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Is Beta Blocker Sufficient To Treat A-fib?
Hi I am a retired male 79years old physician. I have had afib since 1991--I am controlled with a beta-blocker and a 81mg. asa I have not chosen to use any of the new anti-platlet drugs. My cardiologist is not pleased. what is your thoughts--c d pickett do mph
Mon, 16 Nov 2015
Hi. Thank you for your question and welcome to HCM. I understand your concern.
As far as I understood, you are diagnosed with chronic atrial fibrillation. In these cases the followed strategy is that of rate control. I am assuming you are properly anti-coagulated, with acenocoumarol or warfarine. As about the heart rate, there are certain drugs used for this aim, and beta blockers are among the effective ones. Of course, the aim is to keep the ventricular response under 90 beats per minute, because every rapid ventricular response can trigger serious, dangerous, life-threatening arrhythmias. Regarding your problem, there are anti-arrhythmic classes of drugs, that can work well with or without the beta-blocker. In my opinion, amiodarone, propafenone or flecainide can be started in your therapy, if the beta-blocker is not working to keep the ventricular rate under 90 per minute. Every one of these agents has its benefits and possible side effects, which I recommend you to discuss in details with your cardiologist. Personally, I would recommend adding amiodarone. It is an effective anti-arrhythmic drug, with the lowest profile of pro-arrhythmic side effect and safe and effective even in a damaged heart muscle.
I hope I was helpful with my answer. Wish you a good health.
Kind regards,
Dr. Meriton
As far as I understood, you are diagnosed with chronic atrial fibrillation. In these cases the followed strategy is that of rate control. I am assuming you are properly anti-coagulated, with acenocoumarol or warfarine. As about the heart rate, there are certain drugs used for this aim, and beta blockers are among the effective ones. Of course, the aim is to keep the ventricular response under 90 beats per minute, because every rapid ventricular response can trigger serious, dangerous, life-threatening arrhythmias. Regarding your problem, there are anti-arrhythmic classes of drugs, that can work well with or without the beta-blocker. In my opinion, amiodarone, propafenone or flecainide can be started in your therapy, if the beta-blocker is not working to keep the ventricular rate under 90 per minute. Every one of these agents has its benefits and possible side effects, which I recommend you to discuss in details with your cardiologist. Personally, I would recommend adding amiodarone. It is an effective anti-arrhythmic drug, with the lowest profile of pro-arrhythmic side effect and safe and effective even in a damaged heart muscle.
I hope I was helpful with my answer. Wish you a good health.
Kind regards,
Dr. Meriton
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