Full blown afib episode...I have questions

Hi all and thank you in advance for your knowledge, experience and generosity!

I had an ablation 7.5 years ago and was afib free up until a couple months ago. I started having PAC’s and a couple afib lite episodes that didn’t last very long. Yesterday morning as I bent over to pick up something I went into full afib mode. Lasted 11 hours. Went to the emergency room after about the 4th hour. They couldn’t get me to convert. Filled me full of metropolol and digoxin. I was going from the 70’s to the 130’s. Back and forth, back and forth. They offered to cardiovert me, but said it probably wouldn’t last.

So, they sent me home with a new prescription of digoxin and told me to keep taking my metropolol as well. They said I may just have to live with being in afib and as long as my heart rate doesn’t get too high (over 110) then I am in no danger. They said the metropolol will keep the heart rate down and the digoxin will keep it from jumping all over the place. This came from the on-call cardiologist at the hospital. When we talked about me being an athlete she said there were other avenues of drugs we could try. She did mention also having another ablation as well.

I feel very disheartened as this does not feel like a very good way to go about my life, I went from being afib free to possibly living with permanent afib in a matter of 2 months. I’m a bit shell shocked, to say the least!

I’m a fighter and do not give up that easily. I am going to get more serious about magnesium -potassium-taurine and following up with that cardiologist as she actually understood what it was like to be an athlete and on these drugs. Being that I am a member of an hmo, Natale is out of the picture as I am sure he is super expensive if you have to go out of pocket. But, if I were to go that route, does he have an office and perform procedures here in Los Angeles? I think I read he has an office here in Thousand Oaks, CA.

Anyway, thank you for reading my story. Any suggestions on what path(s) to take next? Thoughts on what I can do to not have 11 hour afib sessions? And thoughts on how I can enjoy being an athlete again?

All suggestions, thoughts, opinions and flames welcomed.

Steve

Yes, Thousand Oaks. Maybe you just need a touch up ablation. Many posters don't like Digoxin. Diltizem works pretty well lowering the pulse. Sorry about your dilema regarding being an athlete. A lot of athletes get afib, although I'm sure that's no consolation.

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jpeters
Yes, Thousand Oaks. Maybe you just need a touch up ablation. Many posters don't like Digoxin. Diltizem works pretty well lowering the pulse. Sorry about your dilema regarding being an athlete. A lot of athletes get afib, although I'm sure that's no consolation.

What about Digoxin do they not like?

Sorry to see your having issues again. Could be you just need a touch up ablation as jpeters mentioned. I’ve had 2 touch up procedures this year . One by the same EP that did my first ablation back in 2009. Then a more comprehensive ablation done by Dr Natale mid July.

Following my ablation in 2009 I was afib free for 5 years then used flecanide and metoprolol as a PIP for the years that followed when I would have an episode,until they no longer worked. I get the being an athlete thing as you will find many here that have found themselves in the same situation. It’s also what probably caused us to find our way to this site.

Will someone please point me to the area that talks about quantities of Magnesium, Potassiumand Taurine needed.

Thank you so much!

Steve

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Socalsteve


What about Digoxin do they not like?

It worked well for me, but some had reactions and there are studies indicating increased mortality rates.

You need an EP. Digoxin is an inappropriate drug for afib. It doesn't prevent afib, there are better rate control drugs, it has a narrow therapeutic range, and it increases mortality.

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Carey
You need an EP. Digoxin is an inappropriate drug for afib. It doesn't prevent afib, there are better rate control drugs, it has a narrow therapeutic range, and it increases mortality.

"What does digoxin do to the heart?
It strengthens the force of the heart muscle's contractions, helps restore a normal, steady heart rhythm, and improves blood circulation. Digoxin is one of several medications used to treat the symptoms of heart failure. It may also be prescribed if you have atrial fibrillation (a common irregular heart rhythm)."

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jpeters

What about Digoxin do they not like?

It worked well for me, but some had reactions and there are studies indicating increased mortality rates.

Digoxin was the very first drug I was put on when I was first diagnosed. It made me feel terrible along with making my afib worse.

