Can not speak to the Ivabradine. When I came off amiodarone the EP wanted me to take 120mg Sotalol twice a day! This dose was to start 4 weeks after being off amiodarone because amiodarone stays in the body for a long time. I decided on my own to start with 40mg sotolol twice a day for 2 weeks and then slowly increase to 80mg twice a day. At 1 month from quitting amiodarone I stayed at 80mg in thby calvin - AFIBBERS FORUM
To answer both sets of questions, no, I was fortunate to have an EP who is excellent and who was interested in having another crack at my arrythmia. He won the second round with a KO? >< No pacemaker. And yes, as many here will attest, Carey being one, metoprolol is great for mild and early cases of AF, but later on, certainly once the heart is being fiddled with, or when the dose of mby gloaming - AFIBBERS FORUM
Quotegloaming I also had long pauses, but I feel it was caused by the metoprolol. In my case, I had gone for almost three years on 12.5mg/BID. Then, my AF seemed to become more aggressive, and before long I was taking 100mg per day. I had a first ablation, but ended up in the local ER six days later feeling distinctly unwell, and in AF detected by my own GP when I went in per instructions uponby calvin - AFIBBERS FORUM
I also had long pauses, but I feel it was caused by the metoprolol. In my case, I had gone for almost three years on 12.5mg/BID. Then, my AF seemed to become more aggressive, and before long I was taking 100mg per day. I had a first ablation, but ended up in the local ER six days later feeling distinctly unwell, and in AF detected by my own GP when I went in per instructions upon release from tby gloaming - AFIBBERS FORUM
I am presently on 80mg twice a day. Been on it for 2 years except for a 4 month period after my pace maker install where I was on amiodarone. amiodarone is a disgusting med so I went off it and back on the Sotalol. I go into AFib 5 or 6 times a week always at night or early morning and the sotalol keeps the heart rate lower, I stay in A Fib for only 1 hour at a time. I do have fatigue but stillby calvin - AFIBBERS FORUM
When my first ablation failed on Day Six (yikes!!), the nursing staff found that my heart rate was varying between zero to 150+ BPM. The 'zero's' lasted the equivalent of about eight beats, and they freaked out, rushing in to find me talking calmly with my wife. The internist consulted with my EP during the evening and the result was that I was to cease taking metoprolol immediatby gloaming - AFIBBERS FORUM
@ Daisy, In this case I was sitting at a table very still and didn't move at all. I don't think there is much or any noise/static in the EKG? Being that flecainide caused a wide QRS for you I wonder If amiodarone is doing the same. Carey mentioned it isn't wide enough to be of concern and I'll see what the EKGs over the next few weeks look like. @Joe, Thank youby cornerbax - AFIBBERS FORUM
QuoteDoes amiodarone affect QRS duration? Amiodarone's effect on QRS duration is between that of the IB and IA agents consistent with its tau rec of 1.5 seconds. Moricizine's effects on QRS duration are more marked than would be expected from its tau rec of 2.6 seconds but may be explained by the slow onset of inactivation block.by Joe - AFIBBERS FORUM
I don't have the experience here, although I was on Amiodarone for eight weeks two years ago. However, it seems that a wide QRS is often associated with right bundle branch block. This might not be a compelling issue, particularly if the results show NSR consistently, but it's definitely worth a fly-past of your cardiologist.by gloaming - AFIBBERS FORUM
Kardia flagged my most recent ekg as Sinus Rhythm with Wide QRS. I've attached it here. It's the first time I've seen the Kardia say this. I've had tachycardia, unclassified and afib over the last couple of weeks but this is the first Sinus Rhythm with Wide QRS. Is there any reason to be concerned about this? My rate was 99 during this ekg, so I'm wondering if itby cornerbax - AFIBBERS FORUM
Quotecornerbax Any specific medications work better for Sinus Tachycardia then the amiodarone and metoprolol combo I'm currently taking now? It's not unusual for Amiodarone and a beta blocker like Metoprolol to be given post ablation -- tachycardia's or not -- especially after a Maze. The Amiodarone to hopefully help keep things in rhythm until the heart heals during blanking. Soby mjamesone - AFIBBERS FORUM
Carey, I'm not sure if amiodarone is doing anything at all at this point. The reason I say this is my initial amiodarone dose for two weeks was 800mg total 400mg twice a day. When I noticed the higher heart rates and sinus tach and or flutter, I still had two full days of 800mg of amiodarone which I took before the taper down to 400mg. My rate hasn't changed at all going from 800mby cornerbax - AFIBBERS FORUM
The best combinations are individualized, so what works great for one person might not work at all for someone else. You're just going to need to work with your EP on this. Hopefully, metoprolol alone will work for you because you don't want to remain on amiodarone long term.by Carey - AFIBBERS FORUM
Jim, Thank you again that is more excellent info! I'm glad to know how Kardia flags over 100bpm with the premium service. I'm just under 3 weeks out from surgery so I don't think I'd have anything classify as inappropriate sinus tachycardia. My EKG from my doctor's visit last Wednesday was classified as Sinus Tachycardia but with a statement that flutter can'tby cornerbax - AFIBBERS FORUM
EPs are supposed to be able to map out the heart's electrical system and to look for re-entrant foci, which is what I'm sure we're dealing with here. When ablations time-expire, it means another re-entrant has been established (and proving, despite the denial of a few, that AF is progressive in nature). IF you have an EP wiling to tackle your heart, and indicates that he/she willby gloaming - AFIBBERS FORUM
