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Heart Disease (Expert Forum)
Suggested new drug therapy for a heart and diabetic patient
This forum is for questions and support regarding heart issues such as: Angina, Angioplasty, Arrhythmia, Bypass Surgery, Cardiomyopathy, Coronary Artery Disease, Defibrillator, Heart Attack, Heart Disease, High Blood Pressure, Mitral Valve Prolapse, Pacemaker, PAD, Stenosis, Stress Tests.
Suggested new drug therapy for a heart and diabetic patient
by Muggles, Mar 10, 2007 12:00AM
In April 2006, my husband suffered a second heart attack (first was in 1984 and had open heart surgery in 1991 which served him well. In December 2007 he had a defibrillator installed and was put on Coumadine which joined the other drugs he takes, namely Zocor, Coreg, Diovan, Lasix, Potassiuma, and Glipizide. Yesterday at his followup appt. for his defibrillator his electrophysicologist suggested adding Tikosyn since he is now experiencing swollen ankels and feet even with the Lasix, etc. He had a cardioversion in December to shock him out of atrial fibrillation (which also was new to us) and about 1 1/2 weeks out of the hospital returned to atrial fib. Since we were totally unprepared for the long term use of Coumadin, etc. we would like all information about Tikosyn (the good, the bad and the ugly) before we make a decision this time instead of being very trusting.
In reading about these drugs We also would like to know how Amiodarone compares to Tikosyn and why Tikosyn would be better for him instead of amiodarone?
In reading about these drugs We also would like to know how Amiodarone compares to Tikosyn and why Tikosyn would be better for him instead of amiodarone?
Doctor's Answer
by Forum-M.D.-MJM, Mar 10, 2007 12:00AM
Hi Muggles,
I am sorry to hear about your husband. Unfortunately, I cannot answer all the questions -- full understand of tikosyn and amiodarone is way beyond the scope this forum.
I will tell you that we use amiodarone for ventricular arrhythmias more often than atrial arrhythmias. It is efficacious for both, but the side effect profile amiodarone pushes us to use other medications s first line (sotalol, tikosyn).
There is a website posted by an electrophysiology fellow at the Cleveland clinic dealing with medical issues. The website is www.askdrwiki.com. The following link goes into detail about tikosyn use:
http://www.askdrwiki.com/mediawiki/index.php?title=Tikosyn
There is also some information on this site about amiodarone. This is a very technical website intended for physicians, but it may help explain some of your concerns. Posting on the askdrwiki.com site is intended for physicians only so please do not post unless you are a physician.
Tikosyn is a safe medication when used correctly. The main side effect is a low incidence of ventricular arrhythmias. This is not a great concern, especially in patients with ICDs. The medication, like all a fib meds, is intended to decrease the incidence of atrial fibrillation. The unfortunate truth is that some people are difficult to keep out of a. fib. I am not sure if this is your husband or not.
Depending on your husbands age and risk factors, coumadin may be the right choice regardless of whether his a fib is constant or intermittent.
I do agree that being an informed patient is important, but sometimes you do have to trust your doctors. These are not black and white decisions, and as I a sure you know by now, they are sometimes difficult to make.
I hope this helps. Thanks for posting.
I am sorry to hear about your husband. Unfortunately, I cannot answer all the questions -- full understand of tikosyn and amiodarone is way beyond the scope this forum.
I will tell you that we use amiodarone for ventricular arrhythmias more often than atrial arrhythmias. It is efficacious for both, but the side effect profile amiodarone pushes us to use other medications s first line (sotalol, tikosyn).
There is a website posted by an electrophysiology fellow at the Cleveland clinic dealing with medical issues. The website is www.askdrwiki.com. The following link goes into detail about tikosyn use:
http://www.askdrwiki.com/mediawiki/index.php?title=Tikosyn
There is also some information on this site about amiodarone. This is a very technical website intended for physicians, but it may help explain some of your concerns. Posting on the askdrwiki.com site is intended for physicians only so please do not post unless you are a physician.
Tikosyn is a safe medication when used correctly. The main side effect is a low incidence of ventricular arrhythmias. This is not a great concern, especially in patients with ICDs. The medication, like all a fib meds, is intended to decrease the incidence of atrial fibrillation. The unfortunate truth is that some people are difficult to keep out of a. fib. I am not sure if this is your husband or not.
Depending on your husbands age and risk factors, coumadin may be the right choice regardless of whether his a fib is constant or intermittent.
I do agree that being an informed patient is important, but sometimes you do have to trust your doctors. These are not black and white decisions, and as I a sure you know by now, they are sometimes difficult to make.
I hope this helps. Thanks for posting.