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jpeters
t strengthens the force of the heart muscle's contractions, helps restore a normal, steady heart rhythm, and improves blood circulation. Digoxin is one of several medications used to treat the symptoms of heart failure. It may also be prescribed if you have atrial fibrillation (a common irregular heart rhythm)."

You're quoting old information. None of those effects have been confirmed in placebo controlled trials but what has been confirmed is that people who take digoxin for afib are more likely to die. No knowledgeable cardiologist trained in recent years prescribes digoxin for afib without heart failure.

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Carey

No knowledgeable cardiologist trained in recent years prescribes digoxin for afib without heart failure.

I was prescribed digoxin by Stanford Health, and restored ejection function from low 20's to 55. Digoxin was just prescribed to the poster. Unlikely the poster is going to get heart failure from taking his prescribed dose.



Edited 1 time(s). Last edit at 08/12/2018 01:56PM by jpeters.

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Socalsteve
Will someone please point me to the area that talks about quantities of Magnesium, Potassiumand Taurine needed.

Thank you so much!

Steve

Everyone’s needs are different. Be sure to get high quality supliments. I uses chelated magnesium and high quality potassium. Not sure about the taurine as I have never used it.

For the magnesium I continue to raise the amount I take to tolerance then decrease the amount until things settle out.

For potassium I take about 1500 mg a day. I try to eat bananas to get as much natural K as I can as natural K is better absorbed. The absorption of K willl be better once you get your magnesium levels up.

Hope that helps.

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rocketritch

Will someone please point me to the area that talks about quantities of Magnesium, Potassiumand Taurine needed.

Thank you so much!

Steve
Everyone’s needs are different. Be sure to get high quality supliments. I uses chelated magnesium and high quality potassium. Not sure about the taurine as I have never used it.

For the magnesium I continue to raise the amount I take to tolerance then decrease the amount until things settle out.

For potassium I take about 1500 mg a day. I try to eat bananas to get as much natural K as I can as natural K is better absorbed. The absorption of K willl be better once you get your magnesium levels up.

Hope that helps.

Thank you!!!

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Carey

t strengthens the force of the heart muscle's contractions, helps restore a normal, steady heart rhythm, and improves blood circulation. Digoxin is one of several medications used to treat the symptoms of heart failure. It may also be prescribed if you have atrial fibrillation (a common irregular heart rhythm)."

You're quoting old information. None of those effects have been confirmed in placebo controlled trials but what has been confirmed is that people who take digoxin for afib are more likely to die. No knowledgeable cardiologist trained in recent years prescribes digoxin for afib without heart failure.

Wow! Thanks! I do believe the digoxin was more recommended while I’m having a long term afib episode as opposed to daily usage. The way it was explained was that the metropolol would lower rate and the digoxin will keep me from the rate jumping all over the place and making me more comfortable . I was going from the 70’s to the 130’s during my episode.

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Socalsteve

Wow! Thanks! I do believe the digoxin was more recommended while I’m having a long term afib episode as opposed to daily usage. The way it was explained was that the metropolol would lower rate and the digoxin will keep me from the rate jumping all over the place and making me more comfortable . I was going from the 70’s to the 130’s during my episode.

The metoprolol should control your heart rate itself without the digoxin. The only thing is figuring out the dosage required to do it. Adding and anti rhythmic drug would be a much better choice than the digoxin IMHO. You really need to see an EP.

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jpeters
I was prescribed digoxin by Stanford Health, and restored ejection function from low 20's to 55. Digoxin was just prescribed to the poster. Unlikely the poster is going to get heart failure from taking his prescribed dose.

I didn't say he was going to get heart failure from digoxin. Quite the contrary -- digoxin is prescribed for heart failure, which is why you got it with an ejection fraction of 20%.

Again, digoxin is no longer recommended for the treatment of afib. It actually increases mortality in afib patients so why would a cardiologist who knows that prescribe it? The answer is they wouldn't. I pretty much judge people's cardiologists when they come here reporting they've been prescribed digoxin and aspirin for their afib. That tells me the cardiologist has been out of med school for 30+ years and hasn't maintained his continuing medical education.

