Lasting side effects of various heart medications

[dabernz]

I am a 74-year-old male and have had periodic episodes of atrial fibrillation since 1973. It was controlled for many years with Digoxin supplemented with low dosage aspirin. When I experienced tachycardia and fibrillation it never lasted more than three days and then my heart would recover spontaneously.  Three years ago the frequency of my occurrences of fibrillation and tachycardia increased significantly, especially while playing tennis. After an episode during which it took about 8 days to recover my cardiologist put me on Coumadin to prevent the formation of a blood clot and after I recovered, changed my medicine to Tambocor. While on this drug I experienced tremors in both of my hands and on occasions I would experience extreme body cold. After 2 months I was taken off Tambocor because my doctor had reservations about this drug, and placed on Atenolol. I remained on that drug for about 8 months. However, the two significant negative side effects mentioned remained. I also now suffer insomnia, although I’m not sure whether the incidence of this symptom was coincident with Tambocor or Atenolol.  When I questioned the doctor about these effects he said that Atenolol is brain permeable and so the brain’s response might be the cause. My medicine was then changed to Coreg, and though the tremors and insomnia have remained my encounters with the chills have abated in that it occurs less frequently. In the three years since I was taken off Digoxin and placed on Beta- Blockers I have had only one recurrence of fibrillation.

My question is whether my tremors, insomnia and chills are now permanent or is there another drug regime I can follow that would eliminate these symptoms. I am otherwise an extremely healthy person with normal blood pressure, cholesterol and weight. I work out in the gym 3-5 days a week and play tennis about 3 days per week.

Thank you for any information you can provide.  
  

[CCF-M.D.-MJM]

Hi Dabernz,

Atrial fibrillation is common problem that becomes more frequent as we, as a population, grow older.

Tambocor (flecainide) is a medication used to treat atrial fibrillation in patients without coronary artery disease.  It is true that tremor is a known side effect of flecainide, but symptoms resolve after the medication is discontinued.

The same is true for atenolol and insomnia--the side effect should abate when you discontinue the medication.  Atenolol may cause cool extremities, but not frank chills.

For someone your age, a new onset tremor could be an essential tremor or less likely Parkinson’s disease.  You doctor should be able to recognize the signs and symptoms of each.  The more common of the two, essential tremors, is treated successfully with propranolol (an other beta blocker with different receptor blocking properties than atenolol).

Keep up the good exercise regiment.  That is great to see.

I hope this helps.

[dquenzer]

It's good that the meds have controlled your AFIB.

I'm 49 and had to get an ablation for AFIB which worked great.

Mayo recommended I just stay on atenolol even though I have no arrythmia problems.

Atenolol does give me insomnia.  I fall asleep fine, but wake up after 4 hours and can't get back to sleep.  One of the major side effects of Atenolol is insomnia.

My doctor prescribed a small dose of clonazepam (sp?).  This enables me to sleep and works great.  It's a mild sedative.  I don't take enough to get "hooked" on it, but just enough to counteract atenolol to help me sleep.  You might ask your doctor about it.

[Dreamer Ho]

I take Tambocor Flecainide Acetate 100mg twice a day for 2 years and it really controls my VT from Left Ventricular Outflow Track.   However, I feel difficult to breath recently, and consult doctor yesterday. He founds that there are one new VT position which is from the left artrium.  The doctor also advises me to stop the medicine and suspects it may be the side effect of the Tambocor.