Re: Tambocor and other drugs

[Guest guest]

Hi Bruce,

I take flecanide, which I believe is the same as Tambocor...

> Anyway, my questions are as follows:

> 1) Has anyone else experienced bad side effects from Tambocor?

> (Zombie like state, insomnia, fatigue, etc.)

I take 100mg per day and with the effect that has with regard vision

and general lightheadedness I told my Dr that I didnt ever want to

have to take more. I have got used to the side effects of 100mg and

can accept them to avoid the risk of blackouts that I experienced in

AFib before. However, I cannot think how I would feel if the symptoms

were twice as bad if my dosage was doubled.

> 2) Given that I never had daily A-fib episodes prior to treatment,

> and given some of the articles I've seen posted about these anti-

> arrhythmic drugs possibly causing the arrhythmia's that they are

> suppose to prevent in some people, have there been any studies to

> confirm or deny their links to possibly causing A-fib, etc.?

I had Afib about every 10-14 days before treatment, more frequent

when stressed. Since treatment with Flecanide, the what I

call 'episodes'(flutters in the chest) have become more frequent

(almost daily) but the 'attacks' (mammal flapping about violently in

the chest and feeling faint and dizzy) have gone. I did have two of

these fainting 'attacks' whilst trying Rythmol however.

> 3) Is it the usual course of action for cardiologist to simply jump

> right to drugs like Tambocor that require hospital stays to monitor

> your reaction to the drug, as opposed to other simpler drugs first

> that don't require a hospital stay? Has anyone gone from Tambocor

to

> something simpler (for lack of a better term) and benefited from

it?

When I was diagnosed I went straight onto Sotolol which made me feel

like sh*t, then to Rythmol which gave me the two fainting attacks I

mentioned before. I then went to Flecanide (which was 3 months after

first treatment) It has worked for me at 100mg a day but I have made

a great effort to reduce stress in my life, excercise moderately

every day rather than going hell for leather 3 times a week in the

gym, which I think has contributed greatly to the success of the

medication.

I had my first Afib attack with blackout 15 yrs ago and I am only 42

now. I take meds so I can stay safe when driving (and so others can

too!) but will continue to work on my lifestyle so I dont need to

increase or change medication and in the hope I can come off it at

some point.

Lesley in the UK

[Guest guest]

Bruce

Your story sounded a lot like mine when I was put on sotalol (Previously I

had been on digoxin for 10 years) Once on sotalol my AF seemed to get worse

and each time I went to the GP she upped the dosage. She said my AF was

needing more drugs to control it.. Everything got worse. It got so bad I

asked for another drug. I was given Tambacor. After three days I went into

Tachy, was having pulsating vision and tremoring from head to foot. GP

rushed me through for ECG and then he gave me atenolol. That slowed my heart

rate down, but the side effects were very similar to sotalol. In hindsight

the sotalol definately made my arrythmias worse and I swear it was down to

the pro arrhythmic action of the pills. After this I gave up with drug

treatment. I could not understand why I was taking drugs when they did not

stop the AF, and seemed to make it worse, and, why I should suffer terrible

side effects to boot. I am NOT saying for you to do what I did. It could be

a very drastic measure. But I was at my wits end. I stopped eating eveything

that I suspected as triggers and have not had a run of AF since. But I still

get a lot of ectopics. I think why I am saying all this is because you asked

if anyone had gone from the heavier duty drugs to the lesser ones. I did,

and it got a bit better. Hope that helps you a bit.

FRan

Tambocor and other drugs

> Hi all,

>

> One of your newest members again with another info request. Thanks

> again for the responses to my other postings.

>

> I started out on 200mg of Tambocor (as well as 2 baby aspirin/day)

> about a month ago. I've had my Tambocor dosage upped to 250mg/day a

> couple of weeks ago, and this past week my cardiologist upped it to

> 300mg/day. (My event recorder has captured almost daily episodes of

> A-fib, A-flutter, PAC's and PVC's)

>

> Anyway, I had enough after yesterday's zombie-like state. Ever since

> I've started on this drug, I haven't slept well, and during the day I

> find myself fatigued often. Each dosage increase has simply

> magnified those side effects. In addition, before I started to be

> treated for A-fib, I never had daily episodes. Although they seemed

> to be occurring more frequently in the preceding months, they simply

> weren't daily. Although they would last several hours longer, they

> were occurring every few weeks at most. I know during the preceding

> months I was in a job situation that was stressing me out to no end.

> I have since found a new job and start this coming Monday. (Have

> left the oilfield and decided to head back to NASA.)

>

> Anyway, my questions are as follows:

> 1) Has anyone else experienced bad side effects from Tambocor?

> (Zombie like state, insomnia, fatigue, etc.)

> 2) Given that I never had daily A-fib episodes prior to treatment,

> and given some of the articles I've seen posted about these anti-

> arrhythmic drugs possibly causing the arrhythmia's that they are

> suppose to prevent in some people, have there been any studies to

> confirm or deny their links to possibly causing A-fib, etc.?

> 3) Is it the usual course of action for cardiologist to simply jump

> right to drugs like Tambocor that require hospital stays to monitor

> your reaction to the drug, as opposed to other simpler drugs first

> that don't require a hospital stay? Has anyone gone from Tambocor to

> something simpler (for lack of a better term) and benefited from it?