Hello Mary So your last ablation lasted 4 years which is a blessing to be in NSR for the 4 years. I can only speak to going back on amiodarone as I have been on it in the past and found it to be the most awful med Ive been on. The side effects were truly terrible, I believed the med was worse than the AFib. I have a pacemaker and at the last check up it was pacing 82% of the time so for me to goby calvin - AFIBBERS FORUM
Hello all I am having a difficult time trying to decide on which path to take. My last ablation (#4 done in Feb 2020) finally gave out a month ago, a total bummer. I was asked to take propafenone which is actually working but with bothersome side effects. I have tried so many other meds in the past and none was suitable so the only other drug left is amiodarone which I would prefer to avoid forby NoTrigger - AFIBBERS FORUM
I agree with Carey in that amiodarone is a 10 pound sledge hammer where maybe a two pounder will do. Or a five pounder. If is an effective anti-arrhythmic drug, but it is highly potent and can have serious side effects on the lungs and kidneys, as examples. Even so, when I had some trouble after my index ablation, and metoprolol was putting me into bradycardia at times, but also did nothing forby gloaming - AFIBBERS FORUM
Amiodarone is an antiarrhythmic, not a rate control drug. Amiodarone is very effective, but it does have serious side effects if used long-term. It also has a very long half-life so it takes weeks or even months to get out of your system after you stop taking it. So what does your EP actually want? A rate control drug or an antiarrhythmic? Since you just had an ablation I would imagine itby Carey - AFIBBERS FORUM
Quotemjamesone ... Just looking for anecdotals here on post blanking events and how things eventually turned out. Jim Sorry, I completely forgot that part of your question. As briefly as I can do it: Had an index on July 27/22, and was in the ER six whole days later, put on Amiodarone, told to stop metoprolol completely. Went on to within two days of completing my 8-week regimen of Aby gloaming - AFIBBERS FORUM
I was thinking the same thing that Metoprolol is working great in both ways. I guess as the days continue to go by we'll see if that continues to be the case. So far today I haven't seen an Afib episode and 3 days into metoprolol 50mg my heart rate has averaged 62-65bpm. It hasn't gone too low even at rest. I was not given Colchicine, I have never even heard of it. Directlby cornerbax - AFIBBERS FORUM
Wow, I was in EXACTLY the same situation in early August of '22. Six days after my first ablation, I was in the ER with HR upwards of 145, sometimes much higher. They told me to stop metoprolol immediately. Why?!? Because, said the nurse who hurried in to check on me, holding her two index fingers eight inches apart in front of her, we watched your heart stop beating for this long on theby gloaming - AFIBBERS FORUM
@gloaming, This is excellent information, thank you. I know there was a reason that my cardiologist didn't prescribe metoprolol with my other medications. They just said when prescribing my medications that metoprolol was one they were gonna hold off on until they see how I do without it the first week. Well, I got through right to the 7 day mark before the Afib yesterday morning. Whenby cornerbax - AFIBBERS FORUM
Well I have to report that I didn't maintain 100% consistent sinus rhythm. I went to the bathroom around 2:30am and felt and saw my heart rate monitor from my watch was at 104bpm and just sitting on 104bpm without changing. I know when I've seen this in the past it's due to Afib. The only full proof way to know is to run the watch ekg which showed 145-152bpm. I ran it a coupleby cornerbax - AFIBBERS FORUM
I couldn't wait to get on that operating table. I was giddy with excitement, even though I felt like hell in the weeks leading up to it due to increasing episodes of AF. For me, drugs and all the other palliatives and 'remedies' were flying in the face of all the research telling anyone who wants an honest appraisal of AF that it is a progressive disorder. It will almost certainby gloaming - AFIBBERS FORUM
My journey with medications has also be hell. I was on Metoprolol for 5 months and it did nothing to help my A Fib.I then switched to Sotolol which kept me in NSR for about 3 months then quit working and every night I would have 2 episodes of A Fib as recorded on my Kardia .This went on for 6 months then I started to pause when coming out of A Fib, I actually looked forward to the pause as it sby calvin - AFIBBERS FORUM
A bit late here but I did take propafenone for many (7 I think) years for paroxysmal afib and it worked very well. Until it didnt. I don't believe I tried it as a PIP nor was ever advised to do so. When it stopped working I tried sotalol, dofetilide and dronaderone and they either did not work or caused major side effects. The only drug that worked then was amiodarone but it also stopped worby NoTrigger - AFIBBERS FORUM
[...Managing the anxiety, however, will be a challenge! He told me to take 200 mg’s of flec in one dose and an extra metoprolol and also restart the Eliquis in the event of an episode. He said sometimes flecainide will convert an episode for an afib patient AFTER an ablation even though it had mostly stopped working BEFORE the procedure...] I reread your OP, often a wise thing to do for a guyby gloaming - AFIBBERS FORUM
I was never prescribed it, but when I called for help to the outreach nurse at the AF clinic when my first ablation failed, I had been placed on amiodarone by the EP when the ER called him to ask for advice. The outreach nurse said they usually prescribe propafenone for cranky hearts after an ablation. So, it is useful. I don't have a clue about its efficacy/take up as PIP.by gloaming - AFIBBERS FORUM
The niacin/sauna detox was initially developed by L Ron Hubbard, the founder of Scientology, to help people get out of drug addiction. David Root MD, was an occupational medicine doc. In the late 1970's (I think - I'm writing this from memory), a flyer showed up in his mail, that he discounted initially. But he had a couple of patients with issues he could not solve. So he folloby GeorgeN - AFIBBERS FORUM