I can only speak for myself. I do have arrhythmias daily (PVC's and PAC's) and several times a week I have some PSVT (atrial tachy) but I've found the side effects of the medications to be more bothersome than my dancing heart.
Certainly there are some arrhythmias that require medications for safety's sake. But mine don't fall in that category.
I think all anti-arrhythmia drugs have warnings because they interact with the heart's timing and electrical distribution systems. Some require hospitalization for implementation, others do not. Others, such as Propafenone and Rhytmol (basically the same thing) usually do not, but should be prescribed by a cardiologist in my view.
I order of strength the list I have is:
Amiodarone the most potent, I don't have its class, but it must be at Class III or higher
Sotalol (trade names Betapace)
TIKOSYN® (Dofetilide Capsules)
------ all the above require hospitalization for the start-up by my cardiologist and the consulting EP
Antidysrhythmic (Class IC)
I've used both of the Class IC and Propafenone has helped keep in in normal sinus rhythm for over a year at a time following electrocardioversion processes. None has ever converted me, by itself, but I have never had any troubling side-effects either.
I suffer from Atrial Fibrillation.
Thank you for your responses. I've had svt for about 6 yrs and for that length of time hve had the same cardiologist who ran every test and after the 30 day holter said I have SVT. But for 6 yrs I have been on inderal and he kept saying he would like to increase it but my bp falls too low. So I'm on 40 mg a day. So I asked to be transferred to another doc and he sent me to the EP study place. After going over all my records carefully, the doc put me on flecainide (no hospital) 25mg twice a day. I took one dose and it kept me awake all nite. Total insomnia. Then I stayed off it after I read the awful side effects, including death, (how do these things get past the FDA??) Today I was having a bad time w/arrythmia and so I took a dose. It stopped the arr. immediately. So I've read that pacemakers are for hearts that beat too slow but nothing much for tachy. Any more imput?? I'm anxious.
I don't mean to counter your doctor's prescription of Flecainide, I'm just saying my doctors will not let me try it at "home". You good result, notwithstanding the sleep problem, encourages me to try, I just don't want to spend two or three nights in the hospital while the find out I don't have any life threatening reactions. As you've taken it I think you are past that concern.
There was a survey on the Community a couple of months back about implementing Flecainide with or without hospitalization. My recollection is the majority of the respondents said the did it without hospitalization. I told my cardiologist about this and he said one possible and dangerous reaction if ventricle fibrillation, and that's why he will not prescribe it outside without a hospital stage. So, I continue to suffer from AFib.
As far as the FDA is concerned, I guess it does not guarantee no one will ever have a disastrous result from taking an approved medication, it simply says it has been carefully tested and the results show the risk/benefit analysis to come out with the benefit winning.
I have PSVT (I was born with it), PVC's, PAC's and I take 20mgs of Propranolol and 0.5 mgs of Clonazepam twice a day for mine, and have no problems controlling it.
I have HOCM and I take 150 mgs of flecainide 2x per day and 50 mgs of metropolol 3 x day to control my ventricular arrhythmia`s ( psvt and v-tach ). It has worked great for me so far.
ICD implanted in 1991 for V-TACH and SCA.
I was just prescribed flecainide for Pac's. Started Thursday (7/23) .My ONLY symptom is an occasional few extra beats slight pause and then back to normal . Cardi says structually excellent heart,low cholestrol, no other physical problems other than anxiety about heart trip. so try this drug for 3 or 4 weeks and let me know how it goes for you. It could control "heart dance" or you can live with it without drug. My choice after 6 doses at home of lowest doseage and sleep problems, dizzy I recognized begining of side effects and stopped the drug yestersday . Just my choice. Hoping that living with the "dance" will be the way for me. Time will tell. Only other drug I take is aspirin,and hydrocholorthizide(spelling) ?) for blood pressure control. I was electrically cardioverted for A Fib about 1 year ago and tried Amiodarone for 6 months couldn't tolerate it either. I hope you find your way to peace of mind . We are all here to help each other.
P.S. Middy I forgot to mention in my list of drugs I take included is 1/4 tab of Klonopin 2 time a day.. I quess I was so less anxious I forgot to list it. I also go to an accupuncturist once week specifcally for heart issues.
