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Multaq questions
I am 56 years old. I was diagnosed with Atrial Flutter early January 2024. Successful cardioversion(cv) in February. Prescribed Multaq (400mg twice a day) after cardioversion(cv). Was on Diltiazem and Pradaxa prior to cv. No longer on diltiazem or blood thinners. I use an Apple watch every day. My resting rate for the last month was 42-49 bpm. I have had no recurrence of the flutter since cv, but the low rate concerns me and I want to stop taking the Multaq. I do exercise regularly and my blood pressure runs about 135/70. I don't have any recognizable symptoms from taking Multaq except the low heart rate. I'm really interested to know if anyone had similar response to this drug? I have an upcoming appointment with the Cardiologist and want to discuss coming off or discontinuing Multaq. Any advice would be greatly appreciated.
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Sounds like a good outcome for you! Congratulations! I have been on Multaq since 1/30/26 post pulsed field ablation for Afib to regulate rhythm. It has worked like a charm for rhythm regulation. My resting HR has actually been higher since starting the Multaq (86 vs 60s) so I’m curious about Multaq effects on heart rate. I am on Metoprolol too, which is more for rate control as I understand it. But, the difference/similarity in medication effects are still a bit confusing to me.
I had my last ablation last May 2025. (3 total) Went into Afib 30 days later. hard a cardioversion (12 total in 9 years) and back in rhythm. On multaq now ( 3 months so far) and getting some blurred vision in right eye and feeling just "off" a lot of the time. I also have a slow heart rate when chilling, in the high 40's low 50's which concerns me. Has anyone been on Multaq for a period of time and then slowly got off of it and stayed in rhythm?
@akminn It is quite unlikely that your heart rate is a problem if you are truly relaxed and at rest, not placing a demand on your heart, and it's in the 40's and 50's. It 'could be', but it's unlikely. I suspect that you have something else going on with the blurry vision.
Most people successfully stop any medication that can be stopped, although sometimes it requires a 'taper'. You should be able to do this if for no other reason than to see if you still need it...in my thinking. However, your cardiologist or EP would need to have input at the very least, and give you advice about HOW to initiate the taper and to close it off at some point.
I've been on Multaq, on and off, for about 10 years. Came off of it for a few years after a cardiac ablation. Then Afib returned. Had another ablation which lasted less than 2 years. Back on Multaq. For me, I still have Afib instances, but not as often. Usually once or twice a year while on Multaq. While sleeping, my heart rate is in the 40s. But when I get an Afib attack it's over 120. I have paraxsysmal Afib. Multaq's side effects scared me too. But my cardiologist believes it's the safest of all the other drugs out there to treat Afib.
@nanalu We humans have our 'faves', and I'm guessing your cardiologist is no different. I know physicians whose 'fave' is propafenone, or flecainide. The thing is they each have problems, they aren't equally tolerated across patients, and they have different chemical properties. The trick is to find one you can continue to take that doesn't make you miserable or make your condition worse, AND THAT produces the desired major effect...controlling your arrhythmia.
You are fortunate that your AF is still in the paroxysmal stage. Mine was for about five years before it became objectionable due to increased frequency and how it made me feel. If I could convince you to find another electrophysiologist and have a fresh set of eyes on your heart, I would. You're still in the early stage, a bonus, but it might not last forever. AF tends to progress, sometimes accelerating into another more advanced stage. A new EP might figure out what is going on with you, where you need further ablation, and maybe have you off drugs and free of AF for several years. Just sayin'...
@gloaming
Thank you for your reply. I do think that my cardiologist favors Multaq. My husband and I think he owns stock in the company LOL. I've been to 2 electrophysists. Cardiologist is now talking about another AV node ablation and a pacemaker. Don't understand how a pacemaker would help since my heart rate goes up when in afib. I also have mitral and aortic valve issues and wonder if these are the causes of my afib.
@nanalu If an EP nukes your AV node, there is no further conduction down the Bundle of His and on to the two bundle branches. This means no more ventricular activity, and that is what the pacemaker would manage from then on. This is likely the best way forward if your AF is with RVR, rapid ventricular response. You don't want your ventricles trying to keep up with your left atrium at 120-170 BPM, not for more than an hour at a time. If you have long-standing persistent or permanent AF (a cardiologist would have to formally diagnose it), then your ventricles are spending to much time at an unsustainable rate....so they nuke the AV node and put your heart's two ventricles on pace. Note that in some cases a pacemaker cannot control atrial fibrillation and you may have to remain fibrillating. I believe there are newer pacemakers that can control AF, but it's out of my wheelhouse.
And yes, mitral valve stretching/prolapse can encourage AF....this is well established. Sorry. :-/