Hi all. I’m 57, diagnosed with AF 10 years ago. Well controlled on Bisoprolol for 8 years then Flecainide for 2 years but then episodes increased. Was on Flecainide 50mg twice a day and 1.25mg Bisoprolol. Due to more frequent episodes Flecainide increased to 100mg twice a day and 1.25mg Bisoprolol.
Alter 2 weeks Had bad reaction to increase. Went for ECG and heart rate was 37! Stay in A & E and Flecainide reduced back down to 50mg twice a day then HR back to normal.
Had appointment with Cardiologist who was abrupt and rude. Said it was my own fault AF episodes increased because I’m overweight - I am probably 2 stone overweight but very active and mainly healthy diet. Felt humiliated and embarrassed and am really trying to lose weight.
Cardiologist refused to put me forward for ablation due to weight and just offered amiodrone as only option. Having read side effects I’m apprehensive of taking these.
Would love to hear from anyone who has taken amiodrone and any side effects please.
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Gwright
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So sorry to hear your story. Unfortunately if you are overweight the outcomes of ablation don’t tend to be favourable unless your BMI is under 27 so you are unlikely to get an offer of ablation or a different answer from another EP, but there is no excuse for being abrupt and rude.
I think we all react very differently to medications, some tolerate meds very well, others don’t and we don’t know until we try whether or not we will or not be OK. My husband has taken Amiodarone for 6 years now, 2 years on 200mg/bd, 4 years on 100mg/bd. He has had minimal affects ie: his thyroid has been mildly under active so treated with low dose Levothyroxine successfully - taken x3 weekly. His options were last resort as he has valve issues and aged 90 it’s a matter or weighing up risk:benefit for any other treatments.
Amiodarone is a last resort treatment and a toxic drug but it is the most affective anti-arrhythmic available. If not that, the only other possible treatment option would be Pace and Ablate, again a last resort but can improve QOL and as your HR dropped under 40 on beta blockers/Flecainide you may be considered a suitable candidate, dependant upon age as under 60 there is often some reluctance to go to Pacemaker unless no other safe option.
How symptomatic are you? If not that symptomatic and HR can be controlled then I would consider no treatment and living with AF. Many people live very well in persistent and even permanent AF and report that it is much easier to live with than Paroxysmal AF.
I am really concerned about hearing this, I am waiting to see cardiologist as my persistent AF and heart failure are not being controlled by 10mg of bisoprolol and digoxin and I supposed I would be offered cardioversion or ablation but I am very overweight and trying to lose weight as quickly as possible but did not realize that there would be a possibility of being refused treatment because of it and especially you being told this in such an abrupt manner, I am sorry that this happened to you I would feel humiliated too and I suppose I must prepare myself for the same reaction, can anyone confirm that this refusal for treatment because of weight is the norm?
Being overweight (but not classified as obese) is not an automatic disqualification for the procedure. The EP ideally will evaluate on a case-by-case basis -- overall health and medical history. But each EP may have different approaches influenced by their personal experience.
Switching gears but still on the topic of doctor experiences—years ago, I had to undergo surgery for a congenital hernia, which is a pretty routine procedure. The very first words from the doctor I consulted said, “You could die during surgery.” Well, yes, I knew that—any surgery comes with risks. My surgery, of course, went off without a hitch. But to this day, the only thing I really remember about that doctor was his dramatic flair for being anything but reassuring.
I’m overweight too but have had two successful cardioversions that lasted a few years before breakthrough episodes began again and then stuck again in persistent afib.
I went on flecainade after the second one and it’s been brilliant for me but was told by the EP who prescribed it I wouldn’t be a candidate for ablation as my bmi was too high and also my left atrium was enlarged, (this was probably because I was left in fast afib for months waiting both times, awfully symptomatic ) this EP, a young fit looking man, was also unpleasant, l came out of the appointment feeling completely worthless.
The cardiologist I see now keeps mentioning ablation, I’m getting more episodes and a lot of pvcs which give me chest ache and breathlessness. Also have leaking valves, when I told him what the EP said, he said they can’t just do nothing, but I think if I have anything it could be pace and ablate.
* * * Edited to add, I was given amiodarone, before seeing the EP who gave me flecainade, I asked for blood tests after being on it for three months and my Gp messaged me to make an appointment then asked about my thyroid results being different, I mentioned being put on amiodarone and she took me straight off it.
