What to do

Hi, I'm new in this forum and needing advise. I'm 51 diagnoses with OSA 5 years ago and using CPAP, at that time I had my first episode of AFib, very fast HR around 200 and it went to sinus by itself in 20 minutes, started taking propafenone and bisoprolol. After 2 years, the second one was traveling in an airplane (very scary) 90 minutes prior to landing in Lima-Peru, went to a local hospital, received diltiazem and I was OK the next day. More propafenone and more bisoprolol, I felt always some discomfort extrasystolia and some tachicardia but doing OK, one year ago they changed it to flecainide and toprol, increasing doses and now I'm in flec 150 x2 and toprol 50x1. Four months ago I had another episode with severe arrhythmia and 230 bpm, reverted with diltiazem, 3 months ago another one same thing and 2 weeks ago another one....... All the studies are OK including ecocardiogram, blood, EKG, etc. My EP told me everything is OK.... but the problem is that this episodes are really scary and invalidating, I have to be always with someone and close to a Hospital !!!! I travel a lot, I'm a diver and a private pilot, try to enjoy life as much as I can..... I really want this to be out of my mind... If they tell me ablation, I'll do it without thinking twice... were to go ? what to do ? Thanks

Mauricio,

I am curious how the EP could say "everything is okay" when you are having these symptoms. Someone else with more knowledge can chip in, but your symptoms and the use of flecainide may indicate another EP opinion is needed. Seems like I have read that flecainide can sometime contribute to pro-arrythmia. It also sounds like your symptoms could be related to tachycardia, instead of afib.

Essentially, I am just guessing here and that is counter intuitive, but sounds like you need a more thorough EP consult. If your problem is indeed tachycardia, it is my understanding that is a pretty easy fix.

Sorry couldn't be of more help,

Draino

Mauricio,

I second Draino's advice. You need to get evaluated by a competent electrophysiologist (EP). 200-230 bpm is an unusually high rate for atrial fibrillation. If the rhythm is regular it is likely flutter or inappropriate sinus tachycardia, in which case flecainide would not be a good choice. If you are considering an ablation please see the 2008 ablation/maze survey for EP's with proven success records [www.afibbers.org]

Hans

Thanks Draino and Hans.
I have (5 minutes ago) filled up an appointment form for the Texas Cardiac for Dr. Natale...... I hope I can get one sometime soon..
Thanks again

If you have the money or the insurance you can't go wrong with Dr. Natale, Bordeaux, or Drs. Khaykin and Verma in Toronto area. These are the best in the world with the most experience and will put you on the right track.

You don't mention anything about supplementation or bloodwork. My earlier posts will tell you what I supplement with for general health and to deal with AFIB. One thing for sure in my case is my serum potassium level. I want it at around 4.5 or so. If it falls to 4 or below I am guaranteed arrhythmia like symptoms although they tell me that they are only skipped beats at this point. I am on TIKOSYN, which is not for everyone, but if you can tolerate it well (I can) it is the #1 AFIB med. I am NSR for over a year now and all I am taking is TIKOSYN. You need robust kidneys to take it mind you. 80% of what you take in is expelled in your urine within 2 hours. If your kidneys are not scrubbing your blood it is very dangerous; so I have my Cratinine level checked every month at least.

Give it your best shot, NOW, while you are only having the odd AFIB episode because as I said earlier on here... it is but a short hop from occasional AFIB to permanent AFIB.

And regards your OSA; closely related to AFIB. I would be using a Respironics S9 Auto II APAP and a full face mask so that if your nose gets congested you don't mouth breath and defeat the machine. It is dead silent and works like a charm. I have been using one for 4 years now with the resultant wonderful night of sleep most nights.

Try www.cpaptalk.com forum.

Murray L

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Tikosyn uptake Dec 2011 500ug b.i.d. NSR since!
Herein lies opinion, not professional advice, which all are well advised to seek.