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Socalsteve
Wow! Thanks! I do believe the digoxin was more recommended while I’m having a long term afib episode as opposed to daily usage. The way it was explained was that the metropolol would lower rate and the digoxin will keep me from the rate jumping all over the place and making me more comfortable . I was going from the 70’s to the 130’s during my episode.

That's what antiarrhythmics are for. You need an EP. Your cardiologist is woefully out of date with his training.

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Carey

That's what antiarrhythmics are for. You need an EP. Your cardiologist is woefully out of date with his training.

Yes, I'll have Stanford Health contact you for an update.

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jpeters
Yes, I'll have Stanford Health contact you for an update.

Sarcasm noted but it's unfortunately very common for general cardiologists to do this. Ask yourself why EPs don't.

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Carey

Yes, I'll have Stanford Health contact you for an update.

Sarcasm noted but it's unfortunately very common for general cardiologists to do this. Ask yourself why EPs don't.

Perhaps because they have to deal with decreased cardiac functioning resulting from afib all the time ?? They refer to an EP when ablation is in the cards.


"The symptoms of atrial fibrillation relate either to the irregularly irregular heartbeat causing palpitations or decreased overall cardiac output from loss of atrial contraction and fast ventricular rates resulting in congestive heart failure"

In my case, the decline happened within several weeks of afib. Going from swimming 85 laps to about 2 without a break.



Edited 1 time(s). Last edit at 08/12/2018 06:41PM by jpeters.

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Carey

Wow! Thanks! I do believe the digoxin was more recommended while I’m having a long term afib episode as opposed to daily usage. The way it was explained was that the metropolol would lower rate and the digoxin will keep me from the rate jumping all over the place and making me more comfortable . I was going from the 70’s to the 130’s during my episode.

That's what antiarrhythmics are for. You need an EP. Your cardiologist is woefully out of date with his training.

It’s a her, she is young and works for a very large HMO. She is board certified In both cardiovascular disease and internal medicine. I cannot imagine she is prescribing me something that will kill me. Probably not very good for her or the HMO. I’m sure keeping me alive and healthy is much better for their business model.

Just curious, what are you board certified in?

Folks, you're mixing up diseases. Digoxin has its place in treating heart failure, but it has no place in uncomplicated afib. It increases mortality for such patients, plain and simple, and the only benefits it provides can be better provided by other, safer drugs. That's all I'm saying and I'm not trying to play doctor. If you have afib and don't have heart failure, and your doctor prescribes digoxin, my advice would be to find another doctor.

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Carey
Folks, you're mixing up diseases. Digoxin has its place in treating heart failure, but it has no place in uncomplicated afib

What exactly is uncomplicated afib?

Steve,

Here is a search on the site for digoxin: <[www.google.com]

You can start here <[www.afibbers.org]

14 years ago, I ended up here about a month or so after I had my first episode, I bought the founder of this stie's book <[www.amazon.com] (it is dated, but still worth a read). Learned digoxin was not indicated for a vagal afibber (which most athletes are & your bending over sounds like a vagal trigger). I had a highly recommended cardio who told me digoxin was his favorite afib med. I wouldn't take it and we'd have hour long "discussions" about this topic. He finally punted me to the EP in his practice. When I told him my story he said, "sounds liek you are vagal and there are certain meds we won't prescribe for you." It was all I could do to bite my tongue and not tell him his partner needed an in-service to get current.

Here is Jackie's "The Strategy." <[www.afibbers.org] magnesium potassium & taurine.

More info: <[www.afibbers.org]

Good luck!

George

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GeorgeN
Steve,

Here is a search on the site for digoxin: <[www.google.com]

You can start here <[www.afibbers.org]

14 years ago, I ended up here about a month or so after I had my first episode, I bought the founder of this stie's book <[www.amazon.com] (it is dated, but still worth a read). Learned digoxin was not indicated for a vagal afibber (which most athletes are & your bending over sounds like a vagal trigger). I had a highly recommended cardio who told me digoxin was his favorite afib med. I wouldn't take it and we'd have hour long "discussions" about this topic. He finally punted me to the EP in his practice. When I told him my story he said, "sounds liek you are vagal and there are certain meds we won't prescribe for you." It was all I could do to bite my tongue and not tell him his partner needed an in-service to get current.

