I’ve been on Amiodarone for 7 months now with no side effects.

So I’ve had two heart ablations within the past year. After the first one I was back in afib 2 days later. My EP suggested giving tykosyn a try but unfortunately I developed QT and had to stop it. Two months later I went to an EP at NYU Langone. He performed another ablation in May and put me on Amiodarone. I have been taking Amiodarone for 7 months and have had no issues. I’ve not been in afib or have had any side effects thus far. I have blood work drawn every 3 weeks to ensure my thyroid levels are normal. So my question is why is there so much negative talk about Amiodarone. I understand, depending on the individual, there can be some nasty side effects. However, fortunately for me I have not experienced any of them yet. The plan is to discontinue the Amiodarone and put me on Multaq soon, which I am not looking forward to since I’ve been feeling so good on the Amiodarone. Thoughts??
Thanks -Maryann

I don't get why, since you've been ablated 7 months ago, your EP hasn't yet tried freeing you from rhythm drugs, and particularly amiodarone.

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(...) I understand, depending on the individual, there can be some nasty side effects. However, fortunately for me I have not experienced any of them yet (...)

You're OK to date with the drug, but you might be OK too without it! And maybe without needing to switch to another rhythm drug.
I'm no expert, but isn't it the goal of ablation?

If your ablation was successful, you don't need amiodarone at this time. The way to see if it was successful is to stop taking the drug.

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Mabmedz
So my question is why is there so much negative talk about Amiodarone.

Because of lung, liver, and thyroid toxicity. Amiodarone can have devastating side effects, some of which can leave you with permanent lung and liver damage. And yes, thyroid problems too, but that's not going to kill you like the liver and lung toxicity can. Pompon is right: you feel okay so far. Amio is not a drug you want to stay on one day longer than necessary. Is your doctor also monitoring your lung and liver function? Were you even made aware of these risks?

So you shouldn't fear stopping the amio; you should be looking forward to it. Now, what I don't understand is why he's switching you to Multaq. He seems to believe your ablation was a failure if he's not even going try stopping the antiarrhythmics, which is the only way you can judge if your ablation was a success. If I were in your shoes, I would stop the amio immediately and just see what happens. Either your ablation was a success and what will happen is nothing, or it was a failure and then you can try the Multaq or one of the other, much safer antiarrhythmics like flecainide while you arrange for your third ablation with one of the top EPs in the country. Since you're apparently in the NYC area you have a couple of good choices, and of course there's always Natale in Texas. There was almost no point in doing the second ablation if you're just going to be parked on amio or some other antiarrhythmic. You could have done that without having an ablation at all.

Thanks for the info. Probably best I provide additional background info about my situation; of note, I’ve had mitral valve repair. I now have significant TR and significant RA enlargement. In May 2021 I had my second ablation (1st one in December 2020 by another EP, my current EP is one of the best in NY). A few hrs after my second ablation I was back in afib and underwent an unsuccessful cardioversion. I was administered Amiodarone, 3 weeks later I underwent a successful cardioversion. I’ve been back in afib a few times during the past 6 months converting on my own to NSR. I have been monitored closely to ensure I am not experiencing any long term side effects of Amiodarone. My EP does not want me to stay on it for a long period of time, for the reasons you stated, hence Multaq. So unfortunately it appears the 2nd ablation was unsuccessful, but we’ll have to wait and see how I do on Multaq. As of yesterday I discontinued Amiodarone and started Multaq. I’ve discussed a 3rd ablation with my EP with a risk of requiring a pacemaker, something he is trying to avoid, if possible.

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Carey
. If I were in your shoes, I would stop the amio immediately and just see what happens. is nothing, or it was a failure and then you can try the Multaq or one of the other, .

Does Amio need to be weaned off or can one stop cold turkey? I had to be weaned off Multaq and Jackie had to wean off of Flecainide.

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susan.d
Does Amio need to be weaned off or can one stop cold turkey? I had to be weaned off Multaq and Jackie had to wean off of Flecainide.

For all the antiarrhythmics, including amio, most people can just stop them.

I've stopped flecainide, sotalol, Tikosyn, and Multaq without weaning, also metoprolol.

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Mabmedz
So unfortunately it appears the 2nd ablation was unsuccessful, but we’ll have to wait and see how I do on Multaq. As of yesterday I discontinued Amiodarone and started Multaq. I’ve discussed a 3rd ablation with my EP with a risk of requiring a pacemaker, something he is trying to avoid, if possible.

Okay, lots of important information that explains your course of treatment. I was concerned that you'd hooked up with an EP who parks unsuccessful ablation patients on amio indefinitely instead of admitting the ablation was a failure (I know of EPs who do that).

Thanks Carey I’m glad I was able to clarify. Update: I had to discontinue Multaq due to terrible side effects. I am now on Propafenone 150mg 3x a day. I’m experiencing PVC’s mainly at night but they now seem to be subsiding. I’m scheduled for an EKG this week to ensure I don’t have prolonged QT. I’m also wearing a heart monitor for the next 2 weeks. I’m scheduled to see my EP doctor the 1st week in February to discuss the meds and test results. 🤞🏻🤞🏻

I just started amiodarone ( 400mg. ) a day to see if this can stop my A-Fib. Going to get an inversion in 2 weeks.