a- fib

[yzerman1991]

I have paroxysmal a-fib with rvr for about a year now.  It has been well controlled with toprol xl and asa.  My problem is that since starting the beta blocker I feel tired all the time.  I have been taking at night to try to help-- do you have any other suggestions or are there any new alternatives out there?

[Brooke_38]

I was on 160mgs of Sotolol back in the winter, I didn't have to be hospitalized for that. I was given an event monitor and asked to send in transmissions 2 hours after each dose, the same was true for starting Flecainide. Unfortunately, Afib is not my only problem, I have AFlutter, competing junctional rhythm & just had ablation on Aug 1st for V-Tach(RVOT).

My EP had mentioned doing a keyhole procedure for AFib but I guess I'm a little nervous about having a hole cut into the side of my chest to access my heart (ouch!) Well, here's to an Afib free day...I hope:)

[Jerry_NJ]

Thanks,
My EP did suggest trying Flecainide without the need for hospitalization.  I may give it a try, but given Toprol XL, Rythmol SR and Propafenone (I have been in sinus using Propafenone for periods as long as 18 months following an electrocardioversion in past years) don't help stop my AFig, I'm not optimistic about trying other drugs.  My EP also listed Sotolol, also requires hospitalization, as a possible medication to try.  He does not recommend ablation (I had a maze procedure done last November when I was opened up for a mitral valve repair - I was in sinus for about 30 days following that surgery).

yzerman, please excuse me for "stealing" you thread, hope you're getting some value out of this exchange.  I think Brooke and I are about to conclude our exchange.  One thing is clear, even AFib and AFlutter have many levels of complications and treatments.

I guess I have AFib with SVR, my Polar heart monitor appears to read only ventricular responses and with heavy toprol that gets down into the 70s pulse rate at rest and is around 100 when walking around.  The bottom line seems to be my EP doesn't see me as having a serious enough AFib problem to justify much risk, e.g., ablation.  Guess he doesn't see the heavy meds as risky, I'm not so sure myself.

[Brooke_38]

Hello-

I can't say for sure that that the Rhythmol contributed to my fatigue...but it definitely didn't help me feel better. Flecainide is...let's just say o.k. My cardio had suggested putting me in the hospital for 3 days to start Tykosin. I am not ready to do that yet. He had also mentioned a short course of Amioderone, but I refuse to have any part of that.

When we referenced, "RVR" that is Afib w/ rapid ventricular response, a very rapid afib. You probably have Afib w/ SVR (slow ventricular response) Are you currently in Afib?

[Jerry_NJ]

Are you saying Rhythmol contributed to your tiredness?  I have a real weariness and I have associated it mainly with my Toprol XL - taking 100/50 mg daily, planning to drop to 50 mg twice a day.  I was taking Rhythmol 425 twice a day, now once a day and may stop altogether as my AFib "rages" on.  How's the Flecainide, is that for AFib?  My EP suggested I may want to try Flecainide, and I haven't made up my mind yet on trying new drugs.  He has a few others that require hospitalization for their introduction.
  
I may not be contributing to this thread, I think I have "simple" AFib (right atrial), paroxysmal and rvr have never been mentioned to me by my doctor.  I assume these other terms are complicating factors, right?

[Brooke_38]

I have tried a host of different combos for my Afib w/RVR. Diltiazem 360mgs as rate control and Flecainide 75mgs as Antiarrhythmic along with ASA 325mgs is what seems to work best in my case. I have been on Verapamil, Rhythmol, and Sotolol. The side effects from these, mainly the fatigue, were intollerable. I cannot take BB's because of my asthma. How often do you experience your Afib?