubt following a virus, and fatigue is also a side effect of the flecainide ( always read the info!) My husband has had to become my carer but it must be very difficult for you if you are on your own and needing to work.
If you are in the UK you might be able to get support from social services or something- it’s a struggle but possible. Big virtual hug!
Hi
What dose of Diltiazem? I take 120mg, 180mg too high and I dropped 105mg within 2 hours.
What is your BP and H/R at rest?
It was explained to me that with AF the circulation of blood carrying oxygen isn't getting smoothly around your body.
I also take 2.5mg Bisoprolol to control BP.
Have you had an ECHO and ECG and 24-hr Heart monitor. This should be done before you go on Flecainide. If your heart structure is abnormal, my H/Spec says no flecainide, cardioversion, ablation, anti-arythmn drugs like flecainide.
cheri JOY. 74. (NZ)
I have had all the tests and my heart is good. It is 120 mg ER. My heart rate at rest averages low 60’s. My blood pressure this morning was 89/59. The highest I’ve seen it was 98/68 since starting this.
Hi Jeep
Your BP is too low. There's your trouble.
In NZ we can no longer have a lower dose of Diltiazem.
If you can take a lower dose of Diltiazem say 60mg ask your Dr. if you can reduce it.
I started at first with 88-96 H/R Day but I guess the weight loss helped. Then now 60s.
The 60mg may bring H/R up to 70-80s and BP 120/80 would be ideal.
See what you go but you need monitoring.
cheri JOY. 74. (NZ)
Hi again
Yikes "the highest BP is 98/68!
So what is the lowest BP?
This an urgent request to get your Dr on to it smartly. No wonder you are tired.
I wonder what your oxygen level is.
As long as you have been prescribed Diltiazem by a Heart/Specialist your GP can lower your Diltiazem. Mine did urgently.
But Diltiazem does not affect my BP but Bisoprolol does.
CBB Diltiazem is a Calcium Channel blocker.
BB Bisoprolol is an adrelin blocker.
Each works by stopping the calcium or adrenalin into the heart muscles. They are very interesting to read about them.
I'm sure UK have both 30mg and 60mg Diltiazem.
Take care, Joy
My BP is often around 98/68 and I feel no effect. My GP and EP are not concerned and said better that way than high. I take Sotalol
Hi
But the fact that you are not suffering from low blood pressure your Dr is not changing you.
We are all different.
60s H/R should be OK, mine has gone down to that level after a year on Diltiazem.
Just as well Diltiazem lasts for 12 hours only because 47 avge at night should not go lower.
Bisoprolol did nothing or little to H/R 156.
Medical team is always asking if you have side effects. That's the most important.
Controlling H/R also controls AF persistent but my AF is not going away but I have my fingers crossed. One day.
Remember it is trying to loose the side effects is the challenge. Trying changes like I did is best until I arrived at an acceptable.
One day you may need a pacemaker.
cheri JOY
I was having major exhaustion and short of breath first thing in the morning. They did change my dose today to half of the original and taking twice a day. So thankful!
Hi
Great.
What is your BP now?
What is your H/R now?
After a month you should have a 24 hr H/Monitor.
In 2021 I had 3 x 24 hr H/Monitors with every change.
I asked a new Dr for an ECHO as it has been 3 years since the last.
Often changing Drs makes a difference. He is also writing to Pharmac re Thyroxin without sulphur and B12 sublingual 1000ug (none in NZ).
It is best to be interested in your meds and diagnosis etc on your well-being.
cheers JOY
My blood pressure is 98/65 with a heart rate of 70. Skipping dose today and start lower dose tomorrow. It’s twice a day and not the ER version. Sure hope it helps. I felt like I was failing.
Hi
I'd listen to those who never had ablation or anti arythmic drugs.
Once the heart is scarred through ablation anything could change. Flex is a risky anti-arthymnic drug.
Do take care.
cheri JOY
Hi
No Jeep ... because your 120mg will last 24 hours (mine 12 hours) wait for that and say you have last 120mg at 7am this morning wait until 7am tomorrow and take the 60mg. Then tomorrow at 7pm take the other 60mg.
Then you are covered daily of the total of 120mg.
I reread the instructions. Diltiazem should be taken on an empty stomach and taken with water only. Wait 1/2 hr to 1 hr and eat.
It is keeping your heart rate just right @ 60s - 80s.
I pray that your symptoms leave.
It says morning best. Because I take Bisoprolol BB I have to separate them from AM and PM meds.
Please let us know how you get on - you may find that 1 x 60mg is enough. Time to balance you with your meds.
When I found that I was down at 60s Day at rest I stopped Diltiazem but my heart with ECG test told me different. I watch out taking BP just 4 times in the month.
CCB Diltiazem saved my life. 187 and 156 HB minute are too fast. On BBs.
I was breathless, no energy and fatigued. Some put it down to the stroke but the public put it down to my TSH level and taking thyroxin to keep me alive.
Day 4 from the stroke found in the carotid artery scan a shadow on my thyroid. Yes papillary cancer. Within 4 months a full thyroidectomy and 12 lymphs on right removed. 2 were infected. I was very lucky. The surgeon, me and Gary Clayman top USA thyroid surgeon guides us to keep TSH between 1.0-2.0.
I feel that I have the right balance.
I hope you do too. I was so lightheaded on Diltiazem 180mg (1/2 dose).
Fingers crossed Jeep.
JOY
Afib started for me about 3 years ago. I’m on carvadelol and Flecanide. Starting doses were way too high. Now down to 3.125 mg 2x day carvedilol and 50 mg Flecanide 1/2 in am and whole in pm. Fatigue much much better and no shortness of breath. Only periodically have SVT medication has been my biggest problem. Also had ablation 2 years ago so no Afib of which I’m aware but have many ectopics. HR 110 last night until I took another dose carvedilol. Always tired but not exhausted as before. Your meds may need to be adjusted. Good luck.
I think a lot of this is the meds . Most all cardiac meds have a adjustment period. Usually around 3 weeks you feel less side effects. Of course my husband had to try so many different meds as he is super sensitive to the side effects. The stress of a new diagnosis may also contribute in my opinion. Best wishes.
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