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Does Intake Of Antiarythmics Help In Curing Atrial Fibrillation?
Question: I have been converted out of Afib 3 times in six years. I recently was placed on sotalol and spent 2.5 days in the hospital for monitoring. Having side effects and the cardiologist has told me to stop taking it and we will start a new med. Should I keep trying antiarythmics or go for a cardioblation proceedure?
My follow up is: How long does it take for Sotalol to flush out of my system so I stop having the side effect of tightness in my chest and hard to breath?
So you know they did an EKG today and it showed a normal rhythm.
My follow up is: How long does it take for Sotalol to flush out of my system so I stop having the side effect of tightness in my chest and hard to breath?
So you know they did an EKG today and it showed a normal rhythm.
Brief Answer:
A trail of medication is still better option for atrial fibrillation
Detailed Answer:
Hello , I am Dr. Mody and I would be addressing your concern.
It's always a treatment dilemma how to treat atrial fibrillation as the the treatment have its drawback .
I would hereby enumerate my observations.
1) The half life of sotalol is 10 -20 hours . So XXXXXXX by a day sotalol is cleared from your circulation and the symptoms should completely subside .
2) Sotalol is one of finer drugs and with minimum side effects . Maybe if you say that sinus rhythm has already been achieved decrease the dose .
Alternatively metoprolol or any other cardioselective beta blocker which may have a minimum side effects but at the same time less effective may be tried .
3) ablation is also not foul proof way and it's success in complete termination of atrial fibrillation without recurrence is less than 60 % . So if that acceptable , you may go ahead with ablation .
4) Do send me the list of medication already tried , and your echocardiography for atrail dimensions, so that I can suggest the medication and how effective ablation would be .
I would still consider a trail of medication with the aim of just rate control rather than rhythm control so as to balance side effects vs . Control of Atrial fibrillation.
Let me know if any clarification needed and I would be happy to help .
Regards Dr Priyank Mody
A trail of medication is still better option for atrial fibrillation
Detailed Answer:
Hello , I am Dr. Mody and I would be addressing your concern.
It's always a treatment dilemma how to treat atrial fibrillation as the the treatment have its drawback .
I would hereby enumerate my observations.
1) The half life of sotalol is 10 -20 hours . So XXXXXXX by a day sotalol is cleared from your circulation and the symptoms should completely subside .
2) Sotalol is one of finer drugs and with minimum side effects . Maybe if you say that sinus rhythm has already been achieved decrease the dose .
Alternatively metoprolol or any other cardioselective beta blocker which may have a minimum side effects but at the same time less effective may be tried .
3) ablation is also not foul proof way and it's success in complete termination of atrial fibrillation without recurrence is less than 60 % . So if that acceptable , you may go ahead with ablation .
4) Do send me the list of medication already tried , and your echocardiography for atrail dimensions, so that I can suggest the medication and how effective ablation would be .
I would still consider a trail of medication with the aim of just rate control rather than rhythm control so as to balance side effects vs . Control of Atrial fibrillation.
Let me know if any clarification needed and I would be happy to help .
Regards Dr Priyank Mody
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Dr.
I have been on Multaq, Metropolol, and Sotalol. The sotalol caused an issue with breathing and I had to stop using it.
While in AFIB this is the last report on heart function.
TYPE OF REPORT: Regadenoson myocardial SPECT stress examination DATE
OF SERVICE: 02/28/2013
HISTORY: This is a 56-year-old gentleman with no known coronary
disease. He has hypercholesterolemia, hypertension, and a family
history of coronary disease. He has a history of tobacco use. He
has been experiencing recent dyspnea.
TECHNIQUE: Rest images obtained after the administration of 10.91
mCi of technetium 99 sestamibi. Post stress examination obtained
after the administration of 30.6 mCi of technetium 99 sestamibi.
Baseline electrocardiogram demonstrates sinus bradycardia with a
heart rate of 53 beats per minute and no ischemic ST or T wave
changes. The patient was given intravenous regadenoson. Heart rate
increased from 53 beats per minute to 85 beats per minute. Blood
pressure increased from 132/84 to 148/84. There were no ischemic ST
or T wave changes.
IMAGES: Careful review of attenuation and non-attenuation corrected
images demonstrates inferior wall attenuation on both rest and stress
images. There are no other reversible or irreversible perfusion
defects noted. Gated wall motion analysis demonstrates overall
preserved left ventricular systolic function with ejection fraction
of 69% and normal inferior wall motion. The inferior wall
attenuation is thus secondary to artifact.
IMPRESSION:
1. Myocardial SPECT images negative for ischemia or infarction.
2. Preserved left ventricular systolic function with calculated
ejection fraction of 69%.
END OF REPORT:
Seems my heart is healthy enough but I would like to not worry about a recurrence of afib.
Thank you!
I have been on Multaq, Metropolol, and Sotalol. The sotalol caused an issue with breathing and I had to stop using it.
While in AFIB this is the last report on heart function.
TYPE OF REPORT: Regadenoson myocardial SPECT stress examination DATE
OF SERVICE: 02/28/2013
HISTORY: This is a 56-year-old gentleman with no known coronary
disease. He has hypercholesterolemia, hypertension, and a family
history of coronary disease. He has a history of tobacco use. He
has been experiencing recent dyspnea.
TECHNIQUE: Rest images obtained after the administration of 10.91
mCi of technetium 99 sestamibi. Post stress examination obtained
after the administration of 30.6 mCi of technetium 99 sestamibi.
