Coming off Amioderone

[Jewel7]

Hi All,

My husband is post AVR 7 weeks now and got the all clear by the cardiac team. He had an arrithymia about a week after leaving hospital which returned to normal sinus rhythm 4 weeks post AVR. He is still on Bispronol 1.25 mgs and on Amioderone 200 mg per day. At what point did anyone in the same situation come off their Amioderone my GP said around the next week.

Regards,

[Hidden]

Hi Jewel, sorry I can’t offer full help, my situation was open heart surgery to fix hole-in-heart, not valve repair, but in case helpful.

I had a big Afib before leaving hospital. Heart rate 150 for 36 hrs. Bisoporol had no impact, started amiodarone. That didn’t work initially, had to be cardio-verted.

I stayed on amiodarone about 8m in the end. I kept getting flutters post OHS, some made worse by stress & anxiety. But none turned into non-sinus as far as I’m aware.

Was you husband in non-sinus for 3 wks???? I hope not.

Anyway, my experience suggests not using GP for advice re amiodarone, or detailed heart recovery. Whilst my Gp is great, he’s not a specialist and often doesn’t know what to look out for, nor the specific risks re meds.

Did your husband get a contact point, such as specialist cardio nurse? If not, ask for a contact. I’d call them to ask about amiodarone timing. They may well arrange a phone chat with cardiologist if there are Q’s to resolve, or may pass on a message if ok to stop. I had a 5day Holter ECG to check I was fully in sinus before stopping & timing compared to stopping warfarin was also discussed.

If your husband was in Afib or non-sinus for 3 wks, that sounds significant & I’d have thought the anti-arrhythmia meds might continue longer, especially if the valve op was open heart (rather than catheter). I’m no medic, but I’d definitely seek specialist cardio doctor advice before stopping. I know it’s not a nice drug, but sometimes it’s the lesser of evils. All the best

[ILowe in reply to Hidden]

Some GPs have worked as cardiologists so may know about these things. The ones I know defer to the hospital doctors for drugs like amiodarone. It is not just a matter of stopping amiodarone. The hospital doctors may want you to stop amiodarone, and start safer alternatives such as flecainide with bisoprolol. Only a specialist can select an alternative that fits you. In Britain, only hospital doctors are allowed to start you on flecainide. To complicate matters there are dosage reductions of flecainide/bisoprolol to consider due to the way amiodarone stays in your system for months.

Having said that, most people eventually come off amiodarone. The question is when, not if. A good marker on that is to avoid taking more than 30 grammes of it, since the more serious side effects tend to kick in above that, which translates to 2-3 months, at which point the benefits of amiodarone (in keeping you in NSR, are negated by the increased risks.

[TroublewithAF]

Can't say about coming off the drug, but I only took Amiodarone for 4 weeks but the effect of it lasted for 4 months for me.It does say on the packet advice that 'side effects' can still continue for a long time e.g. 2+ months, so still be very careful of the sun.