This is a very detailed story of my experience with ablation. It might be of special interest to Canadian afibbers. After more than 12 years of putting up with afib, I had an ablation on January 22, at the Southlake Regional Health Centre in Newmarket, Ontario, by Dr. Yaariv Khaykin. I had been exchanging e-mails with Dr. Khaykin for about 8 months. He trained for two years at the Cleveland Cby Ritva - AFIBBERS FORUM
Hi Keith, I am not taking the stuff. Sotalol works for me every time to stop AF. If you study this page, you will get a better understanding of the class i drugs. My interpretation is that there is a window of therapeutic dosage where these drugs will help, but if you go outside that window and take to much the consequence could be very serious, if not lethal, due to the proarrhythmic propertby Gunnar 61/v/na - AFIBBERS FORUM
"Recognition of vagally mediated atrial fibrillation as a unique clinical entity has diagnostic and therapeutic implications." This quote from the abstract which follows may help bring clarity to the many newbies out there discovering this BB who are not sure where to begin with the treatment offered for AF. Many of us have had doctors and cardiologists who do not understand that theby Justine - AFIBBERS FORUM
Hi LeAnn, let me start by saying that I have no experience of Flecainide myself. I had Disopyramide that also is a Class 1 antiarrhythmic drug and it almost killed me. I have tried to understand how these drugs work. The class 1 drug blocks the sodium ion channels (Na+) of the heart muscle cells (myocyte). "The principal effect of reducing the rate and magnitude of depolarization by blby Gunnar v/61/na - AFIBBERS FORUM
Hi Rob, My weight at a height of 71 inches is the same as yours. All muscles no fat. I feel the effect of 20 mg of sotalol but I use it only as PiP as my pulse will go to low if I take it regularly. Like you my AF attacks are very symptomatic but my pulse usually is below 180. When AF sets in I take immediately 40 mg of sotalol and 50 mg metoprolol retard caps. and it makes wonders within an hoby Gunnar v/61/na - AFIBBERS FORUM
Hi Sara, I got "torsades des pointes" from disopyramide. It started after I had taken the drugs for 3 days. 52 hours exactly. The way you are asking here mean that you will only hear negative comments about these drugs which gives you a false image on how they work. I think most people respond well but it is important to start the drugs in a controlled environment like a hospital. Youby Gunnar - AFIBBERS FORUM
I am perhaps wrong in the last statement. <; AF is not life-threatening and it is not a ventricular arrhythmia.by Gunnar v/61/na - AFIBBERS FORUM
This story dates back to 2003. It took 2 weeks for my heart to recover. The first days I could not walk to the store. My questions to the physician would be to ask how he sees the risk of "torsades des pointes"to happen in your case and if it happens what kind of preparedness they would have to treat such a situation. I would also bring a friend along to outnumber the physician and to fby Gunnar v/61/na - AFIBBERS FORUM
Gunnar, Wow! Hope you are back on track now. Thanks for the warning, Tomby Tom Hopkins - AFIBBERS FORUM
Hi Tom, I am a vagal afibbers and usually gets the attacks in bed. I was sent home from my cardiologist with disopyramide in 250 mg retard capsules. The 3rd night about 6 hours after taking the 3rd pill at 2 in the night I got "torsades des pointes". It came in waves as soon as i used a muscle in my arms or legs for about 4 hours. After 12 hours I dared to get out of bed. I did not haveby Gunnar v/61/na - AFIBBERS FORUM
Thanks for the first three responses. I guess only taking it will be the true test for me. Regarding flecainide, my arrhythmia specialist says I will have to be hospitalized for three days during the initial doses to watch for any serious problems, and right now I'm trying to avoid that but may have to cave in and do it anyhow. Same goes for sotalol trial. I guess that will be in the futureby Tom Hopkins - AFIBBERS FORUM
I felt sick most of the fifteen months that I was taking Norpace. Carolby Carol A. - AFIBBERS FORUM
Tom, I took it for some time. I had no side effects, but I was never really sure I got any benefits either. My EP suggested that it tended to have fewer side effects than other antiarrhythmic drugs, and my experience seemed to support that. Russby Russ mix/35/35(wmm) - AFIBBERS FORUM
I haven't taken it but my EP wouldn't even prescribe it for me because of the nasty side effects. What about flecainide? If you are vagal, it often helps. I have heard about variety of side effects from Norpace including severe dry mouth, urinary retention, lower cardiac output. But some have had good experiences with it.by Kerry - AFIBBERS FORUM
As a first try to replace quinidine I'm considering NORPACE as it sometimes helps nocturnal onset AF. One of my doctors did not recommend it for me as he said in men it causes prostate problems. However, on the internet I only see that it warns about use for men with prostate enlargement, which is not my case. Any good or bad experiences out there, especially with side effects?by Tom Hopkins - AFIBBERS FORUM
I take 40 mg of Sotalol, 50 mg of Metoprolol and half a pill of Cialis at onset of AF. If I have not converted within 6 hours I take 25 mg more of Metoprolol. In very rare cases of long attacs I have taken one more pill of Sotatol. Remeber I got torsades des pointes from disopyramide and have a strong respect for Sotalol which also is a potassium channel blocker. When the drug are in effect I reby Gunnar v/61/na - AFIBBERS FORUM