Here is Jackie's "The Strategy." <[www.afibbers.org] magnesium potassium & taurine.

More info: <[www.afibbers.org]

Good luck!

George

Thank you, George!

Quote
Socalsteve


Wow! Thanks! I do believe the digoxin was more recommended while I’m having a long term afib episode as opposed to daily usage. The way it was explained was that the metropolol would lower rate and the digoxin will keep me from the rate jumping all over the place and making me more comfortable . I was going from the 70’s to the 130’s during my episode.

That's what antiarrhythmics are for. You need an EP. Your cardiologist is woefully out of date with his training.

It’s a her, she is young and works for a very large HMO. She is board certified In both cardiovascular disease and internal medicine. I cannot imagine she is prescribing me something that will kill me. Probably not very good for her or the HMO. I’m sure keeping me alive and healthy is much better for their business model.

Just curious, what are you board certified in?

I’m of the opinion that all doctors mean well.

The thing to remember is that, when it comes to the heart, cardiologists are essentially “plumbers”. Most, if not all, of what they deal with is clogged arteries around the heart. Rhythm is an entirely different animal. It’s electric. Ions transiting cell membranes depending on voltages. It’s why we should all team up with both a cardiologist and an electrophysiologist to ensure the best possible outcome in cases such as ours.

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jpeters
What exactly is uncomplicated afib?

Afib without structural heart disease. Heart failure, for example.

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Carey

What exactly is uncomplicated afib?

Afib without structural heart disease. Heart failure, for example.

AFIB is a progressive disease resulting from multiple (often unknown) causes.

"The symptoms of atrial fibrillation relate either to the irregularly irregular heartbeat causing palpitations or decreased overall cardiac output from loss of atrial contraction and fast ventricular rates resulting in congestive heart failure"

" There is no such thing as generic structural heart disease.
One would have to be living on another planet to not understand that. Why then is this term used so
commonly? " Richard Conti, M.D., M.A.C.C.



Edited 3 time(s). Last edit at 08/13/2018 01:34AM by jpeters.

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jpeters

Folks, you're mixing up diseases. Digoxin has its place in treating heart failure, but it has no place in uncomplicated afib

What exactly is uncomplicated afib?

Lone Atrial Fibrillation

Steve:

How does the the ER Cardiologist know that the Cardioversion would not last? Do you have a history of ECV's not lasting?



Edited 1 time(s). Last edit at 08/13/2018 03:26AM by The Anti-Fib.

What Carey says.

I had my longest ever AF episode in 2002 after being given digoxin - 22hrs whilst every episode ever since has lasted no more than 6 hours (pre-Flecainide) and 1 or 2 hours using Flecainide.

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Socalsteve


Wow! Thanks! I do believe the digoxin was more recommended while I’m having a long term afib episode as opposed to daily usage. The way it was explained was that the metropolol would lower rate and the digoxin will keep me from the rate jumping all over the place and making me more comfortable . I was going from the 70’s to the 130’s during my episode.

That's what antiarrhythmics are for. You need an EP. Your cardiologist is woefully out of date with his training.

It’s a her, she is young and works for a very large HMO. She is board certified In both cardiovascular disease and internal medicine. I cannot imagine she is prescribing me something that will kill me. Probably not very good for her or the HMO. I’m sure keeping me alive and healthy is much better for their business model.

Just curious, what are you board certified in?

I also would like to know what Carey credentials are. Not being sarcastic; When you offer or say things that are actually a Medical situation above a normal layman, I think it is reasonable to ask such a question.
Myself, I have a degree in Retired Electro -Technology With Credentials in Process Instrumentation. I have also had 2 Ablations with Dr. Natale. This Forum lead me to him and Shannon was the Go to Man to whom I have great respect along with many other individuals on this God sent Forum.

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The Anti-Fib



Lone Atrial Fibrillation

No such thing

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The Anti-Fib
Steve:

How does the the ER Cardiologist know that the Cardioversion would not last? Do you have a history of ECV's not lasting?

