AF Getting Worse

I've been under treatment for an arrhythmia (AF?) for about 2 years.  Initially, it was treated with propranolol when it occurred.  As it became more regular, I began taking sectrol 200 mg/day.  This worked for a little while.  When it (the "skipping" - palpatations) returned I was switched to 400 mg/day.  Last spring, it returned and the dosage was increased to 800 mg/day (400 2x).  Around Thanksgiving, It returned worse than ever.  The episodes last several hours and have been joined by an increase in heart rate (pulse).  At times, the rate is over 200 bpm.  They have also become associated with eating at times, but not always. Whether due to anxiety, or the condition, I experience shortness of breath and dizziness.  I am also taking Welbutrin and Lexapro for depression.  They are very effective for the condition.  My Dr. wants to reduce them or eliminate them completly.  I'm not comfortable with this.  Is there a relationship between them and the arrhythmia?  I also experience sleep apnea and am currently using a c-pap machine.  This has helped with the apnea, but the arrhythmia has only become worse. Also, I'm not taking a blood thinner for possible clotting.  Should I be taking them?  I'm considering a visit to Cle. Clinic, but am unsure about my insurance.

[CCF-M.D.-MJM]

Hi Jimnlin,

It sounds like you are having a rough time.  If you are interested in coming to the Cleveland Clinic for an evaluation in our atrial fibrillation center, call 216-444-4369.  If you have insurance questions, try the following numbers:

Daniea  Rogers 216-445-2321
all anthem an d non-ohio blude cross/blue shield insurance payors, all cigna payers and all aetna payers

Robin Johnson 216-444-6598
for all medical mutual insurances payor (supemed plus, classic, hmo, etc)

Andrew Kish 216-444-5343
Medicare, Medicaid, CCHS, United Healthcare and all remaining insurance payors.

Welbutrin is a stimulant and have an affect on atrial fibrillation.  I haven't heard anything about lexapro worsening atrial fibrillation.

Sleep apnea is associated with an increased adrenergic state and may increase the frequency of atrial fibrillation.  C-pap is the best short term solution.  If you have OSA from obesity, the long term solution is weight loss.

Regarding warfarin -- anyone with hypertension or diabetes mellitus and atrial fibrillation should be on warfarin.  There are other risk factors as well like reduced heart function or structural heart disease, previous thromboembolism and age.  You should see a cardiologist or electrophysiologist to help you with -- it can be tricky if there are other risk factors for bleeding.

There are antiarrhythmic options as well depending on your profile, but again, this is a complicated discussion.

I hope this helps.  Please come and see us if we can be of any assistance and good luck.

[jimnlin]

I've been taking the depression prior to the onset of the AF.

[Redbaron]

Hi JIMLIN, That's the big problem with AFIB, it keeps getting worse.I initially only had runs of PVC during the past 8 years. This year I thought that my PVC was getting stronger and more often , so I had the Doctor check me out. Seems I no longer have PVC, but full Atrial Fibrillation! It's Lone AFIB, so my Heart is structurally sound, but now I have to take drugs just to prevent a Stroke. From being a once a week event it has now become a daily event, and the Doctor expects me to be in permanent AFIB within the next couple of years. I hope things get better for you.

[MinnieM]

Glad I saw this post.  Two years ago I was givern Paxil and after the 10day, I went into horrid tach's/palpitations. They did not call it A-Fib.  (took myself off this med and was "normal" within 4 days)  I was given samples of Lexapro three months ago and they are still sitting here untouched for fear. (glad I saw that Lexapro can also cause A-Fib)  I know what true A-Fib is now. Had a severe attack five months ago and had to be converted back. I am not on Warafin but am on Plavix for life, (per cardio)

CClinic is probably the best in the country for A-fib and my cousins in Michigan frequent the clinic often and are very pleased.

~~~~~~~~~~~~~~~Happy Holidays~~~~~~~~~~~

[tickertock]

I always wondered why some persons with frequent PVCs or episodes of PVCs go on to develop PAF or chronic a-fib, yet a-fib is triggered in the pulmonary veins and atrium  and not the ventricle as in PVCs. Does the ventricle pick up the electrical foci from those area of the heart and fire prematurely on a random basis rather than directly from the ventricle itself, just my speculation,I'm lost as what to think. It also amazes me that PVCs and atrial fibrillation can be occuring at the same time, oh well just a thought.

From what read it appears that about 1 in 4 persons will experience a-fib after age 40, whether it be paroxysmal or chronic.

[cheeseburg]

HELLO EVERYONE, I HAVE NOT POSTED IN QUITE SOMETIME, I TO SUFFER WITH AF, I HAVE HAD IT NOW FOR 21 YRS, I HAVE HAD NUMEROUS TESTS DONE IN THE PAST IE; STRESS TESTS, SONOGRAMS, EKGS, HOLTER MONITORS, EVENT MONITORS, CATHERIZATIONS, ONLY TO BE TOLD THAT ALL WAS OK.  I WAS HOWEVER INFORMED AS OF MY LAST HEART CATH THAT I HAVE CARDIOMYOPOTHY, BUT STILL NOT TO THE POINT THAT I HAVE TO WORRY ABOUT.  I HAVE CHANGED DOCTORS SEVERAL TIME AS I FELT THE PREVIOUS DRS, SEEMED TO RUSH ME OUT OF THEIR OFFICE AND NOT SPEND ANYTIME WHAT-SO-EVER IN TALKING TO ME ABOUT THE PROBLEM.  I HAVE BEEN PRESCRIBED LANOXIN FOR APP. 15 OF THE YEARS AND IT SEEMED TO HELP ME UNTIL I DRANK ALCOHOL, USUALLY  AFTER A HEAVY BOUT OF BINGE DRINKING, I WOULD FEEL THE PVCS, PACS, AND EVEN GO INTO AFIB, I HAVE ELIMINATED CAFFEINE, CHOCOLATE, AND ALCOHOL NEARLY 100% FROM MY BODY WITH AN EXCEPTION OF AN OCCASSIONAL GLASS OF WINE AT DINNER WHICH DOES NOT SEEM TO BOTHER ME.  ONE OF THE QUESTIONS I HAVE IS I HAVE RECENTLY BEEN PRESCRIBED AMIRODERONE AFTER MY LAST HOSPITAL STAY IN AUGUST OF THIS YEAR (MY LAST HEAVY BOUT WITH DRINKING), MY PHARMICIST WAS CONCERNED WITH THIS DRUG AS HE SAID IT WAS A VERY POTENT DRUG.  THE DOCTOR WHO PRESCRIBED IT INFORMED ME AT THE TIME THAT HE WOULD ONLY KEEP ME ON IT FOR A LITTLE WHILE, THAT HAS BEEN 4 MONTHS AGO.  MY PROBLEMS ARE VERY RARE NOW WITH THE EXCEPTION OF A FEW PALPS EVERY ONCE IN A WHILE,MY QUESTION IS DOES ANYONE KNOW OF THIS MEDICATION?  DOES IT CAUSE DAMAGE TO THE BODY AFTER EXTENDED USE?  ALSO, I HAVE BEEN TOLD THAT MY HEART IS FUNCTIONING AT 95% SO WHAT IS CARDIOMYOPOTHY?