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Diagnosed With Atrial Fib And Paroxysmal Svt. No Relief From Sotalol. Safe To Take Amiodarone?

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Posted on Tue, 26 Mar 2013
Question: I've been diagnosed with atrial fib and paroxymal SVT - will Pauling therapy work for these conditions as well? Taking 80 my sotalol tbd
(still having afib episodes) and cardiologist prescribed amiodarone today - read side effects and definitely not taking - scared to do so.
doctor
Answered by Dr. Anantharamakrishnan (1 hour later)
Hi friend,
Welcome to Health Care Magic

The issue is to control the rhythm / if not feasibe, to control the rate.
It is especially important for you because the heart may already be in strain from anaemia.

There is no drug – for that matter anything in the world – without side effects.
It is a question of risk versus benefits.

Pauling therapy has not been scientifically evaluated or approved.
It is unlikely to help.

If you do not want to take amiodarone and if the problem is bothering to the extent of interfering with life style, there are advanced techniques of investigations and treatment – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.

There are other advanced treatment modalities - like RF ablation or cryo-ablation – which could be done during EPS. The chances of success and cre rate are high / many may not need a drug...

Take care
Wishing speedy recovery
God bless
Good luck

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Anantharamakrishnan (13 hours later)
Thank you for your response. Much appreciated. Agree side effects with everything but amiodarone's quite extreme and systemic. I'm been one of those patients that follows Murphy's law - whatever is to go wrong happens to me.

I forgot to mention that I was recently diagnosed with a patent foramen ovale and I also am one of those who has a left atrial appendage. My rhythmic specialist has mentioned closure of both to lessen the chances of a clot formation, movement and stroke. I haven't found any research papers on this method that provides clear direction - seems to be two camps - pro and con.

Because of the occasional bleeds, I cannot take usual blood thinners - use aspirin daily. I'm thinking that for 68 years the foramen has not bothered me and I've been quite active, so why close it at this age - risks, etc.

Any insights that you can provide about this is well appreciated.

God Bless.

doctor
Answered by Dr. Anantharamakrishnan (6 hours later)
Hi,

Left Atrial appendage is there in everybody. The blood movement is slower there and hence the chance for stasis and clot formation, when there is irregular rhythm and/or dilatation

Patent Foramen Ovale (PFO) is often an incidental finding. It may allow right to left movement of blood. In normal situations, for example, a clot in leg can go the lungs and is arrested there / but not to the rest of the body. In PFO, it may go from the right atrium to the left and thence to the systemic circulation (paradoxical / right to left) and hence the chance for a stroke.

Hence the benefit of closure – to reduce the chance of clot formation (on the left side) by reducing the size / to reduce paradoxical embolism (from right side to the left). The risk of atrial fibrillation is more from the embolism than the rate itself

Anti-platelet agents (aspirin / clopidogrel) have proved thier worth, but a bit less efective than coumadin, which however has its own problems.

Considering all the factors, the best option will be to go for EPS (Electro Physiological Study) and ablation.

Regards
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Anantharamakrishnan

Cardiologist

Practicing since :1966

Answered : 4505 Questions

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Diagnosed With Atrial Fib And Paroxysmal Svt. No Relief From Sotalol. Safe To Take Amiodarone?

Hi friend,
Welcome to Health Care Magic

The issue is to control the rhythm / if not feasibe, to control the rate.
It is especially important for you because the heart may already be in strain from anaemia.

There is no drug – for that matter anything in the world – without side effects.
It is a question of risk versus benefits.

Pauling therapy has not been scientifically evaluated or approved.
It is unlikely to help.

If you do not want to take amiodarone and if the problem is bothering to the extent of interfering with life style, there are advanced techniques of investigations and treatment – Electro Physiological Studies (EPS) > it resembles angio – a catheter is put inside the heart / electrical activity recorded / stimulation and suppression tests are carried out / suitable medicine tested and so on. Though the test is the gold standard, it is INVASIVE and has a risk (though minimal) and is not generally done unless there are compelling indications. This super-speciality expert is called ELECTRO-PHYSIOLOGIST. The treating doctor may suggest them depending on need, based on his assessment of the situation.

There are other advanced treatment modalities - like RF ablation or cryo-ablation – which could be done during EPS. The chances of success and cre rate are high / many may not need a drug...

Take care
Wishing speedy recovery
God bless
Good luck