Should I agree to Amiodarone?

After a month of staying in rhythm my EF went from 25to 54% and was 58% mid-year, so the cardiologist switched me from Amioderone to Sotolol and I've been in rhythm to this day

You're  right, Amioderone is potentially, a very nasty medication, with some potentially very nasty side effects.

Having said all that, Amioderone really dug me out of the hole that I was in.

Short term, low doses can be quite effective, but I wouldn't want to be taking any longer than was absolutely necessary. 

If it was me, I'd give it a go for a month or to see if it works., but make sure it's only short term use (months, not years)

good luck with it all

Simonz 

So I'll just have to wait and see what happens down the track. I suspect that I'll may end up having one, as I'm yet to hear of anyone who has been able to beat Afib for good simply by getting cardioverted and taking their meds.

I've made a number pretty significant lifestyle adjustments, so just have wait and see I guess?

I guess I'd be ok with being ongoing cardioversions at this point n time if I could get a reasonable periods of time between them (like I have this time). I see ablations as an 'emerging technology', and suspect that considerable improvements will made in this area in the future, so the longer I can avoid it the better really. I figure you can't 'unburn', burnt heart muscle, so I'd like them to get a bit better at it before I have one (if I can that is!).

but if I kept jumping out of rhythm regularly, I guess I'd have seriously look at  an ablation.

Hi again Maggie. Think I need to give you the long version to put it all in context.

I'm a 49 yo male living in Australia. Was taken to hospital just over a year ago with a tachycardia induced cardiomyopathy (rapid beating heart and severely enlarged left ventricle that was pumping very badly) and was also in atrial fibrillation.

I also have a family history of heart disease. My mother has lived in atrial fibrillation for the last 15 years! (She's 82). One of my older brothers went into AF when he was about my age after big night on the booze. He made no lifestyle adjustments and continued behaving like he was 20yo and had to be cardioverted 3 or 4 times over he next couple of years.

he eventually had an ablation and claimed that he'd never felt so good and claimed to be 'all fixed'. He continued to live like he was 20 smoking(not just tabacco!), big nights on the booze etc. No diet changes etc.

Several months later he died in his sleep from a fatal heart rhythm! 

So being confronted with my own mortality, I listened to all the advice I was receiving from all the medical professionals that I was having contact with, as well as doing a huge amount research on the internet.

The cardiac nurse and cardiologist  explained that because my left ventricle was severely enlarged(and also in AF ) that it was severely weakened and not pumping oxygenated blood around my body very well at all. Because of this, my kidneys, liver and other organs were also not functioning very well either.

One of the main effects of this is that my body was struggling to process salt in my diet and and maintain correct salt levels. So, in an effort to cope with elevated salt levels in my body, my body's reaction to this was to retain fluid to dilute salt levels (instead of excreting salt), This extra fluid puts exta strain on an already damaged heart!

So low sodium diet was an important part of recovery. 

I Didn't think I had a high sodium diet and never added salt to my food. I was amazed at how much salt was 'hidden' in everyday foods (even bread was too salty!)

I was very miserable about the prospect of a low sodium diet at first as I love good food. But after a number of long, arduous shopping trips (looking at the sodium levels in all the foods that I normally buy) I managed to find some acceptable substitutes. All also bought low sodium cookbook off the internet.

I also read that sleep apnea was one of many possible causes of AF. My wife had been telling me for years that I would stop breathing for long periods of time in my sleep, particularly when I had been drinking, so did a sleep study.

The sleep study revealed that I had severe sleep apnea. An apnea is defined as 'not breathing for 10 seconds or longer', less than 5 per hour is considered normal, more than 30 is severe. I was having 58 apneas an hour and holding my breath for up to 35 seconds at a time! 

The sleep physician (a family friend) told me about all the health implications that untreated sleep apnea can cause and the extra sarin it can place on your heart, I wasn't aware of any of this!

So I trialed a CPAP machine. After a couple of nights of using it, I felt  like a different person, it was tuely amazing! (Although it was a little uncomfortable). I never realised that I was waking up tired. I would regularly fall asleep on the lounge after dinner etc. CPAP gave me back my energy levels-tuely unbelievable!

Like my brother, I had also been a smoker and drinker and enjoyed a 'good time', although these 'good times' have been gradually in decline since have children 13 years ago.

Looking back now I suspect that I have had regular bouts of AF for the past 30 years or so that self corrected. I used to have pulpatations that went away after a while, so didn't really think that much about it.

I think a big night on the booze(which would've made my sleep apnea even worse) back in Nov. 2014 and me not realising that I was in AF, was responsible for my admission to hospital a couple of weeks later.

So Maggie, there's the long(ish) version of it all.

Low sodium diet (first 4 or5 months - not so important now my heart is pumping better), CPAP machine, no more smoking (of any kind) never more than a couple of drinks when socialising, trying to get eight hours sleep each night and maintainence medication (Sotolol, Perindoprol, and apixaban-a blood thinner).

Afib begets Afib, and being in rhythm begets being in rhythm. I think taking Amioderone for several months got to stay in rhythm long enough for Sotolol to help keep me in rhythm (at least for the time being anyway).

So I think my AF was something that I was predisposed to, but my lifestyle helped to bring it to the fore. 

Mmmm.......silly me I guess!??

I had no problems with Amiodarone and even returned to work on it. 

All mediacations can have side effects, but not everyone gets them. Weigh up your options and keep in touch with your cardiologist.

Take care, and happy hollidays.