1 ablation 3 cardioversions

[Sweetmelody]

I’m 81. My afib was first diagnosed in 2020 but I’m sure it started well before. In 2021, I was prescribed diltiazem at ER. The next evening, after lying on my side in bed watching Masterpiece Theater for 2 hours, I stood up … and blacked out, falling and breaking my arm. I have low blood pressure, never high. Be wary of diltiazem if your BP is low or lower normal.

So we tried metoprolol. The side effects were noticeable, but there was no noticeable change in my afib.

So then we went to amiodarone. Within 36 hours my bpm shot up to the 130’s on average … and stayed high even after we stopped the amiodarone after two weeks. I’ll never take it again; it can be a dangerous and unpredictable drug that should be used, from what I’ve read, as a last resort, not a first resort.

The unrelenting afib and high bpm led to an ablation in August, 2022. Within two days after, I was in the ER getting an electrocardioversion for atrial flutter. It worked. Like magic. I spent an entire year without afib or aflutter, taking only Eliquis most of the time.

In August of 2023, I got two wasp stings and used an epipen. That same day, the afib and tachycardia returned—with the adrenaline from using the epipen the likely catalyst according to my cardiologist. I’ll never use one again unless I truly cannot breathe; I was just trying to avoid the big allergic reaction stings give me, but that is different from anaphylactic shock, the only time an epipen should be used, I’ve learned in hindsight.

That reversion to aflutter was treated with another cardioversion, which lasted a month, during which my bpm was normal but I was getting lots of palpitations and wasn’t managing my stress well, nor being intently careful about my diet and exercise routine. The third cardioversion, two weeks ago is holding, fingers crossed, and this time without the continual palpitations. I’m hopeful.

If I revert again, we’ll head for a second ablation and a Watchman implant.

To sum up what I’ve learned:

Avoid drugs that lower blood pressure if your blood pressure is already on the low side.

Avoid amiodarone unless your situation is indeed dire

Do not use an epipen if you have afib, again unless the situation is anaphylacticly dire.

After a cardioversion, make important changes in stress management, diet, and exercise.

[Hidden]

Hello and welcome to the forum. Not the sort of thing you want to be exposed to when you are 81 years young. You sound pretty well informed so apologies for mentioning stuff you probably already know. Also bear in mind that I’m from the UK and things may be done a little differently. Generally, but not always, if someone is diagnosed with fast AF they are prescribed a lowish dose of either a beta blocker or calcium channel blocker and over a period of time, the doses are increased until they reach the optimum balance between rate and blood pressure. Not always easy and some medics may be inclined to cut some corners. When coming off these drugs, it’s even more important to do it slowly because the risk of dizziness and blackouts are more likely. So what you are saying makes a lot of sense and folk will find it helpful, that’s for sure, especially the summary!

[bassets]

Thanks for this information. I was bitten (I think) by a spider a couple of years ago and went into Afib so then a trip to the ER. Not something I want to repeat!

[BaileyC57]

I had a cardioversion today and it did not work! They want me to start Amodarone but I have not heard good things about this drug! I am at a stand still and have to think about it ! What side effects have you had on Amodarone and Metoprolol! I am also on Metoprolol and feel out of it most of the time! Sometimes a little dizzy!

[Sweetmelody in reply to BaileyC57]

I recently had two electrocardioversions. The first one worked--for about ten days, then the flutter reverted. The second one, one month after the first, took; I'm in NSR and feel pretty good. I was taking diltiazem then metoprolol between cardioversions and (1) neither drug worked, and (2) they made me feel crummy. I had had a bad experience with amiodarone; my cardiologist and electrophysiologist were clear that it was the wrong drug for me (it had sent my bpm skyrocketing within 24-36 hours)--but that doesn't mean it is not right for you. I'm just relaying my experience.

All I can say is that when my first cardioversion didn't hold, a second one within a month did. Are your doctors willing to try again?

[BaileyC57 in reply to Sweetmelody]

I THINK SO!

[carkat22]

So sorry to read this, you have had a difficult time. I kept ending up in hospital with my heart and blood pressure dangerously high. I have now had a Pace maker fitted to stop heartrate going to low and medication to stop my blood pressure going too high and my heart racing. I am on 10 mg Bisoprolol a day and 120mg Diltiazem twice a day and so far only problem is severe tiredness and very short of breath. No other problem like you have had so far. Cross fingers, Carole