Started On Ticosyn

So following my cardioversion last Friday I was scheduled to come back to the hospital to change my meds form Flecanide to Ticosyn. I started the Ticosyn 500/2x along with 50mg Metoprolol on Tuesday morning and converted to NSR a few hours later. They ended up reducing me to 250/2x due to my QT intervals the next day.

Last night when the nurse brought my evening meds I went back into affib with a rate of around 150 bpm. They then gave me another 25mg of metoprolol to try to get my rate down. This brought me down to around 100 bpm with fluctuations below that. I converted back to NSR at around 0400 and have remained there to this point.

One thing that was different about yesterday is that I took Montelukast (Singulair) with my meds in the morning. I take this med for exercise induced asthma and have never had any issues before with it. I have read that Singulair can have effect on folks with AF but it seems to be a rare occurrence.

I spoke to one of my Doctors associates this morning and discussed some short term options going forward. One was to go home on the Ticosyn and see how that plays out. Or spend a couple more days here and start a new drug, Amiodarone, which he seemed reluctant to do as was I

So I m headed home in a few hours on the Ticosyn 250/2x and Metoprolol 50/2x knowing that there is teh possibility of going back into affib.



Edited 1 time(s). Last edit at 04/14/2018 09:57AM by rocketritch.

Some years ago I was put on an Amiodarone drip to revert Afib. It didn't work and when the Cardiologist came to see me the next day his first comment was "I see they've put you on the poison!" Another Cardiologist a couple of years later gave me a prescription for Amiodarone to prevent future episodes. I didn't use it.

Yeah, avoid amiodarone if you possibly can. It's very effective, but it comes with a long list of seriously damaging side effects..

When I first started Tikosyn, I was told by others who had been on it that it becomes more effective the longer you take it. They were right. It took 3-4 weeks for it to become fully effective, so don't give up on it it.

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Carey
When I first started Tikosyn, I was told by others who had been on it that it becomes more effective the longer you take it. They were right. It took 3-4 weeks for it to become fully effective, so don't give up on it it.

The doctor this morning had a similar stance that it may work better as time progresses and hopefully carry me to the next phase. Also, the fact that I did convert on my own is promising. To me anyway.

I also did a search here and it it was mentioned that potassium levels can affect its efficacy as well. Based on testing here last night both my Potassium (3.9) & Magnesium (1.9) levels seem to be within normal ranges anyway.

I took Amiodarone for perhaps two years until the iodine in it hyped my thyroid so high that it burned out. I had to take thyroid lowering medication then start Naturethroid once the iodine was gone. I'm still on the Naturethroid and will always be. This was 20 years ago so there wasn't as much data in on Amiodarone as now exists.

I also didn't know until later how to properly dose magnesium.

I was switched to Flecanide which worked very well for me.

Gordon

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ggheld
I was switched to Flecanide which worked very well for me.

Gordon

I used Flecanide for six months following my ablation back in 2009. I then used it as a PIP but it was becoming less effective. I used it again starting in January following my second ablation but it ended up failing me. Thus the change.

rocketritch,

Where did you have your two ablations?

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mwcf
rocketritch,

Where did you have your two ablations?

UPMC Shadyside, Pittsburgh PA. My current plan is to have a third with DR Andrea Natale in Texas.

Sounds like a good plan!

Had another affib breakthrough yesterday afternoon. I converted this morning.
It's possible that I caused the situation. I was out on the bike on Saturday when I got home and yesterday afternoon. I went into afdib close to the end of my ride today.
I made sure to keep my heart rate low the whole time. My heart rate was around 85 bpm when I went into affib. My average heart rate for the whole ride was 101 bpm. Max was 199 when in affib. That's a number I haven't seen since before my first ablation.



Edited 1 time(s). Last edit at 04/21/2018 05:45PM by rocketritch.

