Rate control issues

My afib has become more frequent, a couple times per week, and rate control has become more of an issue. I am pretty much taking the max amount of metoprolol and will not consider rhythm control drugs. The majority of the time I'm at home and can rest or sit and enjoy rates in the 80's and 90's while in afib. If I need to be out, or God forbid, have to do some freeway driving I will be in the 120's to 140's. Sometimes a little Xanax works. Sometimes a small does of Valium helps, but I'm not sure one can drive if they take Valium. I am without a EP right now and am considering fleeing from my cardiologist because the words "digoxin" came out of his mouth. Any suggestions?

I would highly recommend an EP consult. And don't hesitate to change providers if the relationship isn't working. My AF got me a new general practitioner and cardiologist. I wasted no time in leaving practices that I felt were doing more talking than listening.

Lynn,

I assume the 120's to 140's is new? If it is transient, perhaps let it be. Are you symptomatic at these rates? From my understanding the issue with high rates is when they are persistent. Many "normals" exercise at these rates for long duration training for endurance races. I believe that the issue with high rates and cardiomyopathy is when they are continuous.

As Wolfpack says, an EP consult would be ideal.

George

I took Diltiazem (calcium channel blocker), and that helped quite a bit along with my Beta-Blocker.



Edited 2 time(s). Last edit at 06/24/2016 12:33PM by The Anti-Fib.

Wolfpack, II agree, an EP is always more knowledgeable about these matters. Just had an EP consult which I'll describe below.

George, my rates are not really hitting new highs. I've hit these before, but what makes it worse is any bit of anxiety shoots them right up, for example freeway driving, which I now won't do while in afib. I thought I remembered being told years ago that as long as these rates didn't last days it shouldn't be an issue. Although back early in my afib career I did have a cardiologist try to tell me that RVR could lead to vtach. After getting a second and third opinion he retracted his opinion.

Anti-that may be something to consider.

Anyway, it was discovered that I've gotten a bit hyperthyroid and need to lower the doseage of my thyroid meds and we'll see what that does.

Did get a consult with an EP, you guys are going to love this, he's more incompetent than the cardio (actually I like the cardio, he's just out of his area with afib). Anyway, I explained up front that I wad considering an ablation with Natale, but was first trying some more life style approaches. So first he disses Natale and claims that he himself can do just as well as Natalie (the EP is associated with a small local hospital, not a high volume center). Then he says that he would not do an ablation on anyone unless they had tried and failed rhythm control drugs first, so his rate control solution was rhythm control. Then he went on to recommend I dicontinue Eliquis and use aspirin because I have a CHADS v2 score of 1...in spite of the fact that I am in and out of afib a couple times per week. 😝😝😝. Won't be going back to this one.

I am convinced that the medical community is going down hill rapidly. I've had a few other health issues lately and have encountered a fair amount of incompetence so in my opinion we all have to be willing to seek out the best and travel if need be.

I wouldn't drive with a large dose of Metropolol and Zanax or Valium added. It may impair you, or at least cause you to appear impaired if you were pulled over. The closer you can get your AFIB rate to your Normal NSR rate the less the AFIB will affect you. The Diltiazem I suggested won't cause sedation.

Lynn,

That's unfortunate. Your EP is out of practice, it would seem. There is no requirement to fail rhythm control drugs prior to an ablation. That is 1990s-2000's thinking. I'd suggest finding another EP. I know it's a burden on us as patients but it is critical to find the right providers. I had to "fire" my general practioner and cardiologist both before proceeding to the ablation. It added months to my dilemma but I'd do it again in an instant.

I like to put it this way: if I'm in the hospital because of a car wreck or other trauma (acute condtion), the doctor is in charge. If I'm dealing with a chronic condition, I AM IN CHARGE. That understanding underpins the relationship or the relationship ends.

Best of luck!

I agree Wolfpack, very well put. The same thing applies even more to your Pets when dealing Vets. I just lost a Cat because of trusting what a Vet and his assistants repeatedly assured me of. I did not aggressively enough not take charge of a situation, where my Cat was harmed by improper treatment. You have to be in control, unless its an acute scenario. It's really the worst thing knowing your Cat is dead and suffered because you didn't act strongly enough.

Maybe this doesn't apply if your completely ignorant of a situation, but if your smart enough to make onto this site, then you smart enough to assume a degree of control of your Health conditions.



Edited 1 time(s). Last edit at 07/02/2016 04:25AM by The Anti-Fib.

Hi Anti-AFIB

So sorry to hear that you had to put your beloved cat down after that poor treatment at the vet you told me about when we talked not long ago.
That's a real shame.

Take care,
Shannon