Drugs That May Cause or Exacerbate Heart Failure

Might be useful reference material. Recently released.

[www.10tv.com]

Read it, thanks.

Liz

Thanks Larry. I hope people reading at the Afib side of the forum read this because it's a good heads up.

Very revealing and disturbing... especially this segment ...on anesthesia medications and potential effects for those of us in the aging population opting for ablation procedures that involve both the time and drug combo.

I was also disturbed to see the Major influence category for flecainide and several other popular drugs used for AF.

Jackie

Anesthesia Medications
With an aging population and increasing prevalence of
patients with HF, a growing number of high-risk patients
are undergoing surgical procedures with an increased
risk of perioperative cardiac morbidity, mortality, and re-
source use. Hammill et al 20 observed a 63% increased
risk of operative mortality and a 51% greater risk of
30-day all-cause readmission among patients with HF
compared with patients without HF or coronary artery
disease. Most anesthetics interfere with cardiovascular
performance, by either direct myocardial depression
(negative inotropy) or modification of cardiovascular con-
trol mechanisms (ie, heart rate, contractility, preload, af-
terload, and vascular resistance)

. Without HF Dronedarone is of benefit, according to this article as with most of those drugs listed.

.

Dronedarone
Like amiodarone, dronedarone inhibits the calcium, so-
dium, and potassium channels and is both an
α
-and a
β
-adrenergic receptor antagonist. Dronedarone therapy
reduced death and cardiovascular hospitalizations sig-
nificantly in ATHENA (A Placebo-Controlled, Double-Blind,
Parallel Arm Trial to Assess the Efficacy of Dronedarone
400 mg bid for the Prevention of Cardiovascular Hos-
pitalization or Death From Any Cause in Patients With
Atrial Fibrillation/Atrial Flutter).
67
A post hoc analysis of
a subset of 209 patients (of a total of 4628) with stable
HF in that study found no increase in mortality and a
trend to decreased cardiovascular hospitalization with
dronedarone.

Liz

Not sure if this is right place to post, but it's "doing my head in" having one doc give me a pile of drugs, and another adding to this.

I've never been one to grab a pharma drug, but since June feel bombarded.

Latest is a very rude ophthalmologist whom I had the misfortune to see on Friday who has prescribed pilocarpine drops for my long standing glaucoma. Had what I can only describe as a tantrum when I asked questions about drugs.

Getting a GP appointment is getting increasingly difficult, the only holistic one I know of is taking no new patients.

Know pilocarpine affects the para sympathetic NS but can't work out if that's dangerous for my afib, presently under some sort of control with Bisoprolol, Ramipril and
OAC warfarin.

Comments appreciated.

Hi Joyce... sorry I didn't see your post until just now. It's unfortunate that the doctor had a tantrum over your very valid questions.

Consider asking several pharmacists about your concerns over drug interactions and/or contraindications for afibbers. If you ask several and have a consensus, then it may help you feel comfortable using it. Certainly, it's important to address the glaucoma issue.

Let us know what you learn.

Best to you,
Jackie

Thankyou Jackie. I asked one pharmacist about interactions and he seemed to think AOK, don't know why I didn't think about more opinions!

I did decide to go backwards and re schedule the appointment I should have had in June and wasn't able to keep, with a senior ophthalmologist in England..... Dec 13th.

So will report back.

Thanks again