Hypo type episode while on Forxiga /Dapaglaflozin, waiting for pacemaker upgrade. Any experiences with this drug anyone?

[Coco51]

I felt sweaty and shaky after skipping breakfast this morning, and looking at the leaflet for Dapaglaflozin, I see one of the side effects is to cause low blood sugar levels. It's a diabetes drug which has been found to help with Heart Failure patients. It makes you pee away blood sugar. So I ate some prunes and fruit and honey which helped immediately, thank goodness.But has anyone got any tips to share on this?

The context for me is this. At a routine echo scan a month ago I was diagnosed with Heart Failure. I have a dual lead pacemaker for bradycardia (36 bpm when discovered). I have had two Ablations for AF, 6 and 7 yrs ago, and after some problems the AF has settled. Even so I have remained on Flecainide and Bisoprolol. I also take BP meds Lisinopril and Indapamide, plus Apixaban and a Statin.

I was definitely feeling breathless and having trouble with stairs and hills. At the Rapid Referral Heart Failure Clinic (a month after the scan, but let's not go there...!) the lovely Consultant said my condition was reversible and not strictly speaking HF (yippee!). It's Pacemaker Dissynchrony.

The way I understand it is that my Left Ventricle, which has no pacing lead, is not beating in time with the Right Ventricle which has got a pacing lead. Another CRT pacemaker with an extra lead should solve it. Meantime stroke and MI are an increased risk.

To tide me over the HF specialist has prescribed Spironolactone potassium sparing diuretic (no more Indapamide) and Dapaglaflozin. This is a diabetes drug that tests have shown helps HF patients. He says I can come off it when the new pacemaker is fitted.

Now the waiting begins. I had already emailed my AF specialist and he had put me on the priority list for a pacemaker upgrade even before I got the HF clinic. He also told me to stop Flecainide and continue Bisprolol. The HF man thought dropping the Flecainide was "very cautious", but deferred to the EP. So a little confusion there!

Apologies forTMI. But if anyone is still reading I would love some advice about these meds. I'm meantime fretting and hoping the AF won't return.

[ozziebob]

No replies so far? Your request seems to have stumped the AF Forum. Would it be worth Posting your request on the BHF Forum?

Hoping you get some feedback that helps.

[Coco51 in reply to ozziebob]

You are right! I actually posted it simultaneously on BHF. There is a bit on these drugs over there already, and a couple of responses. Saying eat more regularly.

[Glb1948]

I have been taking flecainide for 3 years with no problems and i take eliquist with it. I decided not to get the ablation because it hasn't worked well on some of my friends. It sounds like you blood sugar is dropping to low with that diabetic drug. Thats a lot of meds to control a-fib. I hope the pacemaker works well for you and you can get off some of those drugs. My next step will be a pacemaker because With the beta blockers i have to take with the flecainide it drops my heart rate to low. The good news is the flecainide is working for the afib.

[Coco51 in reply to Glb1948]

I agree about the blood sugar. I have had an early breakfast ever since and that's been fine.

I also didn't have problems with Flecainide and it worked well to keep the AF at bay. It's just that you shouldn't take it with heart failure problems.

I think the ablations have worked for me. I was a bad case. My AF was permanent and much harder to cure as you probably know. Flecainide didn't stop AF before the ablations, but it didstop it after, and I had far fewer episodes these days. Big relief, and fingers crossed. Like you, the Bisprolol made the HR too low. The pacemaker has kept it above 50bpm and been pretty successful till now.

Once I get the bi-ventricular (i.e. with 3 leads) pacemaker fitted I can go back on the Flecainide if necessary. I am puzzled as to why I didn't get one in the first place. Might be worth asking if you are offered a pacemaker.

[Glb1948 in reply to Coco51]

Thank you, i will do that. It’s so tricky finding the right meds that dont interact or worsen other health problems. I slso have sick sinus syndrome and im not supposed to take flecainide either so looks like a pacemaker may be in my near future.