I’m into 5 days of AFib. Doesn’t feel too bad except when lying on side. Heart rate between 92-120.
When I’ve had AFib before it lasts up to a week and goes away on its own. I don’t know why it starts or stops.
If by day 7 it is carrying on should I start Adizem? I was prescribed some when I first got AF a few years back and it slowed me down so much it was horrid.
Is it safe to carry on with heart rate raised?
I’m sorry but no idea what kind of medication Azidem is? Beta Blockers can give you side effects. Why are you waiting for so long before taking medication?
My main concern if you have been in AF for +48 hours would be anticoagulation, always first line treatment. Your heart rate is quite high and it’s not good to be ‘carrying on’ with a high heart rate for a long time and whilst if you are not symptomatic it may not be an emergency, I would suggest that you go see your doctor or ring 111 or if you are in any way worried or symptomatic go to A&E to be checked out.
Have you seen a cardiologist and when was the last time you saw anyone?
If your tablets have not been used and were sitting in a drawer for a few years please do check and see if they are still in date and know what sort of medication you are taking.
Please ask your doctor to explain what you should do when you go into AF and take notes. In the meantime stay well hydrated and get plenty of rest.
I take Apixaban twice a day as an anticoagulant.
I don’t feel like I’m under a cardiologist as it’s impossible to get any appointments in NHS where I live now. I last saw one a year ago for review. My GP surgery I have to wait weeks for an appointment.
I'll contact them though.
I haven’t actually seen a cardiologist since 2020 so that’s not unusual but I am stable and monitored and have regular telephone contact, GP does bloods every 12 weeks and I get the results. If you are stable cardiology will sign you off after 12 months so you may need to have a re-referral. Appointment to see a cardiologist don’t happen automatically any more. Was the cardiologist you saw an EP (Electrophysiologist who specialises in arrhythmias?
Thank you. I’m not monitored by anyone about anything. I don’t know if the local NHS is able to function any more. Local GP practice privatised and now very tricky to access. I’ll find out if we have an EP in the local trust. I don’t know about this.
In general they like to see your resting heart rate 110 or under. Adizem (cardizem) is prescribed to slow your heart rate down. I don't know how much you were prescribed, but since you're very close to 110, maybe you can ask your doctor for a very low dose, or if you can just forgo it. There is also another drug that works differently, which is the anti-rhythmic Flecainde. Many take it as a PIP (as needed) medication which can convert you to normal rhythm in one to three hours. You might also also ask your doctor if you qualify for that.
Jim
That’s interesting. I’ll ask GP. Thanks.
Unfortunately GP’s cannot prescribe Flecainide in UK unless under direction from a cardiologist but they can prescribe rate control drugs, most of which will make you feel sluggish though so I certainly couldn’t tolerate them. Taking Flecainide without rate control is also somewhat cautioned as Flecainide is a drug which can cause arrhythmias which are considered more dangerous than AF, which is why only prescribed by specialist and after assessment for suitability.
I would urge you to push your GP for a re-referral to cardiology, you may very well need to wait but that’s better than allowing AF to progress without attempting treatment. Sometimes you really have to push your doctor to get things moving, politely of course. Where in the UK are you as maybe some of our members may be able to suggest a good person to see?
If you can afford to, it is always possible to seek a private appointment - cost depends upon area and individual but circa £250 for a private consult, test such as ECG & echocardiogram would of course be extra but you if you can find a specialist who works in a local centre then it would be possible to switch back to that specialists NHS list. Blood (which your GP can do and you should have access to results) should be done every 6 months and with your GP monitoring. Please chase this if not happening.
Accessing none urgent NHS services is very difficult at the moment, AF is considered a none critical, chronic condition so after the first line treatment of anticoagulation and rate control, we can get fobbed off - keep pushing as I found that persistence does get attention.
Hope things have improved for you and you are feeling better today?
Thanks CDreamer. I’m not sure what I’m aiming for right now - meaning, what’s best and what’s available.
I take your point about Flecainide. I err on the cautious side. I don’t feel like I need major interventions. I just heard there was a drug that could settle AF and I didn’t know there might be such a thing. Plus there seems to be an idea that it’s not good to let AF just run. Hence my message here.
My hunch was to let it run, try to get rest. Thanks for the ideas about hydration. I have to remember to drink.
I’ve not had beta blockers and don’t really want them if possible. Do they regulate? And can one them stop taking them when out of AF, do you know?
The Adizem slows HR down so much you can’t do anything
I asked for a change of cardiologist as the first one didn’t pay attention, got all info wrong and just suggested major interventions that I knew I didn’t need. Current cardiologist seems okay but hard to access.
Hi, Adizem is slow release diltiazem. It slows hr, lowers bp, and has a very weak antiarrhythmic effect. So while you are in fastish AF a good choice if your capsules are still in date, otherwise you could get a new prescription from GP or phone 111 since your GP has gone private (never heard of that before 😳). What dose were you on? The problem is that the dose appropriate to an episode of fast AF is too much for NSR. I was taking 120mg of Zemtard but was prescribed an extra 60mg of diltiazem during an episode. This worked great until the 60mg ran out when my GP wasn’t happy about the PIP approach and decided I should take 180mg daily. As I mostly have slow AF now I might try to get a reversion to 120mg because it does slow things down. Your rate is not so high as to cause damage short term especially as you don’t feel too bad, but why wait for 7 days? If this episode lasts for more than 7 days I would phone 111 or go to A&E since a GP isn’t available.
I am in USA and take Cardizem 180 mg daily. This dose has been reduced from 300, 240. My heart rate was dipping into the 50s and made me lightheaded. Talk with a doctor about your heart rate and symptoms.
Thank you. I have been prescribed Bisoprosol today. I haven’t take it yet.
Any advice anyone on what I might expect as side effects? Thanks
Best not read the side effects as everyone reacts very differently. Try it for a few weeks as your body does need to adjust but if you have symptoms after 2-3 weeks go straight back to the doctor and ask for something else. None of us like taking any of these medications but if they improve you quality of life then they can help, if they don’t improve your QOL then it;s not worth taking.
Lightheaded when self converting from afib to sinus 
Sinus Tachycardia following Paroxysmal AFib episode
