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AFIB medication and fatigue
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AFIB medication and fatigue

Problem:  fatigue related to afib medication.  I have atrial fibrillation; this occurred 4 years ago, about 6 weeks after an eye operation.  I have tried 4 drugs, in this order: Lanoxin (produces bearable fatigue but wasn't effective); Atenolol (severe fatigue); Cardizem (severe fatigue); and now Rythmol (severe fatigue).

I feel good in the morning, full of energy. By 10:30 I begin to tire. I absolutely require about 4 to 5 hours of bed rest every afternoon. I have no other side effects from Rythmol.  My heart is in sinus rythm 24 hours per day.  My cardiologist says that I could try another drug.  

Are there any studies concerning fatigue and the drugs my cardiologist has discussed - flecainide, sotalol, or amiodarone?  (I have a background in science and won't have trouble reading these studies.)
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Dear Mike,

There are no studies per se of fatigue and these medications but some are known to have this side effect - particularly those in the beta-blocker family (e.g. sotolol).   Of the three you mentioned flecanide is the least likely to cause fatigue.  The other option is a non-pharmacologic approach such as ablation.
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