Baseline electrocardiogram demonstrates sinus bradycardia with a
heart rate of 53 beats per minute and no ischemic ST or T wave
changes. The patient was given intravenous regadenoson. Heart rate
increased from 53 beats per minute to 85 beats per minute. Blood
pressure increased from 132/84 to 148/84. There were no ischemic ST
or T wave changes.
IMAGES: Careful review of attenuation and non-attenuation corrected
images demonstrates inferior wall attenuation on both rest and stress
images. There are no other reversible or irreversible perfusion
defects noted. Gated wall motion analysis demonstrates overall
preserved left ventricular systolic function with ejection fraction
of 69% and normal inferior wall motion. The inferior wall
attenuation is thus secondary to artifact.
IMPRESSION:
1. Myocardial SPECT images negative for ischemia or infarction.
2. Preserved left ventricular systolic function with calculated
ejection fraction of 69%.
END OF REPORT:
Seems my heart is healthy enough but I would like to not worry about a recurrence of afib.
Thank you!
Brief Answer:
Yes the heart seems well , Some precaution to prevent recurrence as below
Detailed Answer:
Hello,
Yes the SPECT scan of your heart was completely normal in 2013 .
However I would like to point out that hypertension is the most common cause of atrial fibrillation throughout the world, because it cause relaxation abnormality of the upper chamber .
Off all the medication list you have mentioned. Metoprolol is the best and safest medication, so if you tolerate is well , it will take care of your atrial fibrillation and help in reducing blood pressure as well .
Another group which may be tried is calcium channel blocker like Verapamil or diltiazem as an alternative to beta blocker .
If the reason for atrial fibrillation was reversible , it wouldn't occur again , but in your case where the cause is not known and may be plain aging there is a fair chance that there may be paroxysmal event which you may jot even notice (subclinical ) so I would suggest continuation of any of above discussed medication preferably from net a blocker or calcium channel blocker group .
Also if any recurrence , anticoagulation or aspirin should be considered based on your scoring ( discuss the same with your doctor ) .
Some care you should take are
Thyroid abnormality should be ruled out , if obese and snore at night ( sleep apnea) as reversible cause should be ruled out .
Hypertension should be strictly controlled .
Also ischaemia or structural heart problems causing AF should be monitored.
Avoid stimulants like smoking , tobacco , drugs , tea coffee, binge alcohol drinking or excess mental or physical stress . Adequate sleep is necessary. All these will prevent surge of adrenaline in the circulation and prevent triggering of AF.
Whenever possible do send your 2 D Echo cardiography and furthur information about how it all started and the exact present secenerio.
Do let me know if any clarification needed and I would be happy to help.
Do rate for other s reference .
Regards Dr Priyank Mody
Yes the heart seems well , Some precaution to prevent recurrence as below
Detailed Answer:
Hello,
Yes the SPECT scan of your heart was completely normal in 2013 .
However I would like to point out that hypertension is the most common cause of atrial fibrillation throughout the world, because it cause relaxation abnormality of the upper chamber .
Off all the medication list you have mentioned. Metoprolol is the best and safest medication, so if you tolerate is well , it will take care of your atrial fibrillation and help in reducing blood pressure as well .
Another group which may be tried is calcium channel blocker like Verapamil or diltiazem as an alternative to beta blocker .
If the reason for atrial fibrillation was reversible , it wouldn't occur again , but in your case where the cause is not known and may be plain aging there is a fair chance that there may be paroxysmal event which you may jot even notice (subclinical ) so I would suggest continuation of any of above discussed medication preferably from net a blocker or calcium channel blocker group .
Also if any recurrence , anticoagulation or aspirin should be considered based on your scoring ( discuss the same with your doctor ) .
Some care you should take are
Thyroid abnormality should be ruled out , if obese and snore at night ( sleep apnea) as reversible cause should be ruled out .
Hypertension should be strictly controlled .
Also ischaemia or structural heart problems causing AF should be monitored.
Avoid stimulants like smoking , tobacco , drugs , tea coffee, binge alcohol drinking or excess mental or physical stress . Adequate sleep is necessary. All these will prevent surge of adrenaline in the circulation and prevent triggering of AF.
Whenever possible do send your 2 D Echo cardiography and furthur information about how it all started and the exact present secenerio.
Do let me know if any clarification needed and I would be happy to help.
Do rate for other s reference .
Regards Dr Priyank Mody
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Thank you.
Brief Answer:
wishing you the best of health . Regards
Detailed Answer:
It's my pleasure that I could help you in any way ,
Atrial fibrillation is a vast topic and presents with different challenges, resulting in individualisation of treatment.
It's a general rule, that recurrence after ablation is very common so if it is controlled with medication that the best way out , however if there are in tolerable side effects and incessant atrial fibrillation. Ablation can be given a try as it's a safe procedure with no major risks.
Do keep me in the loop about progress in the future , and i would be happy to help.
Wishing you the best of health.
Dr. Priyank Mody
wishing you the best of health . Regards
Detailed Answer:
It's my pleasure that I could help you in any way ,
Atrial fibrillation is a vast topic and presents with different challenges, resulting in individualisation of treatment.
It's a general rule, that recurrence after ablation is very common so if it is controlled with medication that the best way out , however if there are in tolerable side effects and incessant atrial fibrillation. Ablation can be given a try as it's a safe procedure with no major risks.
Do keep me in the loop about progress in the future , and i would be happy to help.
Wishing you the best of health.
Dr. Priyank Mody
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Arnab Banerjee
Answered by
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