Sotalol

Hello,

I'm still new to this phorum and the afib journey. I've read many of "your" posts and learn lots - thanks.

My cardio version went well, but 9 days later I went back into afib - this will be a week now. The last one was over a month before the zap. I have a pacemaker and the device maker included some electronic equipment where it sends info the the cardio clinic every night. That's why I know I"m back in it. I don't feel anything with my pacemaker.

I usually see at cardio PA as I get 30 minutes vs 15 with the Dr. and it doesn't take several weeks to get in to see the PA.

The PA said I should just go to the ablation stage. The Dr. wanted me to take the sotalol. After reading the side effects on the paperwork that came with the Rx and reading some posts here, I am very leery of wanting to even try it.

Is there anyone willing to share their experiences with this Rx. I realize we all react differently to medications. I, for some reason, am very sensitive to pharmaceuticals.

They want me on statins. I lose my memory doing simple daily tasks and the fatigue is awful, for example.

Thank you!

I've been on sotalol. All beta blockers cause fatigue for me and sotalol is no exception, but other than that I had no problems or complaints.

Carey thanks.

Are you on 80 mg twice a day.

How bad is the fatigue for you?

On another note, has anyone had sotalol cause their afib to go away?

Yes, I was taking 80 mg twice daily; that's the standard starting dose for sotalol. The fatigue wasn't as bad as it is with metoprolol. But the fatigue thing is very individualistic. I know people who take large doses of beta blockers and it doesn't bother them a bit. And fatigue is a bit of a misleading word. I feel perfectly fine if I'm not doing anything physical. I only feel it when I climb stairs or hills, ride my bike, stuff like that. It's a little hard to describe but for example, if I'm climbing a flight of stairs it will make my legs feel like I've got weights strapped to them.

Sotalol did control my afib, yes. Not 100%, but 90-ish %.

Thanks, Carey. That is helpful. I read one post here (I think) where the person posting thought it was better to get an ablation rather than taking lots of Rx. They also said that ablations are not the last hope but now becoming more of the first standard of care.

I guess that's just a person opinion.

They gave me the sotalol to get me out of my afib.

From other literature, it seems better to move towards an ablation since I haven't had a lot of afib other than recently.

It's all so confusing.

That's not just someone's opinion. It's the currently accepted medical guideline that ablation is a first-line treatment.

All of the drugs that prevent afib are pretty much terrible drugs, and no matter which one you choose it probably won't keep working forever. Medication isn't a practical long-term solution to afib except for those who choose to just live with persistent afib. Those people can simply take an anticoagulant and, if necessary, a rate control drug like metoprolol or diltiazem. It's the antiarrhythmic drugs that are so problematic.

I was on Sotalol for a few years. My afib episodes were about one a year but eventually they became more frequent and eventually I needed an ablation. Energy level changed but it did not stop me from doing activities. That was only thing I can say that was different.

Carey and Jake - thank you so much!

Carey, I read your "How you end up with multiple ablations and still have afib" and Travis' post too. Great, thank you!

So my question is: How do I get a great Dr. to do the ablation.

I have an appointment with a EP doctor. The earliest is middle of September The clinic I go to doesn't have these specialists, so they have a couple doctors for another hospital come over a couple times a week. I went to the other hospital's website and found the two doctors that come to the clinic I go to have no reviews. A good friend of mine had a ablation at this other hospital (she goes to the same clinic I go to). The doctor that did her ablation (about 10 years ago and it's still working) has 4.9 out of 5 from 266 ratings - the highest of any of the Drs. on that site.

He is accepting new patients, the Dr. who did my friend's ablation.

I was wondering if I should just met the Dr. I am scheduled with and ask those questions Travis suggested or try to change clinics and get this Dr. my friend had.

The hospital where these specialists are is known to be a good cardiac hospital from a surgical nurse I know that works in the area.

Thanks for any thoughts.

The way you choose an EP for an ablation is the one who has done the most afib ablations. The number you're looking for is thousands throughout their career, and at least several dozen per year currently. The more the merrier. This is so important that it overrules distance, convenience, and sure as heck those patient ratings. Ignore ratings. Those are nothing more than a popularity contest and reflect bedside manner more than skill. (I would take Darth Vader if he had done the most procedures.) It's also important enough to make travel worthwhile. You don't want a low-volume EP and you don't want a low-volume hospital. You want a hospital that does ablations every day, which means it's going to be a major medical center. If there isn't one close to you, plan on traveling. It's a lot more feasible than people think.

Wait a minute, you're in Dallas, right? Well, that makes it easy. The EP you want is a 4-hour drive (or 30-minute flight) south of you on I-35.

Carey,

Again, thank you! No, I use a VPN as I don't trust what ISP, Tech companies, etc ... do with my data.

Do you find that doctors don't get bent-out-of-shape when asked those questions. While I am VERY thankful for most doctors I've seen, I've found some get their features ruffled when asked questions they don't like. I try to be very respectful, but still, over the years, I still have some get upset when I don't follow the party line.

I wonder if there is a way to find out which hospitals do the most in my area or even what doctors do the most in my area.
The only way I see is visiting each doctor and interviewing them.

You can call their office and ask the staff. Although most don't keep a careful count, it shouldn't be hard for them to give you a good estimate. If an EP gets bent out of shape because you asked them how many ablations they've done, they just made your choice easy by showing you that their fragile ego is more important than your well being.

Since you read my post about ending up with 6 ablations, you know my thoughts on this. I would fly cross country for an ablation with Natale if I ever need one again. I wouldn't waste a minute looking at local EPs. And if he retires, I'd fly cross country to see Pasquale Santangeli at Cleveland Clinic. And I'm an easy drive from both Boston and NYC, both of which are medical Meccas loaded with plenty of good EPs.

Thanks, Carey. I will do that.

Well, with financial constraints, going out-of-area is not realist at this time, but I'll definitely keep it in mind.

You know, I never looked at it that way, ie, the bent out of shape doc. That's good.

My trip to Austin for an ablation cost me about $1000, and I could have knocked a couple hundred off that by staying at a cheaper hotel or BNB. Meanwhile, all of my prior ablations each cost me more than that in deductible, meds, etc. And getting rid of my afib years earlier would have been worth far, far more than $1000. Just something to keep in mind....

What area of the country are you in (East, South, Central, etc)? You need to definitely research a bit. It can feel overwhelming. But worth it.