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Anyone Taking Diltiazem?

Posted by Myticker 
Anyone Taking Diltiazem?
February 21, 2025 06:40PM
I've been dealing with persistent A-Fib for 20+ years. Always got cardioversions to correct them as they'd last 9-12 months between episodes. Been on Flecainide to help me stay in NSR between cardioversions also. Now a new doctor wants to prescribe Diltiazem in addition to the Flec. However, Dr. Google says Diltiazem is mainly used for high blood pressure. And get this; side effects may include arrythmia. It also may cause slower heart rate, which I've historically also had.

Anyone out there also taking Diltiazem for A-fib and is so what are your thought on it?

Much appreciated!!
Re: Anyone Taking Diltiazem?
February 21, 2025 08:01PM
I take it for hypertension. No issues whatsoever. It's also commonly used for afib, especially in ERs. IV diltiazem is what most ERs will do first if you come in with afib. As for an irregular heart rhythm, I've never heard of that actually happening.

The reason the doc wants you on that is it provides protection against a rare but serious side effect of flecainide known as 1:1 conduction. In 1:1 conduction your heart rate can go extremely high, as high as 250-300 bpm. Naturally, that's a bad thing, potentially very bad. So the diltiazem will slow that rate down but it won't slow your normal resting heart rate by much, much less than beta blockers will. Since you have a normally low resting rate, I would imagine he chose it specifically for that reason.

I wouldn't hesitate to take it.
Re: Anyone Taking Diltiazem?
February 21, 2025 11:00PM
Thank you for that explanation. It makes me feel better about it. I'll follow-up with my Dr for his specific reason for prescribing it to see if the "1:1" thing was on his mind.
CC
Re: Anyone Taking Diltiazem?
March 01, 2025 08:55PM
I've taken Diltiazem, no side effects at all, just made me lethargic. No afib.
Re: Anyone Taking Diltiazem?
March 02, 2025 02:22PM
I love this drug.
Re: Anyone Taking Diltiazem?
March 11, 2025 10:47AM
Ask why, but probably to cover bases and theoretically protect you from a very rare 1:1 flutter. Given you've done so well without it, for so long, personally I would question if the Diltiazem is necessary. The underlying study data here is sketchy and that's why many ep's let patients take Flecainide without a nodal blocking agent like Flecainide. That said, in some cases Diltiazem may have mild antiarrhythmic properties, and therefore can be useful in help preventing certain tachycardias, but probably not atrial fibrillation. That has been my experience so I use it on a PIP basis at times.

Jim
Re: Anyone Taking Diltiazem?
May 04, 2025 10:48PM
I take it for permanent a-fib. It's actually my only drug other than xarelto. I'm not aware of any problems from it. But seeing CC's note about being lethargic, I wonder whether my reduced energy is entirely caused by a-fib/flutter or is partly from diltiazem. Susan, it's reassuring to see you are very happy with it!
Re: Anyone Taking Diltiazem?
May 05, 2025 04:22PM
Drummer. I never was lethargic on it. I had to switch drugs to the highest dose of Tenormin. I feel like napping after my morning dose but it helps my PVCs.

However Diltiazem I has been my favorite drug. It just calms my heart. After my AV node ablation technically I didn’t need it but this drug helped not feeling my wonky heart. Plus I feel calmer with a calmer heart.
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