Meds to stop Afib

I have been Afib free for 4 months. I was taking diltiazam 180daily for years and it was making me dizzy. I lowered dose to 60mg twice daily. Dizziness decreased but it was still there.

four months ago I stopped diltiazam completely. Dizzy no more.
I only take Xarelto 20mg now. No supplements except iron tablets.

I’ve decided to take diltiazam only at the onset of Afib. If it persists, I’ll take amiodarone. I’ll see what my cardiologist says at my next appointment.

I think that your self-imposed protocol might just work, and it will build confidence when and as it does. Just, please, fly it past a physician knowledgeable about those medications. BTW, a great many AF sufferers rely on the PIP protocol (Pill in Pocket) for when AF starts on them. Many just use flecainide, but whatever beats it down for you is what you should take.

Amiodarone worked wonderfully when my first ablation failed just six days later. Over night, my HR went from a chaotic 140-188 down to mid-50s. I was to stop metoprolol immediately, and to start a full week of a loading dose of amiodarone on a whopping 400mg BID (twice each day) for a total of 800 mg. A week later, I took only 200 mg BID for three weeks, and then weaned to only one 200 mg pill for two weeks. It's a great drug, but it has its rather nasty costs levied against the lungs and liver.

I take 50 mg of flecanide twice a day. 2.5of bisprolol once a day at bedtime.
No afib for nearly a year.
So far it’s working for me.

@phillipdobrien -- Generally, folks dealing with AF are better assisted by an EP (electrophysiologist... an MD that specializes in heart rhythm probs), rather than a "regular" cardiologist (a generalist heart MD).

Also suggest you locate an experienced EP in your local area.

All the best!

/LarryG

79 yes. Woman.
I’m on both those meds.
And also Flecinade
Which has been
Very good to me.
I wouldn’t be without
Those metropolol
Elequis and flecinade.

Thank everyone for their input. I visited an EP & was told my risk is so low that Eliquis & Metoprolol are adequate for my Afib & an ablation would not be advised. Thanks again !

I have been taking Metoprolol since I first experienced an episode of Afib that put me in the hospital. This occurred after taking the second shot. I won’t be taking a booster or any other covid shots/ not going to push my luck. I take the Metoprolol and Xarelto and have had no other occurrences. I had no prior heart conditions.

Hello @rgharding1234. Welcome to Mayo Connect. I had an a-fib diagnosis 5 years ago and a small stroke a year later. Your symptoms seem similar but more intense. My cardiologist prescribed Carvedilol as my main medication for a-fib. It is in a class of drugs known as beta blockers. Metoprolol is also a beta blocker, so I'm not surprised that your medical team has put you on it. Your Xarelto is an anticoagulant, one of a small group that is prescribed to defend you against blood clots (like the one that caused my stroke). Each of them has a particular antidote that may be needed to stop bleeding that Xarelto or one of the other anticoagulants is supporting. I have one serious warning about this and other anticoagulants: Not every hospital emergency room keeps a supply of antidotes in stock, OR the ones they stock are less or little effective in neutralizing an anticoagulant. I feel strongly about this because my friend was taken by ambulance to a hospital one mile away after he fell off a ladder injuring his head. He had been taking an anticoagulant for a few years. The hospital did not have the proper antidote on hand, so after an hour or so in the ER, he was helicoptered to another hospital 30 miles away where they found his brain bleed too much to control, and he died in the arms of his family shortly after they arrived from my neighborhood. Since then, I don't enter a clinic, a hospital, or an emergency room without asking the staff if they have the antidote on hand for my anticoagulant, and what is it? Those antidotes are pertinent to specific anticoagulants and sometimes don't work -- don't stem the bleeding and can be more serious as a result of Xarelto or another anticoagulant. Take care, my friend, so that I don't have to lose another friend to careless application of these medications. Martin

Martin, so sorry to hear about your friend. Definitely one of my fears in taking a blood thinner. Can I ask if you were already on the meds when you had your stroke? Also, how frequent and severe were/are your afib episodes? How long did they last? How high did your heart rate go?

Hi @californiazebra. Going right to your questions, I was on a "blood thinner" when I suffered my small stroke. At the hospital, I asked for a Vitamin K antidote, which they did not have on hand. I resolved to not rely on that hospital again. Fortunately, we checked the anticoagulant impact (the INR) every day for a week, and it remained within tolerable limits.

My a-fib episodes have never been frequent or severe. They have been almost asymptomatic and, surprisingly, manifested by missed heart beats rather than more and stronger ones. As such, they didn't "last," and my heart rate remained in my life-long range of 50-55. Martin.