A Fib

I have A Fib every 2 or 3 days lasting from 1 to 4 hours. HR at that time is 70. I take Eliquis. Doctor wants me to take Amidiarone. I don't ,too may bad side effects. Would there be any long term consequences if I did not do anything

Your doctor wants to start with the biggest cannon there is. What kind of doctor are they, a general cardiologist or an electrophysiologist (EP)? If they're not an EP, I highly recommend you find one and get a second opinion.

Yes, amiodarone is the most effective antiarrhythmic, but it comes with the most serious side effects, some of which can be permanent. I spent 7 years on various antiarrhythmics, but never once did any of my 3 EPs even suggest amiodarone. I would refuse it if I were you and ask him to replace it with something else. Flecainide is often a good starting point.

If you do nothing, there's a very strong chance those episodes will slowly become longer and more frequent, and they may eventually become persistent. With an episode every 2-3 days you're already not far from it. Once it's persistent, it becomes much more difficult to ablate should you ever want to go that route. If I were you, I would consider ablation now, but only with an EP who has done thousands of afib ablations and only at a large center that does thousands per year.

I concur 100% with Carey. The negative consequences of Amiodarone completely outweigh any benefits of keeping you in rhythm in afib. There are some rhythm issues where it may be appropriate, but, in my non-medical (but 17+ year afib experience) opinion is not justified in your case. If your heart is otherwise healthy, then flecainide could be a good starting med.



Edited 1 time(s). Last edit at 11/16/2021 10:59AM by GeorgeN.

Thanks for the input. I am a 92 yr. old male with 3 leaky valves so ablation is not a solution. The amidiarone was prescribed by a cardiologist but I am not taking it. I think I will go back and suggest that he put me on flacainide though I read you have to start this in a hospital which i would not want to do. There is aso an other anti arrhythmic whose name I forget but it starts with M

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alfrae13
The amidiarone was prescribed by a cardiologist but I am not taking it. I think I will go back and suggest that he put me on flacainide though I read you have to start this in a hospital which i would not want to do. There is aso an other anti arrhythmic whose name I forget but it starts with M

Good decision. You don't need to start flecainide in the hospital. The other one you're thinking of that begins with an M would be Multaq. That would be worth trying because it's very mild and has few side effects, but being very mild it also might not work for you. But worth a try, and probably worth trying first.

I had an ablation by Dr Natale on December 15th 2020. At the time I had paroxysmal atrial fibrillation with a 51% burden. He ablated a lot of areas and I have been afib free ever since. Currently I can save a lot of money by enrolling in a Medicare Advantage plan in my area which includes all the doctors I am currently seeing except Natale. This plan and does include EPs with good reputations.
My question to the community is this: Am I correct in assuming that if I need a touch-up in the future that it would be a less complicated procedure and that my local EP should be expected to handle it effectively. Otherwise my only reason for keeping a much more expensive Supplement Plan is to keep my access to Natale open. I would appreciate any feedback.



Edited 1 time(s). Last edit at 11/16/2021 02:52PM by frankangelo.

A couple of questions I should have asked you before....

1. How fast is your heart rate during your episodes?

2. Do you feel unpleasant symptoms?

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Carey
1. How fast is your heart rate during your episodes?

From his first post - 70.

About 70 + or - Most of the times it is silent..

Does your cardiologist think the afib is a big problem that has to be addressed with your heart valve issues?

I was wondering same as Carey. I have congenital issues so we go around and around if I really have to address my afib. I'll be 55 next week.. so it is a bit of a different story but I have never done amnioderone. I am between 70 and 90 BPM with rate control drug. I am not a doctor but I would ask yours if it really needs to be addressed... blood thinner for sure but beyond that??