Many of you will remember my post about 3 weeks ago when I was in fast AF and felt dreadful and I really appreciated all of your help and support. Just an update - I couldn’t get to see the cardiologist ( or even speak to him or anyone! ) but coincidentally was called for a CT angiogram that week. I arrived and they did an ECG and found my HR was in excess of 180 and the next thing I knew I was in the resuss department! They tried to bring the heart rate down with a variety of drugs but unfortunately that all failed so I ended up having a cardioversion yesterday. It was definitely nothing to worry about and I did feel absolutely wonderful . They let me go home after a week in hospital - normal BP normal HR and no AF- totally amazing. Then at 3 am I went back into AF! I couldn’t believe it. So back to square I Heart rate not quite as high at the moment but still over130… I have been taken off bisoprolol and dijoxin and definitely flecanide and I had 24 hours intravenous amioderone and yesterday was put on verapamil (40 mg x3 times a day) Spoke to cardiology this morning and they’ve doubled that dose to 80mg 3 times a day- currently feeling quite light headed but I haven’t had any time to research verapamil and only know it’s a calcium channel blocker - I presume it’s widely used so any info would be appreciated
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123Elizabeth
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Sorry to hear of all these woes but glad they are giving you speedy treatment and working to help you.Many people have verapamil as an alternative treatment option and do well upon it, especially those that have early side effects or suffer hypotension using betablockers. Often things like verapamil or candesartan can work more effectively on certain heart patients than the more common first line medications. Although they don't always discover the core physical causes of your aFib outside the heart it's often because the aFib causes can be for neurological.autonomic/ vagal and cardiovascular reasons that aren't just triggered by electrical messages in the heart muscle alone.
The whole situation you've been dealing with, as well as the use various drugs to control it, will have worked to make you more light headed initially anyway, it may not just be the verapamil. Your whole body is in a bit of a spin and in catch up mode at the moment.
You'd need to give it a few days to two weeks on verapamil to really work out if it is the sole cause of light headedness or other side effects and whether those issues were manageable or improved by getting a reduced dose once your aFib is back under better control.
Are they considering doing another cardioversion or other procedure in the future , or have they decided you would be better off just using drug control for the future?
Take care and thanks for the update. Do get as much rest as you can and let us know how things go, hugs. Bee
Thanks for replying. I think a period of iv ameoderone then tablets is being considered plus a further cardioversion - if that doesn’t work they are talking about an ablation. I’m very I keen on an ablation but can’t go on like this so we’ll see. After an initial drop in heart rate for increasing the verapamil - I’m now back at 130 but I’ll give it over the w/e to see if it settles - fingers crossed!
Realistically your H/Rate Day at rest should be under 100.
Anaesthetists will not allw an operation if you are not controlled.
I am so happy on Diltiazem. It's job is to keep calcium out of the muscles in your heart. Bisoprolol stops adrenalin from entering your heart. Some folks use it to feel less anxious.
BBs were only good as low dose 2.5mg at night for BP.
I would change to Diltiazem via a consuktation with your Specialist or because. you are on a CCB your Dr. Go carefuly because 1/2 dose 180mg took me down to 51 in 2 hours as it was introduced.
I trust you have had an ECG, a ECHO or CT Scan of Heart and a 24hr Heart monitor which tells what your meds are doing.
I had 3 in 2021 before I was changed from Metoprolol, then Bisoprolol then Diliazem & Bisoprolol.
Well you would! 80mg x 3 times a Day! Far too much you must be lightheaded at least.
And is your ankles swelling. I'm worried about you.
180mg Diltiazem made me lightheaded, I could not drive.
120mg Diltiazem made the difference.
Pop your feet up at night or raise nd of bed. Better than having to get swellind down after Elizabeth.
Trouble I see is that you should have had ECG, Echo or CT Scan and 24hr monitor before they decided on anything.
I had a CT Brain Scan with a rapid AF and Thyroidectomy before those were done but I had 2 anaesthetists and 2 doctors in at my operation.
I see my discharge showed 135bpm! No one saw that and helped ongoing. I couldn't exert myself. No follow up except for surgeon.
Things get missed. I was all plugged in before someone came in stopped the monitoring I was taken downstairs, had a carotid arteries scan and that's where the scanner Jade found a shadow on my thyroid. Never went back to my room but instead transferred to my local hospital and never to have anything more done or to see a Dr there. Yes therapists were set up the following Monday and I was discharged Tuesday, fatigued, and with knowledge that I had consented to a biopsy on my thyroid.
I couldnt make my bed, walk up my driveway. Anyway not allowed to drive after stroke. 6 weeks then Locum said Driving Test and waited another 5 weeks for that.
I felt so isolated yes finally homehelp started 1 day week 2 weeks after discharge.
Do rest but walk. Your heart is a muscle so needs exercise. Why to keep it strong.
Ver... is a must more risky med than Diltiazem. I'd ask why Diltiazem was nt tried first. Small steps too. Lower dose of 120mg worth trying first. Yes, once a day. Some people take it twice a day. Mine is CD taken early morning. 1 hour after my Thyroid Synthroid tabs under tongue.
You haven't been cared for because if you have abnormality in the lower chambers the ventricles, YOU SHOULD NOT BE TAKING ANY CCBs - VER.... for one, FLEC.. another.