My cardiologist was aware of the term "vagally mediated AF" and sent me home with disopyramide which almost killed me as I got "torsades des points". I guess he got the idea from the internet as I also had read that recommendation somewhere and it has also been cited here. The problem I think is how to update the physicians about new findings, which is now in total control ofby Gunnar v/61/na - AFIBBERS FORUM
Hi Keith, Below is the checklist I received. I don't remember exactly, but I took disopyramide (Norpace) right up to the time of the ablation. Actually I went into AF during my trip to Bordeaux from HI. The episode didn't terminate until its 61st while on the table with Prof Haissaguerre. Checklist You will be coming for hospitalisation in our department. This document will helpby PC - AFIBBERS FORUM
Hi Mark, No sugar and insulin is used when alcohol is metabolised. Full stop. Regarding Sotalol you are not telling how much you take. I, like you, am very symptomatic in AF and a beta blocker when in AF is a real blessing. Before I took a beta blocker immediately at onset, I was out of business for a week after AF. With a beta blocker, it is as if it had not happened afterwards. The reason forby Gunnar v/61/na - AFIBBERS FORUM
Hellp Peter, welcome to the family. Here is what I wished I had known when I was first diagnosed. The heart rate is controlled by autonomic nervous system, which has 2 branches: the sympathetic/adrenergic system (the cardiac nerve) accelerates the rate and the parasympathetic/vagus system (the vagal nerve) slows the rate. With no heart damage and given your age, you appear to fit the profile ofby Justine - AFIBBERS FORUM
Yes. Ask to try a new medication. You will never know whether it is the medication causing the problem or something else if you do not. I know it may be frightening to think that the afib will come back, but even if it does, you then know two things... whether or not the sotalol is actually keeping you in NSR, and whether the ill feelings are side effects from it. I can testify firsthand that drby Russ na/35/35(wmm) - AFIBBERS FORUM
Thanks again PC. I seems to have a problem with my computer as the "new" flag does not alway appear. I have 7 EKG recording here in front of me. The problem is that they are all taken when I have AF but the last one which is when I had bigemini and trigemini. I suppose they do not get very reliable then because I have found that the software of the EKG recorder computes the QTC from tby Gunnar v/61/na - AFIBBERS FORUM
Hi Mariam. I disagree a little with you there. If you take a beta blocker for a long time the body get used to it and you take a lot more than 40 mg. To stop right off could be dangerous, but if you do not take any beta blocker at all and then take 40 mg of sotalol it is not a problem the same is certainly true with 50mg of metoprolol and you could take more, half pill or a whole pill after 4 houby Gunnar v/61/na - AFIBBERS FORUM
Diana, In answer to your question: "Does Rythmol (propafenone) always work on demand?" One study showed that it worked in 94% of cases and no studies, that I am aware of, has found that this approach is unsafe for lone afibbers or people with SVT. The following excerpt from Volume III of my LAF book will give you some more details of the approach. And, yes I agree with Gunnar that if the pill-by Hans Larsen - AFIBBERS FORUM
Bob., Disopyramide and Flec are both best characterized as "rat poissons". Sotalol is nothing compared to those. I have especially bad experience of Disopyramide as it gave me "Torsades des Pointes". All three drugs are dangerous if you have a high QTc value even if Flec is less so. See What is QTc: Drug list:by Gunnar - AFIBBERS FORUM
From pp. 1250-1251 of ACC/AHA/ESC Guidelines - Guidelines for the management of atrial fibrillation - 2001 http://circ.ahajournals.org/cgi/reprint/104/17/2118 "Disopyramide or flecainide may be used in cases of vagally mediated AF, whereas beta-blockers or sotalol is suggested as the initial agent for adrenergically induced AF." Is this correct? Are there exceptions?by Bob K. - AFIBBERS FORUM
Hi Pam, since 1988 I have been taking varoius drugs for hypertension. In 1999 a cardiologist in Encinitas, Ca finally got it right and I have taken these drugs with good result ever since: 160 mg Diovan 40 mg Zestril (lisinopril) 10 mg Norvasc (amlodipin) 2002 I fell on the tennis court and broke a rib and cracked the cartilage in the center of my chest. I do not live in US any longer. My BP weby Gunnar - AFIBBERS FORUM
Drug-Drug Interactions propafenone and sotalol (major Drug-Drug) Description: GENERALLY AVOID: Class IA (e.g., disopyramide, quinidine, procainamide) and class III (e.g., amiodarone, dofetilide, sotalol) antiarrhythmic agents can cause dose-related prolongation of the QT interval. Theoretically, coadministration with other agents that can prolong the QT interval may result in elevated risk ofby Doug Symonds - AFIBBERS FORUM
Carol: Here's what RXList has to say about it: "The mean plasma half-life of disopyramide in healthy humans is 6.7 hours (range of 4 to 10 hours). In six patients with impaired renal function (creatinine clearance less than 40 ml/min), disopyramide half-life values were 8 to 18 hours. " I'd think it would be well gone in a few days. Gordonby Gordon - AFIBBERS FORUM
My question was generated from the questions about AF prompt at the top of the BB. It Says Prevention of vagal type LAF Flecainide and disopyramide can be quite effective in preventing vagal LAF episodes. They are both powerful drugs and can have very serious adverse effects so they should only be used by afibbers with structurally sound hearts. Beta-blockers and antiarrhythmics with beta-bloby jim - AFIBBERS FORUM