No, I’ve never been cardioverted. Not sure. Felt, in many ways, that it was a waste of everyone’s time by me going to the ER. I still cannot believe they sent me home before I converted. Maybe things have changed since the last time I ended up there ( 7.5 years ago ). Back then they would have kept me there or in the hospital until I converted.

Just got off the phone with my regular cardiologist. He told me to stop taking the metropolol and digoxin and he prescribed flecanide 50mg x 2 daily as a start. Also said to take more if I feel an episode. He also ordered a Zio patch and a referral to the EP department of my HMO. I think I’m headed for another ablation. I have no problem with this at all. I actually welcome it.

Thank you all for your great wisdom, advice, suggestions and opinions!

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smackman
I also would like to know what Carey credentials are.

I don't claim credentials. I have a medical background but mainly my credentials are the same as yours, Shannon's or anyone else around here. I've battled afib and flutter for 16 years, I've undergone multiple ablations, I've undergone dozens of cardioversions, I've received a Watchman, and I've taken nearly all the antiarrhythmics, beta blockers and calcium channel blockers at one time or another. I successfully controlled my flutter with potassium for two years based on information I found in the archives here. But mainly, I read, I learn, and I try to pass on what I learn to help others.

If I've said something incorrect, I welcome having someone point it out and explain why I'm wrong. But as far as digoxin goes, I've simply repeated what the science says: it increases mortality in afib patients without heart failure. Digoxin has been around since the 1930s, and yes it was a mainstay of afib treatment for decades, but that was then and this is now. There are equally effective drugs that control rate and rhythm without the toxicity and increased mortality of digoxin, so it's a very poor choice of drugs for afib unless heart failure is also present.

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Socalsteve

Just got off the phone with my regular cardiologist. He told me to stop taking the metropolol and digoxin and he prescribed flecanide 50mg x 2 daily as a start. Also said to take more if I feel an episode. He also ordered a Zio patch and a referral to the EP department of my HMO. I think I’m headed for another ablation. I have no problem with this at all. I actually welcome it.

Thank you all for your great wisdom, advice, suggestions and opinions!

I’m not a medical professional but I’m pretty sure if you are going to be taking flecanide you need the metoprolol as welll. I’m basing this off of personal experience considering I am on both right now and have been in the past. Even

When I just used flecanide as a pip it was suggested I take metoprolol with it as well.

Also he recommended you take more if needed. How much more? Too much would be no good. The max I was told to take in one day (24 hour period) was 300mg total. That was back in December when my afib returned with a vengeance. I also had a history of good results and zero isssues with it.



Edited 1 time(s). Last edit at 08/13/2018 02:12PM by rocketritch.

FWIW I've found all of Carey's posts excellent. And I've been here on this forum for nearly 20 years under one nickname or another. If I recall correctly Carey has 15 years EMS experience behind him. And I am not in the anti-ablation sect or the pro-ablation sect in so far as one might argue such sects exist on this forum these days. I'm right down the middle and open to all ideas and wisdom.

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rocketritch


Just got off the phone with my regular cardiologist. He told me to stop taking the metropolol and digoxin and he prescribed flecanide 50mg x 2 daily as a start. Also said to take more if I feel an episode. He also ordered a Zio patch and a referral to the EP department of my HMO. I think I’m headed for another ablation. I have no problem with this at all. I actually welcome it.

Thank you all for your great wisdom, advice, suggestions and opinions!

I’m not a medical professional but I’m pretty sure if you are going to be taking flecanide you need the metoprolol as welll. I’m basing this off of personal experience considering I am on both right now and have been in the past. Even

When I just used flecanide as a pip it was suggested I take metoprolol with it as well.

Also he recommended you take more if needed. How much more? Too much would be no good. The max I was told to take in one day (24 hour period) was 300mg total. That was back in December when my afib returned with a vengeance. I also had a history of good results and zero isssues with it.

I have an appointment with him tomorrow. I will ask about the pip dosing amounts. Thank you for bringing this up! He is taking me off the Metropolol and digoxin because it doesn’t seem to have any positive effects ( still have A-Fib bouts and extra beats ) and the downside is that I cannot exercise while on it. It also makes me very lightheaded and kind of stupid ( I’m already stupid enough without the drugs).