It did absolutely nothing to help my afib symptoms, no difference in kardia readings and I was really glad to come off it. That’s just my experience though. * * *
I took amiodarone for just over two years without any adverse side effects at 200mg a day. Mind you, it didn't work for me in terms of maintaining NSR. So I stopped taking it.
cheeky cow! Report her. No one needs to be humiliated. I had ablation with a BMI of 30 and it worked and I’ve now lost weight and exercise more without all those drugs and BMI now 27. EP never mentioned weight but very supportive re making changes afterwards.
When I was put forward for ablation, I was about 2 stone overweight. The EP didn't bat an eyelid. By the time the surgery came around my bmi was pretty spot on. But he would have done it anyway. He was only concerned about very high bmi due to risks.Ironically the reason I gained weight was due to underactive thyroid...brought on by amiodarone. The reason I lost weight was because I stopped amiodarone was then being treated for the thyroid, which allowed me to get back to my usual weight. Though the thyroid issue is permanent.
I'm now overweight again due to long term steroid use for rheumatoid arthritis and can't wait to get off them so I can lose the weight. I'm constantly worried it will trigger the AF that's been behaving so well since my third ablation.
Unfortunately with long term health conditions and associated meds weight gain is sometimes out of our control and it can have serious consequences.
I've had some brutal and blunt doctors in my time but yours seems to have taken the biscuit...which perhaps they should have eaten, and spoken from a place of humanity. I wish people would think before they speak. Weight gain is a complex business and a very sensitive issue.
I hope you are able to lose weight, for yourself, and get the treatment you need. I also hope you can rise above the insensitive comment and not let it get in the way of you living life the way that is most congruent and healthy for you. We are all different.
My own experience with Amiodarone wasn't good, I had extreme skin sensitivity and disturbed sleep while on it. But some people seem to tolerate it so I'd suggest you see how it makes you feel. You will need regular checks on your thyroid function.
how rude of that cardiologist and so upsetting for you. . We all know that being overweight is not good for is, but the way if saying that to you when you feel ill enough was horrible and to lose weight especially if our afib prevents too much exercise is not easy to lose weight. If possible could you change to a different cardiologist
I can’t help on the amiodarone as I’ve never taken that, but regarding the flecainide as I have been told it can cause extra flutters. It was a miracle drug for me but now I have permanent afib I’m told I can come off it as why put a toxic black box in my body if it’s no longer doing any good. I haven’t as yet but I am going to try to wean off it
Of course mine is a different situation to yours, but I guess you will get lots of information from others on here
I took Amiodarone for 6 months prior to planned ablation since no other drug worked for me. Depending on your age, you should only be on Amiodarone for 6 months due to its long term detrimental effects (it's basically toxic but, it works).
By the way, taking beta blockers to slow heart rate will cause weight increase. The AF making you less active will also cause weight increase. You need to find a new consultant, if you can afford it, go private for consultation but wait for ablation on NHS if UK.
Very sorry to hear your experience with your Cardiologist. I empathise with your reaction as I too was upset by a professional telling me I was overweight when my heart was deteriorating.
I think what is sometimes missed by the professionals in the "heart" field is that over the long term, when a heart is struggling, that one can, and very often do, put on weight. Water retention in the body being the principle culprit, as the heart fails.
From my long term experience, I found that when I received the right treatment, my heart worked better. My experience was that I ballooned with water retention over several years -it looked like I was overeating, which I was not. Even I started to question whether I was overeating.... I felt so unwell.
When I had my ablation, followed by a pacemaker, my heart was pumping better and I shed a lot of weight.
I joked at the beginning, I could not go very far from the bathroom. I lost 4kg over time as I was able to resume life and get fitter as my heart was not putting my body under the strain of being unwell, with my heart failing my body.
Not only was I gradually gaining more weight but other adverse health conditions were being triggered.
I note that you say your heart was recorded as beating at 37bpm. Has anyone mentioned Bradycardia to you? Please look into the medication Amiodarone as Amiodarone is contra-indicated for anyone with a history of Bradycardia.
I had a very bad experience with Amiodarone because I was prescribed it by a professional who had not read my notes....
You say you have seen a Cardiologist. Do you know if he/she is a Electrophysiologist.
It was described to me that a Cardiologist looks at the "plumbing" of a heart and an EP the "electrics".
