What different medications control rhythm
I’m an 81 year old female with a CRT pacer. I have a history of chronic A-fib and recently had a Super Ventricular Tachycardia episode. Historically I’ve resisted using various heart meds because they slow my heart too much, make me fatigued and/or cause my thinking to lose its sharpness. Also, I’ve had typical dermatitis from numerous medications. My new cardiologist gave me amlodipine.
What are some of the choices or problems people here have had?
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Multaq is a prescription medication.
Hi John
Can you tell me which metoprolol, Tartrate or Sucrafate.
Thanks
I see we have a lot of different meds and I've been on Amiodarone and Solitol but one I was on that I don't hear much about is mexiletine. along with Amiodarone were my 2 during most of the 10 years I had VT. I remember once after an ablation I was taken off mexiletine and I had to be rushed to the hospital due to lots of arrymias and pacemaker/difibulator shocks. Once they got the Mexiletine going again things calmed down. I wonder why I don't see that one mentioned anymore. I know prior to my Heart Transplant I thought it was a pretty good medication.
Update: I did not have Supra Ventricle Tachycardia. After numerous tests in my current hospital stay, the determined I had V T (that’s worse) and changed my device to a CRT-D yesterday! It both paces for slow and will shock in the event of VT. Taking Mexiletine, it controls VT & does not slow the heart. Was allergic to amodarone!
con't ... my body knows when I'm having an "event", I felt no need for a risky inplant. Events are short-lived and rarely top 130 bpm.
What factors might one consider of ablation vs. medication? Apparently, med no longer working. This is for 87 year old, male with dementia that’s pretty substantial. Quadruple bypass in 2000 with 4 stents since. On Amiodarone for last couple of years prescribed by top cardiologist who is located in another city from patient. Cardioversion worked well several years ago, but AF returned despite meds. Care now with PCP due to difficulty of travel long distance for cardiologist. Concern since patient doesn’t understand surroundings and does not tolerate anything on his skin like IVs. Picks at any wound, difficult to manage in a facility as he demands to leave immediately. We are considering hospice evaluation, but not sure if any procedure could help with comfort at this point. He reports no pain, but weakness, fatigue. EF score has been low, under 35, since 2016, with the exception of one time period. Any input appreciated. Trying to be realistic.
This is easy for me to offer because I have no 'skin in the game' except for my conscience and learning, but no expertise. I used to teach ethics at the university level, if that helps.
Elderly patients are at risk for general anesthesia, so the option would probably be propofol, but that would be up to the anesthetist. A profoundly demented patient, as you seem to suggest your friend/kin is, is perhaps demented due to the effects of prior arrhythmia that went unnoticed or poorly managed, perhaps for years. So, I'm inclined to suggest to you that your patient be allowed to live out the rest of his life 'naturally' with the best medicines that work, but not with mechanical remediation such as what an ablation has to offer. IOW, I think that an ablation might be the best option for the aim of controlling his heart rhythm, as it is for the heavy majority of us without dementia, but I don't think it's the best option for him due to the risk and to the expense. I would even hazard a guess that, given his state, he's not likely to live much longer after an ablation than he would have just being monitored and kept comfortable.
I appreciate that you are attempting to take a serious look at this, even to the extent of seeking other opinions. Mine is but one. Please be patient and others will offer their own in time, and please count theirs with the same weight as you do mine.
Valid points. He has an advance medical directive so I think palliative care is reasonable.
I was prescribed Cordarone 200mg/day for ventricular tachycardia and Ventricular fibrillation, also Concer 5mg/2x day. My heart went to normal sinus rhythm, so Cordarone works for that. However it's toxic for other parts of your body. I can fell when my heart is out of sinc, so I stopped taking both to see what would happen, nothing. My heart staued in NSR for a week, starting going bad again so I took another, good for a week again. Now I am looking at Hawthorn Berries, which are supposedly an excellent herb for Ventricular fibrillation and tachycardia, but this herb takes several weeks before it works, I will keep the board updated.
Talk to your doc about antihistamines for your dermatitis. I take 3 Allegra daily to ward off the medication dermatitis, hives and other allergic reactions.