Bottom line is that I am a cyclist. It’s my passion in every sense of the word and while on metropolol, I cannot enjoy cycling. There has to be other choices.

I do think I will need a touch up ablation, but my hmo is making me go the meds route first. They did my ablation 7.5 years ago and I was afib free for the entire time. Same doctor is still there. I will make sure he does it.

Shannon, and the Moderater before him Hans Larson, both said what Carey has said concerning Digoxin.

As for Flecainide, almost always prescribed with at least a mild Beta-Blocker, not necessarily Metroplol.

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Socalsteve
Bottom line is that I am a cyclist. It’s my passion in every sense of the word and while on metropolol, I cannot enjoy cycling. There has to be other choices.

I do think I will need a touch up ablation, but my hmo is making me go the meds route first. They did my ablation 7.5 years ago and I was afib free for the entire time. Same doctor is still there. I will make sure he does it.

I understand your passion. I'm a 3000-5000 mile a year cyclist hence my comments about my lifestyle creating my AFib situation.

No doubt the metoprolol and flecanide are going to cause you to have to ramp things down. However, I can almost guarantee that continuing to push while you are getting things sorted are probably going to make your situation worse instead of better.

It's a hard place to find yourself, believe me I know. My total miles for this yeatr is 374 and most of those on zwift and nothing since March.



Edited 1 time(s). Last edit at 08/13/2018 04:16PM by rocketritch.

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rocketritch

Bottom line is that I am a cyclist. It’s my passion in every sense of the word and while on metropolol, I cannot enjoy cycling. There has to be other choices.

I do think I will need a touch up ablation, but my hmo is making me go the meds route first. They did my ablation 7.5 years ago and I was afib free for the entire time. Same doctor is still there. I will make sure he does it.

I understand your passion. I'm a 3000-5000 mile a year cyclist hence my comments about my lifestyle creating my AFib situation.

No doubt the metoprolol and flecanide are going to cause you to have to ramp things down. However, I can almost guarantee that continuing to push while you are getting things sorted are probably going to make your situation worse instead of better.

It's a hard place to find yourself, believe me I know. My total miles for this yeatr is 374 and most of those on zwift and nothing since March.

Please tell me what you mean by this?

I’m hoping not to have to use Metropolol at all as it surely seems to not bring anything positive to the table, just negative. Hopefully the Flecanide alone will do the trick.

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Socalsteve
I’m hoping not to have to use Metropolol at all as it surely seems to not bring anything positive to the table, just negative. Hopefully the Flecanide alone will do the trick.

Flecainide alone can be dangerous. The danger is that it will cause afib to organize into atrial flutter, and without a beta blocker to slow conduction through the AV node that can result in 1:1 conduction to the ventricles. The end result will be a heart rate in the 200-300 range. And that runs the risk of evolving into v-tach, which is potentially fatal. It's a rare complication, so some EPs are willing to give flecainide without a beta blocker, but most will insist on it.

I spent two years dealing with 1:1 flutter (not caused by flecainide) that routinely hit rates of 250 and didn't respond to beta blockers. Nothing would slow it down and until I discovered how to terminate it myself with potassium, I was in the ER 2-3 times per week getting cardioverted. I promise you that a rate like that is no fun.

Although it's a bit of a risk, what you could do is keep a beta blocker on hand for use as a PIP in case the 1:1 ever happens. Just remember it's going to take 20-30 minutes to kick in, and you're going to have to tolerate that heart rate until it does.

I'm a cyclist too so I understand your dilemma. Beta blockers cap my heart rate and make me feel like I'm 90 years old. I hate them as much as I hated afib.

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jpeters
" There is no such thing as generic structural heart disease.
One would have to be living on another planet to not understand that. Why then is this term used so
commonly? " Richard Conti, M.D., M.A.C.C.

I've heard the term used by some of the world's top cardiologists. It's a perfectly valid term just like lung disease, kidney disease, etc. The alternative would be to list the dozens of possible specific diseases and disorders. Dr. Conti was being pedantic.

