Afib

[tsco]

I have afib and have had some right atrium tachys. Been on 100mg flecainide six yrs, 12.5 mg metoprolol. Begin having daily episodes of afib lasting 1to4 hrs about a month ago. My Ep increased my metoprolol to 25mg. It stopped the afib episodes for about 3weeks. Now I'm having something different. My pulse rate low 55, bp 115/70. Now if I do anything active like taking clothes out of washing machine or go up flight of stairs, I get palps, doesn't feel like afib, pulse is slow but feels like an off beat  from chest to wrist. Hesitation. Skips a beat occasionally, then I stop and a few minutes it stops and feels normal again. So I reduced back to 12.5 mg three days ago but still doing this.
1)is this related to metoprolol? Is it built up in my system?
2)one Side effect of flec for me is lbbb at approx 125 bp, does this new palp sound like lbbb at a really low rate like 65 or something? Could that be from the extra metoprolol?
3) isn't a few days to eliminate the extra metoprolol in my system enough time?
4)sounds like the flec is stopping to work for me, is that common after a long time?

[tsco]

I read your journal entry and it sounds like you are on the right track. I have not looked into the five box procedure. It is probably a step up both in success and seriousness from ablation. I think you should do what you are doing. You have two good options. As an Ep in louisville explained to me these are becoming more and more routine. Just need to plan the timing.

[tsco]

I have researched and tracked improvements across the us waiting for some ray of hope for a while. With the Firm software and improvements in a new basket catheter it seems there are some improvements in success. My Ep held me off until an improved generation of the firm and the cath were released. I will be somewhat early in the attempt but my Ep feels good about what he is doing so I am confident. I have talked to other eps and the left side ablations are becoming very routine, like the right. I will try and get more exact names of the cath but the firm software is what I'm referring to.  You should find a center that is part of the studies and go for it. My afib is becoming More frequent and I'm determined to have it stopped.

[DeltaDawn23]

What is the new technology -- are you having a particular kind of ablation?  As I mentioned, I am very interested in whatever info I can find.  I looked into the FIRM ablations at OSU in Columbus, OH, but they had only done 26 and the doctor seemed to think I should wait until my present medicine failed.  Any info on any new technology would be appreciated.

[msnbc]

Had another ablation on the left side yesterday so far so good.  Have a excellent EP.  Don't remember.a.thing. Worse part Foley being pulled.  Glad made the decisions to have ablations even though it was a scary one to make

[Jerry_NJ]

To save typos I offer you the reading of my profile "bio".  That said, I responded well to meds and electrocardioversion from the age of 55 to 65, then heart enlargement precipitated open heart surgery.  I have been in AFib since that time.  This is now years and "repairing" is no longer a possibility for me.  My EP gave ablation a low probability of success following the open heart surgery, which included a minoi-maze.

But I am a senior with liveable symptoms, so I will practice "rate control" and "clot management" until the end-of-life.

[tsco]

Thanks jerry, was your afib permanent in nature? I have had three right side ablations. Never on the left. I will have my left side ablation on the pulmonary veins in February. I pray this will help or stop the afib. There is new technology that helps pinpoint areas in the heart much more accurately than in the past so I hope.

[Jerry_NJ]

I didn't see (I'm not the best of reader/comprehension) ablation mentioned.  Has that been discussed with your doctor(s)... has an EP study been done?

There are stronger drugs than Flec.. but they all have risk of serious side effects.  Ablation on the other had is a "fix" not a symptom fixer.

I have never had an ablation for my AFib and am at the point of atrium fibrosis - too late to get them working again.  So, if you are to accomplish a cure/fix it has to be before the AFib destroys the atrium muscles.  

Where am I on this?  I am not an ablation winner, I do not have any personal reasons to suggest/recommend it, but if my EP thought an ablation had a better than 70% change of working I'd have gone for it.  AFib has slowed me down physically a lot, so has age, the two are related.  You are young enough to seek a cure rather than a "patch" or "band aid".    

[tsco]

Well as luck would have it, flecainide causes left bundle block with me. It is an effect of the med and I get it. Everyone will tell you lbbb is something you can not feel, etc. but I get a sharp pain at onset and can tell when I'm in that (as I had to prove to my Ep on a treadmill). So no I cannot increase.

[DeltaDawn23]

Can they increase your dose?

[tsco]

I have taken flecainide for probably seven years and it helped a lot until lately. Kind of think its effectiveness is wearing down.

[MeganNichole4010]

Did the flecinade help with your pvcs?

[is_something_wrong]

Hello. I will try to answer your questions.

1) Metoprolol slows down the heart rate, which may make it more likely for "skipped beats" (premature heartbeats) to occur. Premature heart beats are rarely causing a pulse wave because the heart isn't filled up with blood. There may be other explainations, so the safest thing to do is asking your doctor for an EKG, preferrably while you have symptoms.

2) You cannot feel LBBB, it's purely an electrical phenomenon in your heart. So I doubt it.

3) Metoprolol half life is 4-5 hours, and when taking the extended release pills it's 20 hours plus 4-5 hours. So the answer is yes, but there may be another explaination for your new symptoms.

4) Not as far as I know.