Anyone Taking Diltiazem?

I've been dealing with persistent A-Fib for 20+ years. Always got cardioversions to correct them as they'd last 9-12 months between episodes. Been on Flecainide to help me stay in NSR between cardioversions also. Now a new doctor wants to prescribe Diltiazem in addition to the Flec. However, Dr. Google says Diltiazem is mainly used for high blood pressure. And get this; side effects may include arrythmia. It also may cause slower heart rate, which I've historically also had.

Anyone out there also taking Diltiazem for A-fib and is so what are your thought on it?

Much appreciated!!

I take it for hypertension. No issues whatsoever. It's also commonly used for afib, especially in ERs. IV diltiazem is what most ERs will do first if you come in with afib. As for an irregular heart rhythm, I've never heard of that actually happening.

The reason the doc wants you on that is it provides protection against a rare but serious side effect of flecainide known as 1:1 conduction. In 1:1 conduction your heart rate can go extremely high, as high as 250-300 bpm. Naturally, that's a bad thing, potentially very bad. So the diltiazem will slow that rate down but it won't slow your normal resting heart rate by much, much less than beta blockers will. Since you have a normally low resting rate, I would imagine he chose it specifically for that reason.

I wouldn't hesitate to take it.

Thank you for that explanation. It makes me feel better about it. I'll follow-up with my Dr for his specific reason for prescribing it to see if the "1:1" thing was on his mind.

I've taken Diltiazem, no side effects at all, just made me lethargic. No afib.

I love this drug.

Ask why, but probably to cover bases and theoretically protect you from a very rare 1:1 flutter. Given you've done so well without it, for so long, personally I would question if the Diltiazem is necessary. The underlying study data here is sketchy and that's why many ep's let patients take Flecainide without a nodal blocking agent like Flecainide. That said, in some cases Diltiazem may have mild antiarrhythmic properties, and therefore can be useful in help preventing certain tachycardias, but probably not atrial fibrillation. That has been my experience so I use it on a PIP basis at times.

Jim