Have you considered seeking a different professional? e.g. Electrophysiologist (EP)
"An electrophysiologist is a doctor who's an expert in diagnosing and treating issues with your heart's electrical system. A type of cardiologist, they can do testing to find which area in your heart is causing a problem with your heart rhythm."
I hope you find a way forward that is right for you Gwright.
Just adding sympathy here, I had a meeting with a very unpleasant consultant recently and my only consolation is that the echo he reluctantly ordered showed a potentially very dangerous problem which fully justified the rapid access appointment he was so sulky about 😐 I hope you can find someone with a better attitude.
Use this incident has a great opportunity to get mad and lose weight. In the last year I have lost 79 pounds (30 percent of my body weight) and I put Afib into remission. I also take 100 mg of Flecainide twice a day and 50 mg of Metoprol once a day and I radically changed my diet, especially eliminating totally gluten and cutting out sugar wherever possible. As I said, view this as a great opportunity to turn things around. You can begin now. Your body is like a child, it has to be told what to do, not the other way around. Have confidence in yourself.
Hi, firstly I would acknowledge and agree with the comment posted by CDreamer. As for rude and abrupt cardiologist's, this is precisely my experience of these people who put themselves on a pedestal. Turning to Amiodarone, after only two years on this terrible drug I now have damaged lungs resulting in breathlessness and even more troublesome AF. Oh and I nearly forgot, they decided to destroy my Thyroid with a Radioactive Tablet just in case my thyroid was a contributing factor to the AF. Since, I too have gained weight and am continually badgered and told I need to exercise and loose weight, forget the fact I have been active all of my life and ran a 24-7 business for 35-years. Sorry to be negative however based on my life experiences, I really don't have a lot of time for these experts in white coats who do what they do because that's all what they do.
I posted the same question about Amiodarone about a year ago and received over 100 replies. If you enter Amiodarone into the top search engine, it will be amongst the results, feedback was very informative. Then obviously you can take your own view.
Amioderine is a very tough medicine for many aparently. I took it for 11 days and persevered with its nastiness. I could stand it no longer and called the ambulance. They put ecg on me in the ambo and then I flatlined for almost 2 mins aparently.. in the hospital the ambo officer came over and told me he had to bash hell out of me.. I asked why he hadn't used the defib ? He said that doesn't work if there is nothing happening !!Needless to say I'm listed off amioderine.
I opted for an ablation to avoid taking drugs like amioderone and flecainade as they did some damage to my younger brother and both carry a black box warning. Still in the blanking period but so far so good. I would go for a review to a private cardiologist and get him to advise you for an ablation and then go on the NHS waiting list for it. I think you are very young to be on these medications to be honest with you, though this is just my opinion. A private consultation shouldent cost more than £ 200-£250 and would be well worth it.
As CDreamer has posted, amiodarone and the sister drug dronedarone should be the medication of last resort. However, that isn't always the case. Some people have lasting damage to their thyroid, or they develop cataracts. In rare cases, of which I am one, you develop pulmonary toxicity; that is, one or more masses in the lungs. The prognosis is not good if that happens, but I am still here. Is Ozempic a possible aid to weight reduction for you?
We all want the truth , but it’s how you say it. Words matter. Your Cardiologist requires a lesson in patient management and encouragement. Having worked as a nurse for many years I’ve learnt how important it is to chose your words. My husband was offered Amiodorone and refused after looking at the side effects,saw a different Cardiologist who changed his meds (not Amiodorone).He remained on Flecainide but another med added and he hasn’t looked back so far.I am on Flecainide and bisoprolol,and have gained weight that I struggle to lose.Im afraid it’s the effects of the medications in most cases.Change your Cardiologist or better still see an EP that’s what we did. Take care.
This sounds very much like my story except I have more to lose before being considered for ablation. I was on Bisoprolol and flecainide for 8 years but after Covid the AF came back. I was put on digoxin which really didn’t agree with me. Story cut short but have been on Amiodarone for a year with no ill effects (never say never though). I’ve had one bout of AF due to stress but I think the Amiodarone helped to cut it short. Previously I had it for 36 hours. I guess it’s up to the individual. I also requested regular bloods but this needed to be done at cardiology as GP says I’m under their care which is a bit of a faff! However so far so good.
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Experience with amiodarone
Increasing Flecainide daily dose
Flecainide maintenance dose with beta blocker
Atrial flutter and increase in flecainide
Visit to GP re sudden rise in pulse rate ( regular) for next to no reason
