On the very last morning of a month's visit to the USA from UK, at 4:00am with bags packed, boarding passes printed and a driver set to come to take me to the airport, the beast returned. I couldn't believe it! I through down the max dose of Flecainide hoping I would convert to NSR, but not this time. At 8am, BPM shot up to its highest it's ever been at 198 and stayed there. With the clock ticking, I knew I wasn't going to the airport for a transatlantic 10 hour flight in this state.
To make a long story short, my first cardioversion gave me NSR for 24 hours. The second one gave me only a few minutes. After that I was admitted to hospital and put on a diltiazem dris which eventually got me out of AF. When I was discarged, I was given a prescription of Diltiazem tablets to keep my pulse lowered and less likely to going in AF. The dose is 3/day. The Flecainide was stopped.
I'm writing to say that by the time my nighttime dose come up (8:30 am, 4:30 pm, 12:30 am) my pulse can already be in the 50s and bp can be around 110/65. Therefore, I'm reluctant to take that dose. Like last night, I did, but my iwatch let me know that for awhile my pulse was down at 44.
Anybody care to comment? On the other hand, the wee hours is the time AF usually gets me.
I've already been advised, since returning, that it's ablation time for me. But in the meantime.....???
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Racquet
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Interestingly NZ has dropped all 30mg Diltiazem and the least minimum dose is Diltiazem 120mg. I was just being started on it as BB Metoprolol or Bisoprolol wern't controlling my raid heart rate but was controlling my BP even at low dose od Bisoprolol 2.5. Which also normalises my essential tremor in left hand.
So at Stroke I should have been offered CCB Diltiazem in Sept 2019 for rapid AF. I was not until a private Cardiologist offered it to me December 2021. Always though asleep my heart rate drops to 47avg bpm. The 120mg slow release does not allow my heart to drop further than 47avge Night.
Takind Diltiazem ? is does the Diltiazem wear off as the day goes on? Don't know. Or because the heart slows down automatically (always have cold shoulders asleep which can awake me if I'm not taking this into account.
Interesting ?. I'm not troubled if I get up in the night to loo etc.
I'm now happy with 60s day and 47avge night.
Certainly not the increasing Diltiazem up to 360mg that the Cardiologist allowed Drs to prescribe!
It showed me and Drs that simply increasing BB did not control my heart rate day.
But I do feel one should be very careful with CCB Diltiazem because a drop of 120 plus to 51 in 2 hours is scary. Hospital a god place to monitor one. Or start low at 120mg slow release.
I hope you get sorted.
My AF and Stroke were due to Thyroid cancer now removed but at 4 years I'm having scans because scans show it has returned. The papllary kind.
Fingers crossed for an appointment for the RA Scan to be done Auckland Hospital under urgency. Scan 3.
It would be good to say that my 120mg at first made the heart rate stay around 88-96 (under 100, 180mg was down to 51 Day) But over the following 14 months I dropped 6kg in weight and my Heart rate dropped to 60s Day.
Was it the weight loss? I felt considerably improved where exertion and stayability of a task with the lower 60s. Also 2 more operations made easier on my team. Not related to heart. Johhnson & J ghastly sling mesh 1 and last late October had a Right Inner Cuff Repair.
I take 180 mg Diltiazem. I have an apple Watch, all of my sleep for the last 9 months has a resting HR of between 44-56. Cardiologist said that was fine. I don't feel bad/uncomfortable.
When I first started taking Diltiazem, I thought it was dropping my HR too low and was actually creating anxiety, I also thought maybe the low HR was causing AF. Now 9 months on my body has gotten use to Diltiazem, and I no longer believe it was causing any of the anxiety.
I am happy with it. Good fortune on figuring out what is best for you.
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