Paroxysmal Atrial Fibrillation

Hi Malcolm. My first diagnosis was in 2006 and, as per usual, Warfarin, diliatazem (in capsules of Tildiem) were prescribed, along with short doses of Digoxin. Everything calmed down and only one or two episodes occurred in the following four years. Now it has flared up again, quite recently and strongly. Meds have now been changed to beta blockers instead of Tildiem; problem persists.

I do hope you do NOT discontinue the meds you're on without approval. This type of heart problem is now so very common and nobody seems to know exactly what a permanent 'cure' is. Good luck to you Malcolm and best wishes for a continuing trouble-free heartbeat.

One way of finding out if it's the med. is to give up Flecainide (but not Warfarin) for a while.

I find it interesting the different meds. prescribed for this condition. I've had PAF for about 10 years and like you tolerate it reasonbly well. No racing pulse, fainting or disability but do feel tired after an episode. I was prescribed Sotalol when my PAF started which has a side-effect causing palpitations, the very thing it was prescibed to prevent. Couldn't get an explanation as to why Sotalol was prescibed other than 'it's the standard med. of this condition' and cheapest presumably. Since giving up Sotalol (and Ramipril) the number of episodes has reduced from about 18 to 12 /year..

Marco: Very interesting to read your post.

Seems to coincide with my thoughts on this heart problem. The 'meds' route to alleviating PAF seems to be largely 'suck it and see'. Most cardio consultants have different ideas, or so it seems to me. My Bisololo dosage has increase from 1.25 mg daily to 2.5 mg daily to 5 mg daily and now 7.5 mg a day - all starting on 20 Feb! So, within nine days it has been quickly increased because the drug has had little or no effect. It is, as per usual, a trial and error routine. Goodness only knows how many different beta blockers are available but quite a few I should imagine.

The only other route seems to be invasive surgery, such as ablation - which again does not seems to be a permanent 'cure' in many cases, even though the cardio's say it is about 95% successful. A friend of mine had TWO ablations followed by a quadruple bypass op. Not the sort of route I'd relish but it might be classed as a 'kill or cure' approach. Electric shock treatment (cardioversion) also seems just a temporary halt to an erratic heartbeat in many cases, sometimes having no effect at all.

I do wonder if one simply stops all the high blood pressure drugs, the beta blockers and suchlike and just soldiered on with dear old Warfarin, or one of the newer anticoagulents.

I am a 54-year-old male and I have had atrial fibrillation for about 14 years. I am on 12.5 mg daily of Toprol XL. this dosage seems to be the "sweet spot". Larger doses are hard to tolerate. Years ago I was on atenolol. I didn't really tolerate that well. I was the lethargic, decreased libido, lack of energy.

I have learned to control the atrial fibrillation. stay away from the major triggers: caffeine, alcohol, any kind of nervous system stimulant. another thing you should investigate is your body's food intolerances. I also need to limit the wheat and/or the gluten.

drink plenty of pure water daily. about half your body weight in ounces. stay hydrated. coconut water is good for hydration. it also adds potassium.

magnesium is a "defibrillator". epson salt baths at night, magnesium oil rubbed on the skin, magnesium supplements all minimize atrial fibrillation.

try to walk about 2 to 3 miles daily or at least five days a week.

stay away from artificial sweeteners and artificial flavor enhancers like MSG and all of its derivatives.

Best of luck to you.

CroydonGeorg, every patient is a guinea pig when it comes to prescribing meds., that I can understand. The OP seems to tolerate Flecainide well whereas I've read horror stories on these forums about the side-effects of this drug.

It's when meds. continue to be prescribed when it's obvious that they cause serious side-effects, as they were with me, that I can't understand.

Thanks for all the input gents, I find it interesting that I seem to be alone in taking Flecainide (long term). I also suffer with High Blood Pressure (in fact the cardio specialist thinks the two are linked!) so also take the usual HBP drugs - many of which seem to have been prescribed to you for AF. I'm not planning to arbitarily reduce my drugs but I can't say I'm happy with the amount I take daily. As my AF has been stable for over 12months and the Flecainide documentation says ' when stable your GP may decide to reduce the dosage' I was just curious. However as marco says we are all 'guinea pigs' - no one one seems to know what drugs do and how they interact.

Flecainide for me is a "pill in the pocket" remedy if I go into AF. If I have an AF episode that is severe or lasts longer than 5-6 hours, then I take 3 x 100mg tabs.

This almost always converts me to NSR (Normal sinus rhythm)

For me, I would not take it daily. This is a rhythm control med, whereas Toprol XL is a "rate" control med.

Best luck to you.

Every time I'm shunted into hospital because of a severely fast and crazy heart rate I'm given 500 mcg of DIGOXIN. This gradually brings me back to 'normal' within about 5 to 8 hours. I've asked if I could simply administer this dosage myself, at home ... but no, it does not seem to be something the experts agree with. I just have a strong desire to keep OUT of a hospital ward nowadays; noisy disturbing places in my view.

I am new to this forum and I feel the need to present another opinion of cardiac ablation.

I am scheduled to have an ablation this month and am looking forward to it. I hate meds and the ones I've tried don't help the Afib anyway. They just give me terrible side effects.

This procedure as described by my doctors and many hours of reading on the subject is not invasive surgery. It is a minimally invasive procedure that is done with catheters. No cutting open the chest, in fact no cutting at all. And ablations have nothing to do with bypass surgery. Ablations work on the electrical system of the heart and bypass surgeries are for a clogged up plumbing system. In other words, if your plumbing is OK, as mine is, your ablation will not lead to future bypass surgery. The other point is that the first ablation you have often doesn't work but, the second has a much greater percentage chance of being successful. That's why I'm going for my second one. I will report back as to the outcome. I'm thinking positive thoughts!

Just wanted to clear this up as I understand it. I wouldn't discourage anyone from looking into this procedure which has improved tremendously over time and has a very good success rate for complete recovery.

Matabar, hope this ablation does the trick and looking forward to your report.

Was offered an ablation two years ago and consultant said that there was a 70% chance of success at each procedure. Turned the offer down as I said above I can cope with my PAF reasonably well and at the time I was on meds. that could have caused or aggravated it. I've since taken myself off these.

But for me an ablation is still an option.

Marco, thanks for your kind response. My doctor told me that I have an 80-85% chance of success with this ablation so I'm putting my money on his odds!! It's a very new type of ablation called FIRM. It was developed by a brilliant electrophysiologist from England who now lives in San Diego. Dr. Sanjiv Narayan, if you want to look him up. Only a few centers in the states are trained for and have the equipment necessary for this procedure.

Thanks again Matabar. Should have explained the stats as they were put to me more clearly. First ablation has 70% chance of success. The second has 70% of the remaining 30% chance of success so 91% after the second and about 97% after the third.

I'll look up Dr Narayan's work.

Hi Malcolm. I've had P A/F for 30 years. Since changing from Amiodarone to Flecainide the only episodes I've had were related to either drinking alcahol, taking too much caffeine, or forgetting to take the Flecainide. Don't worry about not having any episodes, that's what's meant to happen. Stop worrying about it and enjoy your life! Good luck!

Hi Hugh

Do you take a beta blocker as well as the Flecainide?

Hi Robin.

No I don't take a Beta Blocker. Apparently some of them (perhaps all of them) interact badly with Flecainide. I do however take Valsartan which is an angiotensin II receptor antagonist, to control my blood pressure.