You sound like most of us and me. Flecainide worked great for me for 9 months then less effective, over the year that followed then came a few ablations and hope at the hands of an incompetent EP. I was put on Tikosyn no luck, Multaq, no luck etc. 7 months ago I went to Dr. Natale and sit here today afib free and off all meds. He gave me life back, I was highly symptomatic afibber with compromised ejection fraction.

Do what you have to to survive to see him if daily Flec works so be it. Go see him, don't beat yourself up over what you did, in hindsight it did nothing for me and in the end the only proven formula was Dr. Natale.

Been one week since being released from hospital on Ticosyn. I'm in rhythm about as much as I am out so far. Longest I have gone in rhythm is 28 hours. Shortest time to convert back to NSR is 10 hours. Otherwise I feel like total crap right now. The metoprolol really does a number on me. Especially the 75mg dose I take to keep my heart rate bellow 100 bpm when in affib. The 50mg nocks the snot out of me as it is.

Starting to get frustrated but hanging in there.

Longest stretch of being affib free since starting the Ticosyn.....32 hours. I had a pretty busy day at work today as I filled a position that I don't normally do. Lots of stair climbing and walking around today with no issues. As soon as I got home and sat down to dinner my heart immediately jumped out of rhythm.

So following my record run in NSR I had a record converson from affib back to NSR of 4 hours. So 2 positives yesterday. Now if I can only figure out teh magic combination.

To convert yesterday I took another 25mg metoprolol to keep my heart rate under 100bpm. This is a constant. What I did differnt yesterday is double up on my Potassium and Magnesium. I normaly take it with my meds which it just so happened I went into affib at the same time I was taking my meds.Toook another dose of Pot. and Mag about an hour later.

Just a quick update.

Being on the Ticosyn has been a roller coaster. From the time I came home up until last Tuesday I had small successes. Every time My heart would convert back to NSR it would remain there for longer periods. Last Tuesday I went into Affib as soon as I sat down to dinner after around 32 hours of NSR. On that particular day it only took 4 hours for my heart to convert back to NSR. This was a milestone, I thought, as up until this point it was taking at least 10 hours to convert. So I was kind of excited about that.

I remained in NSR up until Sunday evening at Midnight (5 Days) when I went back into affib. It then took until 1900 Monday evening to convert back to NSR.So I am hopeful that I will remain in NSR for a longer period this time. One thing about Sunday is that it was my first day back on night shift after a short turn around. I did not get a good nights sleep the night before so I was pretty tired so I will blame the situation on that.

Another thing I am pretty sure of is that the Potassium and Magnesium are definitely helping the process. Another notable observation is that I wont convert until sometime after my next dose of Ticosyn. It is also at this time I take an additional 25mg of Metoprolol for a total of 75mg. I'm not 100% sure that this is a factor as I only take the extra metoprolol to keep my heart rate @ or under 100 bpm when in affib.



Edited 2 time(s). Last edit at 05/01/2018 11:47PM by rocketritch.

In and out of rhythm since Sunday. Converted on Monday then back out last evening for a few hours. Then back out of rhythm this morning.

Yet another eposode of affib yesterday evening upon sitting down to dinner. I Converted back in just a couple hours this time.

I'm starting to see a pattern here.

The Ticosyn call ntnues to fail athikding my affib at bay. It does convert me back but I haven't had a fun of NSR for longer than a day now. I had hgh hioes early on but now am at my whits end.
I have an appointment with my EP next week and am waiting on an appointment with Dr.Natale as well. Hopefully I will get some relief here soon.

Not much has changed. I will say at this point I am in rhythm more than I am out so that is a good thing.

Stopped the Ticosyn today in preparation for my ablation with Dr Natale this Friday.

Been off of the Ticosyn since Friday evening. Still on the metaprolol and elequis. I've had a couple stray heartbeats but still in sinus rhythm. Since I am still taking the metaprolol I will start a short taper on that as I am to not take it beyond Wednesday.
I have been out of sorts since stoping the Ticosyn. I slept most of the day yesterday off and on and slept good last night. Still pretty tired this afternoon. Slightly light-headed and feeling a bit out of sorts as well.