I have had PSVT for over 40 years and have tried many, many anti-arrhythmics. My experience has been that success (or lack there of) of specific drugs and dosages is a VERY individual thing and that it can even change over time in one individual - what worked for someone at one time may not anymore, and visa versa.
Also, different drugs are considered "more safe and more effective" or "less safe and less effective" depending on what your specific condition is. Types of arrhythmia and tachycardia, such as AFib, A-Flutter, WPW, AVNRT, VTach, etc., can have very different mechanisms in the electrical and structural system of the heart and the different drugs actually work in different ways. I think this is why there is some controversy over whether to start someone on Flecanaide with in hospital monitoring or have them try it on their own at home. Some doctors feel Flecainide is safer for certain conditions than for others.
I have WPW and when Flecainide first came out, they put me right on it. I could tell within 2 doses it was NOT good for me and I quit taking. Then, when they started realizing there were some very adverse side effects and it was not the right drug for everyone, I was so glad I stopped. BUT, many, many people have had real relief with it. I do take a nominal dose (25mg) of a Betablocker called Toprol every day and have for over 20 years. I don't think it helps much as I have PSVT episodes pretty much every day, but I do think it keeps the rate of my PSVTs a bit slower. I also take Lorazepam, which is NOT an anti-arrhythmia, occasionally as for me it seems to stop the PSVT if I am having a particularly protracted episode. I will especially use this at night if PSVTs or PACs/PVCs are keeping me awake. However, this is an addictive drug and one that can be pro-arrhythmic in some patients, so I don't necessarily recommend this to anyone.
For many people ablation seems to have been a nearly miraculous cure, but it is not without real risks and some controversy itself. They used to do it only in cases of potentially life threatening arrhythmias, then as they got better at it and technology improved, they started doing it for "lifestyle" improvement and to keep younger patients from having to take anti-arrhythmic drugs for their whole lives. I have avoided ablation for over 20 years, but am now scheduled for evaluation and possible ablation at Mayo Clinic in September.
I think the key is to be cautious, well informed and pay attention to your own body since you know it better than anyone else does. If you don't find the answers and comfort you need from one specialist, go see another one - or another one - if you need to. Many on this site have learned to live very full lives with their arrhythmias, but it does take some practice and perseverance. I have found that watching my diet, getting moderate exercise and especially mindful meditation has helped me tremendously -- but I still take anti-arrhythmics and even after 40 years I'm still hoping someday for that "miracle cure"...
Your experiences mirror mine only I am a male. I have reached a relatively strong conclusion that most drugs that act directly on the heart are not effective for relieving PVC's or PAC's. I also think that PVC's, PAC's, PSVT, and AVNRT originate from the same stimulus, namely the vagal nerve, which has an abnormal connection to the hearts of those of us who experience these things on a regular basis. Most of the drugs prescribed for our conditions are for symptom relief and do not act on the cause. There is no drug that I know of that can affect the vagal nerve or vagal abnormality if it exists. This is the only logical reason, that I can think of, why an EP or cardiologist tells us not to worry about arrhythmias if our hearts are structurally sound because the stimulus does not originate in the heart. It would also explain why there is no real research being done on benign arrhythmias. Comments would be welcomed from any who read this post.
totally agree with your comments. I've been having pvc's for the past 14 years and am also a strong believer that the benign pvc's happen because of the vagus nerve. If only someone put more research into this, would be great! As this condition causes so much anxiety, fear and frustration. No one who hasn't felt it themselves can understand, how it feels, when the heart skips, jumps and races away. I watch what I eat, also do moderate exercise, don't drink coffee or alcohol and take magnesium and my latest discovery: Fish Oil, which has helped greatly with my skips. In my case, I'm sure the stomach acid somehow irritates the vagus nerve, which then irritates the heart = skips. Same when I'm tired/stressed/anxious = affects the nerve = affects the heart. I do wonder if anyone has ever done any research into the vagus nerve?
Following teh identification of slow heartbeats, I was administered Amiodarone in the ER room in a hospital here.Will the medication have a serious side effect on my heart condition.Will it be helpful in maintaining proper heart rate foe a considerably longer period of time before a decision on pacemaker implantation is achieved.