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Carey

The alternative would be to list the dozens of possible specific diseases and disorders. Dr. Conti was being pedantic.

Yes, that was his point. I'll be sure and let him know that he's pedantic. He's editor and chief of Clinical
Cardiology.

He was noting how the clinical community had "shied away" from the use of flecainide in patients with any type of "structural disease" in favor of amiodarone, simply due to a label that means nothing in itself.

Since
the
CAST
publication,
the
cardiovascular
commu-
nity
has shied
away
from
using
flecainide
and
other class
I
antiarrhythmics
in patients
with
any type of structural heart



Edited 1 time(s). Last edit at 08/14/2018 12:40AM by jpeters.

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The Anti-Fib
Shannon, and the Moderater before him Hans Larson, both said what Carey has said concerning Digoxin.

Right, and Hans also advocated nicotine patches. Anyway, Digoxin works very well restoring heart function quickly. My cardiologist switched me to diltiazem after a successful cardioversion. I have no problem with a highly experienced cardiologist.



Edited 1 time(s). Last edit at 08/14/2018 02:40AM by jpeters.

Different folks = different views. Do your own research and - with your EP's input - make your own choice. (FWIW IMO for me as a vagal AFr = no digoxin thanks.) Personally speaking I'm good with info and opinions provided by Hans, Shannon and Carey (and Jackie, George N, wolfpack and some others here).

BTW; has anyone here ever had 1:1 AFlutter with Flecainide? I'm aware a few (incl. Shannon and Carey) have had 1:1 AFlutter but so far as I'm aware that wasn't due to Flecainide.

And how's about 'General Aging Disease' then?! Hardcore lifestyle folks like George here (who I admire greatly) work very hard to delay this highly annoying condition but at the end of the day none of us are going to make it out of here alive!

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jpeters




Lone Atrial Fibrillation

No such thing

Says who? Yes many Doctors stopped using the term 10-15 years ago, but we still know what the term refers to. It makes the Treatment Protocols simpler for the Doctors and Nurses if there are not multiple categories of AFIB to treat.

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mwcf

BTW; has anyone here ever had 1:1 AFlutter with Flecainide? I'm aware a few (incl. Shannon and Carey) have had 1:1 AFlutter but so far as I'm aware that wasn't due to Flecainide.

I've now some atypical flutter mixed with runs of ectopics and afib, but nothing related to the flecainide.
I'm taking bisoprolol on a daily basis and flecainide as PIP. The issue for me with flecainide and AA drugs from its class is a QRS enlargement when my HR reaches +- 120 bpm. It's no fun, since I'm a cyclist. My EP said I should not take more than 100mg flecainide/day. Happily, when I've afib, I usually self convert within 1 hour, with or without flecainide.
Has anyone the same issue (QRS enlargement) with flecainide?

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Socalsteve


Bottom line is that I am a cyclist. It’s my passion in every sense of the word and while on metropolol, I cannot enjoy cycling. There has to be other choices.

I’m hoping not to have to use Metropolol at all as it surely seems to not bring anything positive to the table, just negative. Hopefully the Flecanide alone will do the trick.

Like Carey said, Flec goes with a beta because of the flutter risk.

You could ask your EP or cardiologist about propafenone. In my case, I was able to use that alone without the metoprolol. It still sucks, but not quite as bad. I'm a runner (not fast, mind you), but the betas were a boat anchor. It's almost like you're just going through the motions for no real reason at all.

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Socalsteve
However, I can almost guarantee that continuing to push while you are getting things sorted are probably going to make your situation worse instead of better.

Please tell me what you mean by this? .

My point here is that to continue to forgo any means to keep your heart in rhythm is probably going to lead to making the afib worse. The key is to keep your heart in rhythm so it does not learn new pathways while your deciding on what course of action to take weather that be drugs or a second ablation.

When I first started going out of rhythm again 5 years post ablation I probably should have started to consider taking action then. However 1 or 2 short episodes a year was really no big deal considering where I was at pre-ablation.Even when things got more frequent I still made no attempt to do anything about it because my afib burden was still not interfering with my life until the day I passed out and the bottom dropped out so to speak.