Amiodarone and its impact

[domhnalldubh]

In my last post, I described my cardioversion on January 2nd and the immediate relief that it provided. Unfortunately, after one glorious week, I reverted to AFib. For me, this means a deep level of listlessness and fatigue, a constant headache, and very irritating roaring tinnitus. It is like living behind a waterfall or in a jet airplane ( economy class) The doc suggested that I drop the sotalol that I had been prescribed and try Amiodarone. Before allowing me to proceed, he subjected me to a number of tests to establish a baseline by which to judge later levels. First an ECG, then a blood test that revealed that liver enzymes were high but insufficiently high to abandon the plan. And then a pulmonary function test to get a sense of how good my lungs were. This latter test was somewhat bizarre but apparently is needed because Amiodarone may have a toxic impact on the lungs, and they'll have something to compare with future test results. So I started a loading dose of Amiodarone - 800mg daily for 2 weeks. Exactly one week later, at 6am, I woke up in silence, checked my Kardia and discovered I was back in Normal Sinus Rhythm. I took my ancient dog out for a short walk (half a city block) and found that I was back in AFib but after relaxing on my couch I again returned to normal sinus rhythm . This pattern continued throughout the day: when I increased my heart rate, it seemed that I would descend into the black hole. Magically when I returned to the couch and waited about ten minutes I'd get an all clear. Am I right to interpret this as a sign from the deity that I was born to be a couch potato?

[CDreamer]

Couch potato? I hope not! I believe that you can take it as a sign the Amiodarone is starting to work and that your current AF episodes are triggered by high HR.

The sort of pattern you describe mirrors that of my husband when he started Amiodarone some years ago. It took about 3 months on a much lower dose - 200mg - to slowly convert to NSR and it stayed during which time he was gradually able to be more active, although never quite recovered his pre AF activity levels. He is now 91 and apart from a very few AF episodes, normally in NSR and has reduced Amiodarone to 100mg maintenance dose with very mild toxic affects, with a much improved QOL (he had been in heart failure 6 years ago prior to starting Amiodarone).

Another person’s story does not predict how you will react but it sounds as though you have had thorough screening prior to starting medication and that it is beginning to show positive signs it’s working for you.

[mav7 in reply to CDreamer]

domhnalldubh Another person’s story does not predict how you will react

Very wise/sage advice by CDreamer and the info in the post.

May I ask if your afib was paroxysmal or persistent/permanent prior to the cardioversion/amiodarone ?

[domhnalldubh in reply to mav7]

It became persistent last July after a long period of time during which it was on again/ off again.

[RF260]

Hi, I was in persistent A fib (24/7) which began around August last year. After various tests including Echocardiogram, 24 hour holter etc I was booked for Cardioversion mid Feb. They offered Amiodarone on the basis that it might convert me on its own or might help the electrical cardioversion hold for longer, I decided to take it.So on 2nd January I started loading dose planned as 600mg daily week 1, 400mg daily week 2 and 200mg daily thereafter.

On 11th January I felt a bit more energetic, checked my Kardia and was in NSR. Thankfully I'm still in NSR and now on the daily 200mg daily dose.

I have an ECG at GP tomorrow, if that confirms NSR and looks ok I assume the CV will be cancelled.

So all being well my next decision is if and for how long to stay on Amiodarone, that decision will be supported by blood test results that are planned for 10th Feb.

There are alternatives but maybe not as effective as Amiodarone but with lower potential side effects and shorter half life.

So it's worked for me but will be happier once I get bloods done to check no nasty impact on thyroid etc

Good luck.

[Amiodaroneluck]

Wow, I feel your pain. I had my loading dose in the hospital. Subsequently, they put me on a maintenance dose of 200 mg a day, a dose which I've read has minimal association with bad side effects for most people. I was one of the lucky ones who had few to no bad side effects with Amiodarone. But it is true that some people have bad and even fatal lung and other problems. Physicians are aware of the potential for these effects. So if your docs keep close tabs on your reaction to the drug, you should be fine. I hope you react to it like I did. which was pretty minimal. FWIW, in 2024, after 14 years in NSR, and down a 100 mg/day dose of Amiodarone, I went into AF again. I got a cardio version and then I had a third ablation in July. Because they couldn't stimulate me into arrhythmia in the operating theater, they did the full monty on me and zapped all the likely culprits for arrhythmias to be sure. For the first couple months, I still had some sporadic arrhythmias which is part of the recovery process, but those episodes they've decreased in frequency to 0 after a couple of months and since the first couple months after ablation, I've been fine. I go in for my 6 mo post op check up at the end of February. If amiodarone works for you, you will be happy to take it. But in some people it can have devastating effects. If your doctors are on top of your response to amiodarone, ie. chest X-rays every 6 months, potential thyroid issues due to iodine metabolism etc. and you minimal bad side effects, amiodarone can be a game changer for you. And if you are a candidate for an ablation treatment for Afib, I suggest you go for it. The technology has gotten so good that the worse part of the whole process for me were the IVs that are necessary for the procedure. Even the wound from the catheter, other than the extensive bruise around it was minimal.

[yorkmin]

You might try Dr Mercola Berberine. Also I use Plum Flower BrandThe Great Pulse teapills, the last at bedtime, to avoid AF. I use one or the other 3 times a day.