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antiarrhythmic drugs or ablation
I am a 79 year old woman, developed persistent Afib with rvr in March. Tried metoprolol tritated to 75 mg twice a day and it did not bring rate low enough but blood pressure was too low so switched to diltiazem, which again helped some but rate still not low enough. I also have apical hypertrophic cardiomyopathy. I saw electrophysiologist last week and together we decided to try dofetilide before an ablation. I could have made the choice to go straight to ablation. Now am doubting my choice as the loading process scares me to death. Am scheduled for dofetilide loading in September, so too much time to think about it. Can anyone tell me about their experience with this drug and loading. I can still change my mind and go straight to ablation. Thanks.
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Hello Gloaming,
This is CeCe55. My last post was on Post Ablaltion several weeks ago and as I was scrolling thru the Mayo Connect Subjects for Heart Rhythm I came across yours.
I had my second ablation on May 18 of this year. Unfortunately, my AFIB was corrected but I started having Flutter with heart pauses. This was truly scary. I wear a loop heart monitor under my skin and my EP team saw that my heart pauses were too long and called me to call an ambulance.
I was in the hospital since Monday of this week and just got out yesterday. My EP changed my antiaarhythmic drug which was Flecainade to the drug you are considering which is Dofatelide. I am very drug sensitive so he started me on the middle dose which is 250 twice a day. You have to be in the hospital for at least three days to see how you react. It was too strong for me so they lowered it to 125 twice a day. Please don't be afraid or anxious if you choose this route. I never felt safer than when I was in the hospital and they were watching me. I read, played Soduku, slept and walked the hallways. The hospital food was even very good! I went into sinus rhythm after one dose.
I am home now and taking the 125 Dofatelide along with 25Metoprolol Time Release and my Eliquis. One of the reasons I had the second ablation was to get off of at least Flecainade. Instead, I ended up with a new antiarrythmia drug. I also developed PACs off and on which I didn't have before.
Whatever you choose, do not be anxious about the Dofatelide. I am the most anxious person there is, to the point that they put me on Klonopin during my stay. All was well. Now we will just have to wait and see how I adjust. For me, the mental part of all these arrythmias is just as bad or worse than the disease itself.
Bless you and just know getting loaded with this drug was not a big deal. No one had ever mentioned the heart flutter with pause possibly happening with an ablation but the more that I read, I find it referred to.
All this being said, I probably would consider a third ablaltion. My AFIB for now is gone.
Take care and I will answer anything you would like,
CeCe55
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1 ReactionHi CeCe55,
I posted a message about Dofetilide loading and being terrified of the process. Since I have to wait until September to do this, I have plenty of time to be anxious. Making the choice between that and an ablation was a tough decision. When I asked my EP what he would recommend, he suggested we start with drugs. I started with metoprolol tritated to 75mg twice daily and it caused my blood pressure to be too low and much fatigue, but didn't control the rate enough. So now I have been on Diltiazem 240 once a day, and blood pressure not as low but rate still not controled. Have been in persistent AFIB since March. Since I have Apical Hypertrophic Cardiomyopathy, it seems AFIB is harder to treat. Am certainly hoping Dofetilide works for me even though I hate the drugs. Thank you so much for sharing your experience.
emo44
I've been on dofetilide now for at least 8 years. Never have had a problem with it and have not had any afib events with the exception of 2 in 2021 right after I had 2 Moderna Covid shots. I attribute those events to the shots and I will never have another shot. The loading is a non-event. The only,problem I've had with dofetilide is when, for some reason, my cardio told me to go from 250 to 500 twice a day. This caused a pretty severe rash over my hands and other parts. (As mentioned in side effects). When I went back to 250, it all went away with no ill effects. My cardio has never suggested ablation and I'm happy to stay away from it.
I’m not familiar with “loading”? Are you talking about the 3-day hospitalization to start Dofetilide?
I’ve been on Dofetilide 8 years this week-I’ve never had any trouble and I’m a 77-year old woman. I also take Metoprolol and Diltiazem.
I see my electrophysiologist every 6 mo and have to do lab work and EKG every 3 months.
I was not a candidate for ablation.
Yes, "loading" is the three day stay in hospital to start Dofetilide. Thank you for sharing your experience. Everyone who has shared their experience has helped to lower my anxiety. Am hoping my 3 days in hospital are as uneventful as all who have answered my post.