As I said NO CARDIOVERSION, NO ABLATION, OR ANTI-ARRHYMNIC MEDS SUCH AS FLEC. CCB DILTIAZEM OK.
i have severe dilation of left atrium and my systolic pressure and function ok. so no ventricle abnormality.
Please get interested in results of your blood tests etc get your Dr to do some of the heart levels.
Are your thyroid functions ok.
TSH. BETWEEN 0.6 - 4.2
T3. 3.9 - ? forgotten
T4 under 22
Have your thyroglubin serum level.
also thyroglubin antibodies
thyroid problems cause AF heart rate rapid or slow.
At night do you have a quieter heart rate? Mone goes down to 47avg.bpm.
hi I had bisoperal changed to verapamil as bisopera made my asthma worse I have been fine on verapamil no issues consultant said I might get swollen ankles and constipation my ankles haven't swollen and as far as the other I take plenty of prunes I have permant AF controlled with medication I take 120mg verapamil twice a day and 5 mg apixoban I feel very well neither cause me a problem hope that helps
Bad luck in getting all this trouble. My AF is more regular these days but at a somewhat lower rate and I find this rather easier to deal with. I have only once been into hospital with it, and that was just after my ablation in 2019 when the rate was very high (along with my anxiety levels!).
You do need a way to reduce the duration of your AF if it is very symptomatic but I think it is the rate, above all, that needs controlling as this seems to be the cause of symptoms in most people. Can I ask why you stopped the flecainide? That seems to help a lot of people. I have been given it but have taken only one dose so far.
Hi.This was the second time I was given flecanide. The first time I ended up in a&e with a very high heart rate( 200 plus) The consultant thought it was worth another try so I took it for 4 days / and I think it was the reason my HR is currently still high. When taking it my heart rate increased dramatically and I felt ill beyond words - I felt too ill to go to a&e and honestly didn’t think I’d see the dawn! Hence why I stopped taking it. That’s only my experience of course which is not necessarily typical of others. I know that flecanide is said to be very good for those who tolerate it- unfortunately that didn’t include me! Best of by luck with it and thanks for your reply!
It is a potentially dangerous drug so I think you’re being wise. I took it just once recently and had a day (indeed several) free from all arrhythmia but… with some strange heavy pounding. My GP said to go back to bisoprolol, which I have, but my consultant rang and said I would be fine to continue. Since then, I’ve been rather more settled heart-wise so have left it in the cupboard!
I was prescribed it and lasted about 48 hours as I felt like a bag of the proverbial. I would never touch it again. They may try a loading dose of Amiodarone for a few weeks prior to trying another cardioversion.
I'm 8 years, 8 cardioversions and an ablation in and having had 2 AF free years, I was gutted when it kicked off again in April. I had almost forgotten how awful it makes you feel.I'm also waiting for valve surgery and a Cox IV Maze, which probably doesn't help.
Thankfully, another cardioversion got me back to nsr.
I have taken Amiodarone for quite some time but wouldn't touch Flecanide again.
Sounds terrible! How different we all are. Flecainide seems to work very well for me and I have recently reduced the first dose to 50mg with the evening one remaining at 100mg and continue to be free of AF episodes.
I was put on CCB Diltiazem and settled controlled AM 120mg. It worked within 1 hour!
BBs did not control my rapid rate Metopolol 186 and pauses at night with H/Rate 47bpm (its my normal) and specialist saw cghanged me 1 year 5. months later. Bisoprolol tried next 154 H.Rate Day with 47bpm Night avg no pauses.
Still uncontrolled as above put on CCB Diltiazem AM. Now 60s Day H/Rate.
Great, sorted.
I have an abnormal atrium severely dilated. No cardioversion, no ablation and no Flec.. an anti-arrhymic med.
CCB Diltiazem acts like an anti-arrhyma and its safer.
Heaps more side effects with Ver............. I have no side effects with Diltiazem.
Thanks for your replies - I’ll ask about Diltiazem because I haven’t heard of before and if it has no side effects but does the job that sounds perfect!
Diltiazem is simply another Calcium Channel blocker. And I'm sorry you're having such a rough time - must be frightening. I hope they find a workable solution for you.
What a difficult time you've been having. We know what it's like. I hope the medics find the right solution for you very soon.
Have you tried breathing techniques? It sounds unlikely but just try and breathe deep (right down to your belly) and breathe out very slowly ... over and over, if you can keep practicing deep breathing it can help.
hi thanks for the reply / I’ve always done the breathing and I’m not an anxious person- just very fedup with feeling under the weather! Hopefully they will sort it soon!
I am 82 and had the new pulse field ablation in New York, April 15 , by Dr. Reddy. I had paf. The procedure was a breeze despite me being a high anesthesia risk because of scoliotic restrictive lungs. I had some ectopy during that time which had abated. I also have other health issues but am resuming my activities and exercise. The procedure was about hour and half under general anesthesia. It’s also done under sedation.(Retired nurse anesthetist US).
I don’t fear the new technique - pulse field ablation. So far so good. Continuous AF wears out the heart -can lead to heart failure. In my case I could breathe better because the heart pumped blood more efficiently through the lungs - said my surgeon.
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76 years old with A F
apixaban and hematuria 
3% Afib burden and proposed medication
breathlessness 
PVC’s and Travel
