sorry if i mislead you

i recently posted a message stating that i had a demand pacer for 2 wks and that now the dr wants to do av ablation and be 100% paced. i think readers thought i had not been down the med road i was on 2 different beta blockers which made me feel like heck. however i was only on them for about 2 wks before he took me off them and put me on tikosyn which really kicked my butt not only in the way i felt but all the arrthymias it caused. i was told i would be taken off tikosyn once i agreed to a pm, however he has continued me on it , it does not control the rate or the a fib. he has increased my cardizem to 240 mg i feel he should have at least kept me on the beta blockers longer instead of deciding to do an av ablation and keep me on tikosyn which by the way without ins is around 240 dollars a months supply. i am frustrasted that i am stilll on tilkosyn.......thank god for ins but if im not able to return to work i cant afford this useless expensive med sorry for the confusion its been a heck of a day

4 Comments

medications

by Susan - 2009-04-02 03:04:16

Sounds like you have lots of frustations right now. Having been down a similar path, I offer the following: 1. An AV node ablation should only be considered if all other options have failed or have been ruled out. 2. If I remember correctly, you haven't had your pacemaker very long. I know I went through months and months of getting if fine tuned before it was going smoothly. What kind of adjustments have been made to your pacemaker? 3. I am on Tikosyn and I have been for years. It initially did not stop the arrhthymia but the dr. kept me on it and only after at least one year or longer did I acheive NSR. Also, when I stopped it I could just stop it, no weaning. And when I started it again, for I went back into flutter, I didn't have to be rehospitalized.
4. What about the digoxin? Are you still taking it? I know that it is contrainidicated with some kinds of afib/afutter. I learned about that on one of the sites dealing with afib.
It does take time to get things straighten out. Hang in there.
Susan

Medications

by SMITTY - 2009-04-02 09:04:01


Hi Pattycake,

First and foremost, if at all possible get another opinion. I'm not smart enough to make any specific comments, but something about your message leads me to believe you need another opinion.

I will say one of the major problems with Cardizem (diltiazem) is it can cause arrhthymias. It is an excellent medicine for lowering blood pressure and controlling some angina pain, but one of its short comings, that we seldom hear about, is causing an irregular heart beat. Of course not everyone taking diltiazem has such problem, but some do.

In the early '90s I kept complaining of chest pain and my doctor kept increasing my daily dosage to help my problems until I was taking more than 300 mg/day. He interpreted my chest pain complaint as my having angina. I was almost a semi-invilaid because of arrhthymias until I noticed one day that when I got up in the morning my heart rhythm would be relatively stable and I had no chest pain until about an hour after I took my first dose of diltiazem. After that each day, things would continue to go down hill. I reached the point that were so bad that I felt I had nothing to lose and I started reducing the amount of diltiazem to see if that would help. (That was the only heart specific medication I was taking at the time.) Over the following 6 months I went from 300+ mg/day to 60 mg/day and got rid of 90% of my arrhthymias problem. I now take 30 mg/day and while I have some arrhthymias problems they are so much less than when I was on the high dosage of diltiazem there is really know comparison.

NOW THIS IS ONE REAL IMPORTANT. Lowering my dosage worked for me, it may not work for everyone as the cause of arrhthymias are many. I would suggest that you monitor your arrhthymias symptoms after taking your diltiazem and see if you can find any correlation between it (or any of your heart medications) and the severity of your problem. If you do try talking to your doctor about what you find.

I wish you the best.

Smitty

Medication change

by kcruz - 2009-04-02 09:04:49

I would recommend that you discuss other optional medications prior to an AV node ablation, I am also on Tikosyn and can totally understand the financial aspect of the medication, I would be willing to guess that it's probably not that your doctor doesn't want to stop it, but it has to be gradually weaned due to the pro arrhythmic effects. Sometimes doctors are not so good in verbalizing what they are really thinking in the grand plan of care. Why not set up an appointment with him and bluntly ask him what are you thinking long term with me? Would it be feasible to consider an AF ablation first before knocking out my AV node?

I worked with a exceptional EP that had discussed with me my case as a friend and he said that he would much rather exhaust all other option before making someone pacer dependant, I have been dependant since 2003 and although it helped dramatically in the beginning I did develop other issues. Just remember that with medications you can at least stop and try others, stop and restart if needed, but with an AV node ablation there is no turning back in some cases that is the best thing but it is no guarantee that your symptoms with subside completely.

hi

by jessie - 2009-05-18 11:05:43

hi there. i was born in 41 and is ee you 42. i am also a retired registered nurse. it is nice to read abvout you. hope you are better. jessie

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