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Which drug is the best for SVT to control rhythm problems?
Hi. I have had AF for 15 years and in that time I have had 2 ablations and a cardioversion and also with frequent visits to the ER. I was in hospital last week and been diagnosed with SVT. It was quite different to previous turns as not only was my heart shaking but my neck was pulsating and my tongue went to the roof of my mouth and I found it hard to control my tongue to speak. Is this normal when you have SVT. Also has anyone been on Amiodarone long term and been okay? I have now been put back on it but previously it has put stress on my liver. Any suggestions would be appreciated.
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Amiodarone is sometimes the 'right hammer,' as my internist told me when I was flat on my back six days after my index ablation. My heart was pausing up to 15 seconds and then restarting (metoprolol was the culprit in my estimation. I was still taking 50 mg BID). I asked why not Sotalol, flecainide, diltiazem, Multaq, Tikosyn,.....anything but amiodarone......pleeeeeezze! I added that amiodarone is a pretty big hammer. My electrophysiologist agreed. I know this because Cohen called Novak and that's what the two of them decided.
I know a lot about amiodarone, as you must, and wasn't keen. But it did the job. Fortunately for me, I only had to be on it for eight weeks. Then, my Holter showed a lot of PACs, which was a bummer. Four months later I had a second ablation, also with Novak, and that one took.
These people know their poop. They've all dealt with many patients, and they know what drugs to pair with what flavour of presentation, yours included. Amiodarone is indeed The Big Hammer, but they must have you on it for your own good...that's all I can say about that.
Can you get off it ere long? Probably...it's worth it being a goal. Maybe Tikosyn will be a better drug, if you can tolerate it, and maybe it will hold you up before another ablation.
I found this website that explains it in modest detail: https://www.cardiovasculardiseasehub.com/archives/8962
You may qualify for another ablation, or you may need a pacemaker....your EP will be the one to advise you on that. Whatever the course for you, would you consider reporting back, at your convenience, and letting us know what was done for you and how it went?
You will get some other people commenting, I think.
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3 ReactionsThank you very much for all that information. I totally agree with you that all the specialists know what they are doing, but I think we need to make decisions we can feel comfortable about. Concerning the Amiodarone, my specialist just seems to want to keep me on it for very long periods of time as I do tolerate it quite well but because of its toxicity my liver readings are not good.
I saw that in your first post. If your liver is healthy at the moment, no worrying markers, then you can probably safely be on it until another intervention, say six months. This is just my suspicion, nothing based on evidence except what you report on your own behalf here. You are right, I feel, to want to resist a wholesale return to using amiodarone, and with reason. Except for changing caregivers entirely (a new cardio or a consultation directly with an EP), you should press this first guy/gal to help you to transition to something else....if....IF....it's a reasonable thing to do. He/she has to feel good about it as much as you, or find someone else as enthusiastic about getting off amiodarone. Either way, ya takes yer chances.
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