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Afib and taking only Sotalol

Posted by payette78 @payette78, Sep 12 11:05am

I just found out i have paroxysmal afib. Showed up on a holter test 4 years ago. My primary care doc didn't bother to tell me. Cardio put me on Sotalol back then and i have had no episodes in 4 years. Also have SVT. Had a normal ECG yesterday; cardiologist is OK with Sotalol only. Ordered echo but the wait is a year here. Anyone else on just Sotalol for Afib? Thoughts? Concerns?

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payette78 | @payette78 | Sep 12 8:35pm
In reply to @payette78 "I have both SVT and AF. I was on metoprolol for years when diagnosed with only..." + (show)
Profile picture for payette78 @payette78

I have both SVT and AF. I was on metoprolol for years when diagnosed with only SVT. Then a holter test in 2021 showed episodes of SVT and Afib and the cardiologist switched me to Sotalol. No talk of anticoagulants. The cardiologist has been practising medicine for 50 years. I got caught off guard by the Afib because i didn't discover it till i got home and read the holter report myself. I think he just assumed the doc who treated me 4 years ago had told me about the AF.

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The first time i saw the 2021 holter report was yesterday, in case i didn't make that clear. I read it after i got home from my cardio appointment.

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tsch | @tsch | Sep 13 5:23am

@payette78 I am a dual citizen, born in Canada, but living in USA. I have thought of moving to Canada, even where you are. I am sorry your medical options are so bad. This is outrageous., sadly.

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gloaming | @gloaming | Sep 13 11:14am
In reply to @tsch "@gloaming -I see no reference from @payette78 to AMA or any place. I can't imagine waiting..." + (show)
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@gloaming -I see no reference from @payette78 to AMA or any place. I can't imagine waiting a year for an echo. Seems not possible, its not a big deal test.

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My mistake. It was crewsr who had replied, not payette.

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gloaming | @gloaming | Sep 13 11:18am
In reply to @payette78 "I have both SVT and AF. I was on metoprolol for years when diagnosed with only..." + (show)
Profile picture for payette78 @payette78

I have both SVT and AF. I was on metoprolol for years when diagnosed with only SVT. Then a holter test in 2021 showed episodes of SVT and Afib and the cardiologist switched me to Sotalol. No talk of anticoagulants. The cardiologist has been practising medicine for 50 years. I got caught off guard by the Afib because i didn't discover it till i got home and read the holter report myself. I think he just assumed the doc who treated me 4 years ago had told me about the AF.

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Normally, unless there is a specific reason to not do so, a cardiologist who learns his/her patient has formally diagnosed AF will ask that person to take a DOAC. They go by the CHA2DS2-VASc calculated score where if the patient is at 2 or above, they are supposed (?) to be placed on a DOAC. Maybe your score is under that, or perhaps your cardiologist is concerned that a DOAC is counterproductive for you. Might be something to run past that person next time.

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tsch | @tsch | Sep 13 12:01pm
In reply to @gloaming "My mistake. It was crewsr who had replied, not payette." + (show)
Profile picture for gloaming @gloaming

My mistake. It was crewsr who had replied, not payette.

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Actually glad she answered. Atlantic Canada medical system is pitiful.

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payette78 | @payette78 | Sep 13 2:01pm
In reply to @gloaming "Normally, unless there is a specific reason to not do so, a cardiologist who learns his/her..." + (show)
Profile picture for gloaming @gloaming

Normally, unless there is a specific reason to not do so, a cardiologist who learns his/her patient has formally diagnosed AF will ask that person to take a DOAC. They go by the CHA2DS2-VASc calculated score where if the patient is at 2 or above, they are supposed (?) to be placed on a DOAC. Maybe your score is under that, or perhaps your cardiologist is concerned that a DOAC is counterproductive for you. Might be something to run past that person next time.

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My score is 4. Why wouldnt cardio put me on a DOAC

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gloaming | @gloaming | Sep 13 2:41pm
In reply to @payette78 "My score is 4. Why wouldnt cardio put me on a DOAC" + (show)
Profile picture for payette78 @payette78

My score is 4. Why wouldnt cardio put me on a DOAC

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[....GULP!...] He may not have kept up with the latest research on AF and stroke risk, which is about 3-6 times what a 'normal' heart would have when not in AF.
https://thrombosiscanada.ca/hcp/practice/clinical_guides?language=en-ca&guideID=STROKEPREVENTIONINATRIALFIBRIL

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jtrasper | @jtrasper | Sep 13 4:28pm
In reply to @gloaming "Thanks for all that. So, you do have AF. And, going by all that you have..." + (show)
Profile picture for gloaming @gloaming

Thanks for all that. So, you do have AF. And, going by all that you have shared, I am all but certain that you are taking a DOAC (rivaroxaban or apixaban? Plavix?)
I couldn't agree with you more about self-education, even extensive note-keeping. And it's true, a GP is only able to give you maybe 15 minutes, especially in the socialized medicine systems. That may, with his/her good will, allow some dialog over two problems. Here in Canada, if you whip out a list, the GP will hold his/her hand up and say one item per visit (although truthfully they don't usually mind a couple of conditions).
As for any medication for arrhythmia, it depends on the arrhythmia and on the patient. Some can tolerate flecainide, some can't. Tikosyn (Dofetilide), the 'second strongest drug' behind amiodarone, must be started in hospital under observation, usually a two to three day stay. But there are others like propafenone (Multaq).
https://www.drugs.com/drug-class/antiarrhythmic-agents.html

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Multaq is dronedarone. Propafenone is different

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payette78 | @payette78 | Sep 13 5:22pm

Thanks to everyone for the detailed and thoughtful replies. You are all my heroes.

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gloaming | @gloaming | Sep 13 9:18pm
In reply to @jtrasper "Multaq is dronedarone. Propafenone is different" + (show)
Profile picture for jtrasper @jtrasper

Multaq is dronedarone. Propafenone is different

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Quite right. Brain fart. Thanks for pointing that out.

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