Full blown afib episode...I have questions

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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.

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Socalsteve


What about Digoxin do they not like?

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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.

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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.

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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)."

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Carey

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

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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

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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.

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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.

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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.

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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.

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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.

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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.

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

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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.

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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.

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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

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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

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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?

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jpeters
What exactly is uncomplicated afib?

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Carey

What exactly is uncomplicated afib?

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

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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?

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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?

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The Anti-Fib



Lone Atrial Fibrillation

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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?

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

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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!

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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.

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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.

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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.

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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.

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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.

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Carey

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

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

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jpeters




Lone Atrial Fibrillation

No such thing

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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.

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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.

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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? .

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jpeters
Anyway, Digoxin works very well restoring heart function quickly.

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mwcf
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).

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You need an EP. Digoxin is an inappropriate drug for afib.

Your cardiologist is woefully out of date with his training.

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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.

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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.

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The Anti-Fib





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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jpeters
are completely inappropriate for non-professionals

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Carey

are completely inappropriate for non-professionals


I'm sorry but I don't share your unquestioning worship of doctors. I've seen doctors kill patients through ignorance and lack of up-to-date training. Seriously, you've never read or heard stories of medical incompetence? You haven't seen the stats? I've seen it first hand. I've even seen doctors kill patients. In fact, I've literally rescued patients from doctors.

Patients who educate themselves and question their doctors are patients who survive and get better.

As for the digoxin that helped you, one more time.... Yes, you had heart failure and that's why digoxin was appropriate for you. It is, however, no longer considered appropriate for the treatment of afib in people who don't have heart failure. Feel free to do some reading of the literature if you doubt that.

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Carey
Yes, you had heart failure and that's why digoxin was appropriate for you.

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Carey

Patients who educate themselves and question their doctors are patients who survive and get better.

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Socalsteve
As a follow up: Just got back from my cardiologist who put me on 100mg of Flecainide twice daily, plus a low dose of metropolol if my heart rate gets too high to be comfortable. He put me on blood thinners ( just in case they want to cardiovert me in the future and also to prepare for another ablation ), set up a zio patch monitor ( so the EP department knows what they are dealing with) and set up a referral to the EP department of my HMO.

Hopefully the flec will calm my heart and I can go on riding my bicycle into the sunset!!! It already feels better than the beta blockers in regards to exercise. We shall see.

Thank you all for your knowledge, experience and passion ( lots of passion ).

Wish me luck!

Steve

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Carey
I'm sorry but I don't share your unquestioning worship of doctors. I've seen doctors kill patients through ignorance and lack of up-to-date training.

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mwcf

As a follow up: Just got back from my cardiologist who put me on 100mg of Flecainide twice daily, plus a low dose of metropolol if my heart rate gets too high to be comfortable. He put me on blood thinners ( just in case they want to cardiovert me in the future and also to prepare for another ablation ), set up a zio patch monitor ( so the EP department knows what they are dealing with) and set up a referral to the EP department of my HMO.

Hopefully the flec will calm my heart and I can go on riding my bicycle into the sunset!!! It already feels better than the beta blockers in regards to exercise. We shall see.

Thank you all for your knowledge, experience and passion ( lots of passion ).

Wish me luck!

Steve
The only thing I'd add Steve is this. I've taken Flecainide 100mg BID for 10.5 years during which time I've also always added a small amount of Diltiazem (60mg modified release tablet) with my am dose - as during the day is the time I'm most likely to get my HR up - along with it to offset any (admittedly very small) risk of 1:1 AFlutter being caused by the Flecainide (as it is rarely known to do). As a vagal AFr I decided to go the Diltiazem route rather than the BB route in this regard. This all - I'd add - with the agreement of my doc and EP.

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wolfpack


I still remain optimistic and feel that doctors mean well. I've never encountered malice but I've sure seen people out of their leagues. Sometimes by miles. You've got to take the reins to as much of an extent as possible. No one cares more about your health than you do.

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SueChef
I learned a lot about digoxin when I started a thread. I had heard of this med before as being contraindicated for older patients.
Here's the link in case you want to do more reading!
[www.afibbers.org]
Edited to add: Dr. Natale also works out of Scripps, La Jolla (San Diego county)...depending on where you live in SoCal, it might be a better option than Thousand Oaks.

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SueChef
I learned a lot about digoxin when I started a thread. I had heard of this med before as being contraindicated for older patients.
Here's the link in case you want to do more reading!

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Victoria
Doctors may mean well, but they miss the ball sometimes.

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jpeters


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.

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The Anti-Fib



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.

Why do you assume that the Digoxin helped that much? IMO it may have helped some, but Digoxin did not restore your EF from 20 to 55. Getting back in NSR and lowering your HR did. If Digoxin consistently helped HR with a spectacular recovery like that it would heralded as a "Wonder Drug'' It is known that if some instances slowing down the Heart from uncontrolled AFIB can restore EF in the dramatic fashion that it did for you. I also had undiagnosed AFIB, resulting in TachyCardia induced Cardiomyopathy. I went from 20% to 65-70% after 18 months. I did not take Digoxin! As far as I know, the best Drug for improving Heart Contractibility (EF),is Coreg. The studies only show around a 5% increase in EF, and that is only on certain populations.