Transition from Sotalol to Dronederone

[BobRBob]

I have been on Sotalol for over a year to control my a-fib. Recently, I've started to have breakthroughs and my cardiologist has prescribed Dronederone (Multaq) in place of the Sotalol. He has also referred me to an EP to investigate an ablation. My question relates to the transition from Solalol to Dronederone. My cardiologist told me to just switch from one drug to the other with no taper and no overlap. I'm wondering if anyone here has done this transition. The Sotalol is a beta blocker and it comes with a warning to not suddenly stop taking it. Of course, this warning assumes no alternate drug therapy in it's place but I'm still concerned that I may develop tachycardia or some other condition upon withdrawal of the Sotalol even though I've switched to the Dronederone. My pharmacist agrees that this is the correct approach but I'm a little afraid at this point to just do it. Has anyone here had this experience? Dronederone is not a beta blocker.

[LindaTX]

Hi, I did convert to normal in the middle ofthe night last night...after I'd taken my first dose of Multaq about 6 hrs earlier. I can only hope it will hold me in normal rhythm.  I'm not sorry I had the ablation, the meds just weren't working for me anymore after 12 yrs.  I think eventually they all become pro-arrhythmic. I think it's good that you are going to look into having an ablation.  Only time will tell with me but i figure I needed to give it a shot.  I did have one of the best Dr's to do mine so shop around for someone who has done a lot of them.  I guess "practice makes perfect" when it comes to ablations. For me, the actual ablation was a piece of cake.  I was completely out for the whole thing.  It'll be 3 wks tomorrow for me and it's been dealing with the a-flutter afterward that has kicked my butt.  They say it takes 3-6 months for the inflamation and agitation to subside.

So they didn't convert you back with meds at the ER? Maybe the metoprolol will be just the ticket along with the Multaq.  I've got plenty of that in my medicine cabinet.  Keep me updated.

[BobRBob]

Hi Linda. Sorry to hear your quest for NSR has been delayed. Mine, too, is uncertain at this point. I have been in a-fib for 3 days now and just came home from the ER where they gave me a Metoprolol 12.5Mg BID. This is to complement the rate control already offered by the Multaq. This is disappointing (although I still may convert back) but one thing I have noticed with the Multaq is that the a-fib is not as symptomatic as it was before. Basically, I can't really feel much. Still hoping for a conversion but I guess we'll have to see...

[LindaTX]

I went out of rhythm into a-flutter last Fri and I'm still in it.  I called the Dr's office but no call back yet.  I need something other than this rhythmol because it is clearly not working.  I'm thinking my options will be digoxin, sotalol or Multaq.  Can't imagine they will come up with something other than one of these.  How are you doing on the Multaq?  

[LindaTX]

Just got a call from my EP's office.  Instead of Sotalol, they want me go on Rhythmol 3 times a day....which is what I took a yr ago.  So hopefully it will keep my rhythm regular until I can discontinue it in a couple of months.  Yeah, don't rule out an ablation....a-fib is a progressive condition.  I didn't want an ablation but with my history i thought the time was right .  Only time will tell...there are no real guarantees.

[BobRBob]

Great that you've converted Linda. Glad to hear it. Hopefully, this means your ablation is successful and you're healing. I have an appointment in December with an EP to investigate an ablation. I'm scared but it may be the only way.

I went into a-fib yesterday around 5pm but converted back at 10:30pm. One thing I noticed is the a-fib is smoother and less bothersome on this drug than it was on the Sotalol. I'm still hopeful though that this drug will stabilize and hold me in normal rhythm for extended periods. I've started to notice slightly cold hands today. Nothing too bad but noticeable.

[LindaTX]

Glad you are still in NSR....that means a lot! :)  I was only on Sotalol for a few days after I got out of the hospital.  It was keeping me at 103-108 bpm.  I finally converted into NSR and went to 72bpm immediately so I was worried about continuing the Sotalol because I hated to see my resting heart rate up so high.

I'm willing to do what I need to do but I don't feel like I'm getting any real clear direction from my EP's office.  After talking with them today they said they did get my EKG that was faxed to them LAST Wed.  They are supposed to call me back after talking to the Dr. about whatever med they want me on.  My normal resting rate is in the 60's so I reall miss that.