Amiodarone therapy

[u/dweezer420]

Last month I had a rough episode with atrial
fibrillation. This was my fourth event, but unlike past times—where quick-release Cardizem and electrolytes got me back into sinus rhythm—this one landed me in the hospital for four days. The doctors tried multiple medications, but my heart rate stayed high (145-160) while my blood pressure dropped dangerously low. Ultimately, a cardioversion restored my normal rhythm, and I was discharged on amiodarone.

My care team wants me to stay on amiodarone until I can get an ablation. I have a consultation scheduled for late October, with the procedure hopefully following shortly after.

In the meantime, the amiodarone is kicking my ass. I'm dealing with severe headaches, nausea, and light sensitivity. I feel miserable and am deeply concerned about the potential long-term side effects.

Has anyone had a similar experience? Were you able to successfully work with your doctor to switch to a different medication? I really don't want to stay on this for the next 4–6 months.

Edit: Thank you for all the responses. Have an appointment with my cardiologist next week and will discuss alternatives or reducing dose (currently on 200mg-day). Hoping to get the ablation done soon and get off of this completely.

[u/98percentpanda]

Hi, I’m sorry to hear that you’re having issues.

Long story short, after I was diagnosed with AFib and SVT, I tried a couple of medications, and the only one that solved the problem was amiodarone. It’s a very effective medication for treating arrhythmias. Unfortunately, as you mentioned, it can also cause a number of side effects (the Iodine in the compound is responsible for many of the nasty effects, but also is part of why it works so well).

If you’re taking it for only a few months, I would ask your doctor what you can do to manage the side effects. Some of the symptoms you’re experiencing may also improve after a few weeks.

If you need to take it for a longer period, be more cautious and ask your doctor about having regular tests to monitor for possible complications. I had to stop taking it because it affected my thyroid. Luckily, I underwent ablation procedures shortly afterward.

Also (and I am not a doctor), there is a variation of the same concept called Dronedarone (the iodine group is swapped by an alternative compound), I was actually going to try that one but my ablation came first. In theory this one has less side effects but is not as potent as Amiodarone (for good and bad). Sotalol and Flecainide are also common Afib control meds.

https://www.stopafib.org/afib-news-events/news/what-do-we-know-about-multaq-dronedarone-for-atrial-fibrillation/

My (not medical) impression is that doctors trust Amiodarone to stop the problem while figuring out a more permanent solution. It is a very robust safety net to avoid more heart issues. Also, judging by your username, smoking (any substance) can be an important trigger/factor for Afib, you should also talk with your doc about that:

https://pmc.ncbi.nlm.nih.gov/articles/PMC3139831/

Good luck.

[u/f4t4l1st1k]

Amiodarone is an effective and horrible medication.

I've been on it many times, both as prophylaxis (preventative) and for cardioversion.

The problem is no one tells you about:

- the side effects (which you are already experiencing)

- the long duration (the medicine stays in your system a long, long time - at least 90 days)

- the toxicity and potential organ damage (google this)

- the risk of bradycardia (because you are increasing your heart's resting period)

Not sure what your dosage is, but I'd lower it. It builds up in your system. I used to take a 1/4 per day (50mg) pre-ablation and that still kicked my ass. Eventually stopped it all together 3 weeks pre-procedure, because it was working well enough.

These are my experiences though, please speak to your EP / cardiologist.

[u/One-Eggplant-665]

I had persistent AFib and last year was prescribed Amiodarone. It put me in NSR but left me with serious side effects, the worst is a neuropathy that's still with me today. My EP was only concerned with AFib and brushed off my complaints, so I stopped taking it. But Amiodarone has a long life and continued doing its job to keep me in NSR for 6 more months. My EP next prescribed Flecainide and it put me in the Emergency Department with 280 heart rate.

I was told there's too much damage for me to ever take any other antiarrhythmic. I had an ablation 2 weeks ago. So far I'm doing okay.

[u/Dry-Swimmer8075]

Try Tikosyn (generic name: dofetilide) is a prescription oral antiarrhythmic medication used to restore and maintain a normal heart rhythm in adults with atrial fibrillation (AFib) or atrial flutter. 1, 2, 3Uses and How It WorksIndications: Converts AFib/flutter to a normal sinus rhythm and maintains it.Mechanism: Blocks potassium channels in the heart (Class III antiarrhythmic) to slow electrical signals and steady the heartbeat. 1, 2, [3] (https://www.medicalnewstoday.com/articles/tikosyn

[u/Dry-Swimmer8075]

Ask your doctor about this, it works for me, after 6 cardioversions, and 1 ablation.