Paroxysmal Atrial Fibrillation patient wants med management only

Posted by lov @lov, Nov 21, 2019

I want have my intermittent A-Fib managed with only medication, not with any invasive procedures, given I have only had 3 episode since 2015.
Anyone successful with this plan?

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Definitely successful. I take dofetilide, diltiazem, and warfarin to help control my afib - since 2015. I'm 85 - making it risky to have an ablation. I have found that over exertion definitely can bring on an afib attack and avoiding that happening can keep attacks away. Like many, I also avoid alcohol and caffeine and smoking. Good luck to you and finding what you need to do or not do to keep the attacks away.

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I manage my Ventricular Tachycardias with Flecainide. It has harsh side effects but it does suppress VTs. I'm sure your drugs would be milder. Before committing to a new drug, I would start supplementing 400 mg of magnesium every day just to make sure it isn't as simple as low magnesium. Blood tests can show you are in range, but it doesn't say anything about magnesium in the heart, which is critical for cardiac conduction.

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Since you have only had three episodes of paroxysmal AFIB since 2015, why would you want to take any medication at all? With episodes as infrequent as yours, I wouldn't even consider antiarrhythmics and you are miles away from needing an ablation. Unless your episodes last for many, many hours and your heart rate is dangerously high during them, I would just try to learn to live with them. (I have paroxysmal AFIB and lived with it for over 10 years) If your heart is otherwise structurally sound, the type of AFIB you have is not considered dangerous. If possible, try to recall what was happening in your life when you had these episodes. Virtually all of us with AFIB have triggers that set off an episode. For me it's stress and anxiety, so I do a lot of work to manage both of those. I would recommend you have a long talk with your cardiologist about your concerns and how YOU want to manage your AFIB. I hope that discussion will give you the peace of mind you're searching for.
RubyWitch

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It took many hours to reduce my heart rate in hospital in Oct.; I have regurgitation in one valve, and have 3 risk factors with chad vasc score: female and age counts twice (74).

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@olgringo1

I manage my Ventricular Tachycardias with Flecainide. It has harsh side effects but it does suppress VTs. I'm sure your drugs would be milder. Before committing to a new drug, I would start supplementing 400 mg of magnesium every day just to make sure it isn't as simple as low magnesium. Blood tests can show you are in range, but it doesn't say anything about magnesium in the heart, which is critical for cardiac conduction.

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I am on Eliquis for blood thinner, metoprolol & diltiazem for rate control, and flecainide for rhythm control.

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@soph

Definitely successful. I take dofetilide, diltiazem, and warfarin to help control my afib - since 2015. I'm 85 - making it risky to have an ablation. I have found that over exertion definitely can bring on an afib attack and avoiding that happening can keep attacks away. Like many, I also avoid alcohol and caffeine and smoking. Good luck to you and finding what you need to do or not do to keep the attacks away.

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emotional and physical stress seem to be triggers.

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Once again, I can only recommend you take these concerns to your cardiologist. When I read your SECOND post where you wrote "It took many hours to reduce my heart rate in hospital in Oct.; I have regurgitation in one valve, and have 3 risk factors with chad vasc score: female and age counts twice (74)" this was information I didn't have when I read your original post. With these other issues present, my advice to discuss ALL of these issues with your cardio takes on a bit more importance. I wish you the best outcome and peace of mind.

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I just started flecainide. What have you experienced as side effects to this drug? I also take Eliquis,Metoprolol and diltiziem

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I have not noticed any side effects to any of the drugs. On Eliquis 5mg 2 x a day; diltiazem 24 hr ER 180 mg 1 a day; metoprolol succ ER 25 mg 1 a day; added flecainide acetate 50 mg 1 every 12 hrs, only added this 10/30/19. Good Luck.

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@lov

I have not noticed any side effects to any of the drugs. On Eliquis 5mg 2 x a day; diltiazem 24 hr ER 180 mg 1 a day; metoprolol succ ER 25 mg 1 a day; added flecainide acetate 50 mg 1 every 12 hrs, only added this 10/30/19. Good Luck.

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I just added Flecainide a week ago because I still have afib events about once a week. I take same Eliquis as you, 100mg of Metoprolol and 30 mg of diltiziem as needed when I have afib event. I take 50mg of Flecainide 2 times a day too. I worry about side effects of the Flecainide but doing ok so far.

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