Edema and amiodarone

[C.N.]

About 2and a half weeks ago I was put on the medication, amiodarone.  I now have edema. I normally weigh 100, now 111lbs.  This happened over about a 3 day period.  I was placed on the amiodarone, as a last resort, after trying the gamut of antiarrythmic meds.  This is to treat afib with a very rapid ventricular rate, about 280bpm.  I have been also having significant shortness of breath, particularly when lying down.  I went to my cardiologist and he said he thought it was probobly due to another reason besides my heart.  He doesn't understand why I started out with sinus tachycardia, BPM were about 130-150 24 hrs. a day.  I had an ablation of my sinus node, now a pacer, and now afib. He thinks that the cause of my edema maybe from the underlying cause of the conduction problem, effecting the heart, not caused by the heart.

He sent me to my internist, who said he thinks it's my heart medication, and that my cardiologist does not want to let go of this medication because it's a last resort, before doing an av node ablation.  He said he totally understood why he would not want it to be the med. but he thinks it is.  Now, I have such respect, and I great relationship with both these doctors, but am left at the net, because neither wants the ball in their court. I don't expect you to get in the middle of this debate and would not say anything to either of them.  I do understand where they are coming from.  But I would like to ask a question

Do you think that the swelling could me caused by the amiodarone, and if so is this an indication of stopping it? I have 3+ pitting edema, and I'm taking 40mg lasix.

I have had my thyroid tested, there is no protein in my urine.
Can you think of something else that could be checked?

My cardiologist is afraid that doing an av node ablation in my case would cause decompensation.  I'm not sure why he thinks this.  What might cause this in a 33 year old?

Please, do you have any other ideas?

Have a wonderful holiday season. I am so thankful for all you have contributed to people in need of advice.

[Lai. S N]

I do on amiodorone for the last 12 months for AF. I had cath. ablation six mosth ago. And my last 24hrs Holter shown I am sitll having 10%> I had regular blood test for the side effect of amiodorone.

[CCF CARDIO MD - DLB]

If amiodarone had affected your thyroid function, that can cause edema. Amiodarone can rarely cause preexistent heart failure to become worse, resulting in edema. If you have not previously had an echo to assess your heart muscle function, I would suggest this. If your kidney and liver function tests are normal, I cannot think of any other causes.
The AV node ablation may be useful since medications do not appear to suit you, though an AV nodal ablation is usually not a great option in someone who is young and wants to be active. Also, you would probably still need to take coumadin after the ablation if you remained in atrial fibrillation.