Afib medication

[layla3]

just spoken to a heart consultant first appointment. He has took me of bisporpol as heart rate still to high 180 bpm especially when I’m a sleep while in AFib. but I mentioned when I go back into normal sinus rhythm my pulse crashes to 30 beats per minute which makes me poorly in a way that I’m nearly crashing out. He has put me on Sotalol 40mg twice daily. Any good advice while taking this new medication of anybody please?

[Ppiman]

It's also a betablocker that slows the downstairs, ventricular, part of the heart, but has extra anti-AF effects on the atrial part upstairs. Keep an eye on any bradycardia, still, I would think. So, fingers crossed for you. I would bet that all will be well. These things almost always work out for the best and you do seem to be in good hands.

Another medication that is more commonly given out these days is called flecainide. Sotalol is a rather older drug that some cardiologists prefer for a variety of reasons.

Steve

[mjames1 in reply to Ppiman]

Another medication that is more commonly given pout these days is called flecainide. Sotalol is a rather older drug that some cardiologists prefer for a variety of reasons.

Flecainide is much an older drug than Sotalol. Many people do not qualify for flecainide, and that is often why Sotalol is prescribed.

Jim

[Ppiman in reply to mjames1]

That’s interesting, Jim and I didn’t know that. I can’t be given either, I was told owing to my LBBB or whatever. The cardiologist I saw told me that sotalol was an older “dirty” drug compared to flecainide (a strange adjective but only meaning that its action was much less targeted and specific). That led me to think of flecainide as a newer drugs as they are often seen as “cleaner” being focused on specific receptor sites.

Steve

[mjames1 in reply to Ppiman]

Maybe we're getting into semantics here. At least in the United States, I've been told that Sotalol is not used as much anymore, so in that sense, maybe it's "older". However, as I mentioned, it's actually a newer drug than Flecainide.

Jim

[Bagrat in reply to Ppiman]

Strange, my GP now retired said when I was put on flecainide "It's a dirty drug but if it works for you that's fine"

[Ppiman in reply to Bagrat]

Which might tell us both something about consultant cardiologists, BG!!

Steve

[Ppiman in reply to mjames1]

A very quick look shows flecainide as being discovered in 1972 but not available medically till 1985, with sotalol being discovered 1960 but not till 1992 as an oral tablet formulation.

Steve

[mjames1 in reply to Ppiman]

Flecainide was also discovered in the 60s, but you go by the date drugs were approved for use. therefore, Flecainide is the older drug. I am using FDA approval dates.

Jim

[Ppiman in reply to mjames1]

I wasn't getting into semantics at all, and I'm sorry if it seemed that way. I was judging from what my cardio told me in the sense that flecainide was focused on receptor sites on specific heart cells, rather than having a more systemic effect which (he said) sotalol had.

Steve

[mjames1 in reply to Ppiman]

Steve I didn't mean you were. I just think your doctor was using "older" more in terms that it used to be prescribed more in the past than it is today. And he is correct on that point. All good 😄

Jim

[Ppiman in reply to mjames1]

Well, I am not sure as he's a prof at a teaching hospital and knew of my background in pharmaceuticals so we had an interesting discussion, covering also amiodacrone, which I almost was given.

I am feeling a little pedantic now - sorry for that. But the information on the internet shows flecainide acetate as being discovered in 1972 but being first approved for arrhythmias in 1985, and sotalol as being discovered in 1960 but not coming into medical use for arrhythmias in 1974.

Reading around this drug, I suspect its adoption in the UK at least was much later than in the US.

Steve

[Paulbounce]

Hi Layla.

180 BPM - ouch far too high. Then dropping to 30! No wonder you feel poorly. That's enough to knock anyone about.

I'm on Sotalol and cope with it fine but we are all different. I don't know what to say to you except 180 bpm down to 30 bpm isn't right.

Don't panic or worry but that one needs sorting. I can't give you medical advice as I'm not a doctor. Steve's advice about flecainide is worth a Google.

Paul

[layla3 in reply to Paulbounce]

It crashes down to 30bpm when I go back into NSR . pattern seems to be afib for 5 days then NSR for 1 or 2 days

[Paulbounce]

30bpm is a little low IMO. I still say 180 - 30 needs discussing with your medic.

Paul

[layla3 in reply to Paulbounce]

That’s why consultant this morning has told me to stop Bisoprolol and try Sotalol instead just waiting for prescription for this.

[Singwell in reply to layla3]

As others have said, it's possible you'll do better on an anti arrhythmic together with a rate controller. Ask your cardiologist or EP what is their thinking behind the prescription? Really important to know.

[Dudtbin]

bisoprolol didnt work for me at all but a mixture of digoxin and sotalol worked to get me into nsr and now im on sotalol and it works fine .

[TracyAdmin Partner]

Have you downloaded the 'AF Drug information' booklet from the Resources tab on the AF Association, of which contains information about Sotalol: api.heartrhythmalliance.org...

Alternatively, if you would like any advice, please contact our Patient Services Team: heartrhythmalliance.org/afa...

[layla3 in reply to TracyAdmin]

Thank you I’ve just downloaded the AF Drug information

[Dollcollector]

Sounds like you have Brady/ Tachy . I was given a pacemaker for that as my pulse would shoot up and down.

[MWIC]

keep a close eye on your HR - Bisoprolol had same effect on me and Solatol might also do the same - if it does go back to GP

[layla3 in reply to MWIC]

Yep that’s what will scare me . Heart rate this morning was 54 bpm so I have not took any solatol cause I know my heart rate will drop , so I am just going to take one tonight as I know my heart rate goes to 180 bpm in the night .

[MWIC in reply to layla3]

Not easy when you flip from high to low - I had an ablation in December and within the 1st few weeks went into 160-170 for 4 days - advised to take Bisoprolol again and made no difference as was stuck in an arrhythmia which Bisoprolol doesn’t take you out of - after 4 days I went to A&E and Solatol IV brought it straight down in minutes to @ 80 - Day later back up to 160 and another 5 days at that. When it came down on its own ( well actually after chewing through 3 raw cloves of garlic) it dropped to 38 at a couple of points but 30 mins on a running machine brought it back up to @ 80 again. My normal HR is @ mid to low 50’s which is fine, but if I take Bisoprolol when not in AFib it brings it down too low and feel awful / so what’s been explained to me is Bisoprolol and Solatol help to bring your heart rate down but don’t help with the high rate Arrhythmia e.g won’t help in reverting to NSR / I would explore the options open to you with regard to drugs that do help with breaking you out of Arrhythmia and/or other options such as ablation. I’m 6 weeks post mine and after a rocky 3- week period have been really settled with no episodes in 3 weeks and for the last year have pretty much had an episode every 2 days - early days but have my fingers crossed

[wilberwoo]

I can't advise on solatol but I was previously taken off bisoporol as my heart rate was too low, as with you crashing at night. I have had ablation for tachycardia and had an ICD fitted. Now back on bisoporol as the device paces my heart if rate drops below 60, so this is an option if meds cause low heart rate. Hope you get on with the new meds 💓