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Suggest Treatment For Side Effects Of Amiodarone
Question: I am male 64 years of age I was diagnosed with Atriall Fibrillation XXXXXXX 2015, I had an electrical external Cardioversion on 12th Oct which failed, my cardiologist put me on Amiodrone after my 1st cardioversion failed.
I had another Cardioversion on 30th Nov which also failed, and I was told to keep taking Amiodrone as they want to try an internal Cardioversion at the beginning of year 2016.
I consider myself to be very active, my main symptom is breathlessness, I have read a lot about Amiodrone and its long term side effects, I felt much better before I started taking Ami as it lowers my pulse down to some days 55/59/60 BPM. Before taking Ami my pulse was around 70 BPM
My main question to you is should I continue taking it prior to my internal Cardioversion, or should I just come off it, if I new it was going to contribute towards my internal Cardioversion, I will continue taking it,
Look forward to hearing from you
I had another Cardioversion on 30th Nov which also failed, and I was told to keep taking Amiodrone as they want to try an internal Cardioversion at the beginning of year 2016.
I consider myself to be very active, my main symptom is breathlessness, I have read a lot about Amiodrone and its long term side effects, I felt much better before I started taking Ami as it lowers my pulse down to some days 55/59/60 BPM. Before taking Ami my pulse was around 70 BPM
My main question to you is should I continue taking it prior to my internal Cardioversion, or should I just come off it, if I new it was going to contribute towards my internal Cardioversion, I will continue taking it,
Look forward to hearing from you
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
I passed carefully through your medical history and would like to explain that taking Amiodarone for this period of time before programmed electrical cardioversion will not increase the chances of successful conversion.
This is, because the main predictors for a successful electrical cardioversion besides a correct electrical energy delivering (amount of energy, correct transmission, etc), are time-period from atrial fibrillation onset (which defines the level of electrical and geometric left atrial remodeling), severity of left atrial enlargement (measured by ECHO), persisting predisposing factors (severe valvular dysfunction, severely impaired left ventricular function, thyroid dysfunction, etc.).
As the time from atrial fibrillation onset to the next electrical cardioversion attempt has increased (more than 6 months), the chances for a successful cardioversion have decreased due to progression of electrical and possibly structural atrial re-modelling.
Nevertheless, you should not lose the hope for a successful procedure.
My personal professional opinion would be to stop taking Amiodarone as you are experiencing symptomatic bradyarrhythmia, and it would not be much helpful in increasing the rate of success.
If your doctor insists on drug continuation, discuss with him probably to decrease the daily dose or to use another strategy (to load Amiodarone only a short period of time before cardioversion attempt).
Don't forget to continue a correct anticoagulation at least 4 weeks before cardioversion, to avoid the risk of potentially dangerous cardioembolic events.
Hope to have been helpful to you!
In case of further uncertainties, do not hesitate to ask me.
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
I passed carefully through your medical history and would like to explain that taking Amiodarone for this period of time before programmed electrical cardioversion will not increase the chances of successful conversion.
This is, because the main predictors for a successful electrical cardioversion besides a correct electrical energy delivering (amount of energy, correct transmission, etc), are time-period from atrial fibrillation onset (which defines the level of electrical and geometric left atrial remodeling), severity of left atrial enlargement (measured by ECHO), persisting predisposing factors (severe valvular dysfunction, severely impaired left ventricular function, thyroid dysfunction, etc.).
As the time from atrial fibrillation onset to the next electrical cardioversion attempt has increased (more than 6 months), the chances for a successful cardioversion have decreased due to progression of electrical and possibly structural atrial re-modelling.
Nevertheless, you should not lose the hope for a successful procedure.
My personal professional opinion would be to stop taking Amiodarone as you are experiencing symptomatic bradyarrhythmia, and it would not be much helpful in increasing the rate of success.
If your doctor insists on drug continuation, discuss with him probably to decrease the daily dose or to use another strategy (to load Amiodarone only a short period of time before cardioversion attempt).
Don't forget to continue a correct anticoagulation at least 4 weeks before cardioversion, to avoid the risk of potentially dangerous cardioembolic events.
Hope to have been helpful to you!
In case of further uncertainties, do not hesitate to ask me.
Kind regards,
Dr. Iliri
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Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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