>

> Thanks in advance for any input!

> Bruce

>

>

>

>

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be acted upon without consultation with one's physician.

>

>

[Guest guest]

My answers:

1) Has anyone else experienced bad side effects from Tambocor?

(Zombie like state, insomnia, fatigue, etc.)

Only the visual effects.

2) Given that I never had daily A-fib episodes prior to treatment,

and given some of the articles I've seen posted about these anti-

arrhythmic drugs possibly causing the arrhythmia's that they are

suppose to prevent in some people, have there been any studies to

confirm or deny their links to possibly causing A-fib, etc.?

Tambocor, as well as some of the other drugs, ca have pro-arrhythmic

characteristics for some people. That is why my doctor, and some others,

prescribe a beta-blocker to be taken along with it.

3) Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay? Has anyone gone from Tambocor to

something simpler (for lack of a better term) and benefited from it?

Tambocor does not require a hospital stay. A doctor might require it,

but that is his prerogative. There have been many that have tried

Tambocor and moved on for various reasons, and found other things that

work for them. I believe Ellen, for one, tried Tambocor and had adverse

reactions, then changed to dofetilide with great success.

One disadvantage of Tambocor is that one has to be sure there is no

structural heart disease. Many doctors require x-rays, echocardiograms

and stress tests before prescribing.

[Guest guest]

My answers:

1) Has anyone else experienced bad side effects from Tambocor?

(Zombie like state, insomnia, fatigue, etc.)

Only the visual effects.

2) Given that I never had daily A-fib episodes prior to treatment,

and given some of the articles I've seen posted about these anti-

arrhythmic drugs possibly causing the arrhythmia's that they are

suppose to prevent in some people, have there been any studies to

confirm or deny their links to possibly causing A-fib, etc.?

Tambocor, as well as some of the other drugs, ca have pro-arrhythmic

characteristics for some people. That is why my doctor, and some others,

prescribe a beta-blocker to be taken along with it.

3) Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay? Has anyone gone from Tambocor to

something simpler (for lack of a better term) and benefited from it?

Tambocor does not require a hospital stay. A doctor might require it,

but that is his prerogative. There have been many that have tried

Tambocor and moved on for various reasons, and found other things that

work for them. I believe Ellen, for one, tried Tambocor and had adverse

reactions, then changed to dofetilide with great success.

One disadvantage of Tambocor is that one has to be sure there is no

structural heart disease. Many doctors require x-rays, echocardiograms

and stress tests before prescribing.

[Guest guest]

> 3) Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay? Has anyone gone from Tambocor to

something simpler (for lack of a better term) and benefited from it?

I forget if I already posted my answer to this. When I was first

diagnosed, the cardio wanted ot put me on an antiarrhythmic. I

forget if it was solatol or rhythmol, I think the latter. However,

he decided this on the basis of a few telephone conversations I had

with his nurse after the initial exam. He doesn't deign to speak to

patients on the phone himself. This was a scary time, because

besides my freaking out as a newly diagnosed person, the nurse

insisted it was crucial I go on the stronger med, but there was no

way she would let me speak to the cardio for several weeks due to his

being booked up. I knew stronger meds had significant risks, thanks

to this group.

My internist of the time said, let's do a holter monitor first and

see what's actually happening. The answer was, not afib, rather

ectopics, etc. So he kept me on toprol, and I am still on toprol, and

having an episode every few months. I am happy to not be on the

stronger meds.

Of course, your situation may differ. Also, I have a new

cardiologist :-)

[Guest guest]

First of all, one person can do great on a drug and another not. I'm

currently on Rythmol for 4 years and doing great w/no afib and

adapted to the initial side-effects.

That being said, my experience with Tambocor. I was on Tambocor for

a few weeks, first drug I took steadily for A-F, after being

converted in the hospital a second time.

After a few weeks, I developed a mild temperature. Having returned

from India, I was tested for malaria, this that and the other thing,

and had an MRI - all negative. The temp kept rising. Eventually, I

was running 102 every day by 4 PM or so with NO other symptoms.

Cardiologist switched me to rythmol. My daily maximum temp began

falling and returned to normal after 4 or 5 days.

Because I had to take rythmol 3 times per day vs. twice for Tambocor,

after 4 months, I switched back to Tamobocor. After about 2-3 weeks

on Tambocor, my temp started rising each day in the afternoon, and

after a week or so it was hitting 102 again. Switched back to

Rythmol, and the fever went away.

Cardiologist could find no other reference anywhere to this side-

effect, but it was very real for me.

Who knows - maybe I was allergic to something they use in the

manufacturing process, or it's just an unreported very rare side-

effect.

Naturally, your mileage may vary <smile>...

[Guest guest]

I just returned from my second trip to the er in the past week....they kept me

for a couple days the first time, and sent me home tonight....nothing

wrong...anxiety. Yeah I have anxiety...the doctors dont tell me anything, I dont

know what to ask really...all I really want to know is how to make this stop,

and how to do it fast....I am supposed to do the cardioversion thing soon, I

guess they needed to wait for the blood thinners etc. I was just diagnosed with

afib and really cant believe this ...does anyone have any info on the likelyhood

of getting back to normal from the cardioversion.

trudyjhagain wrote:

> 3) Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay? Has anyone gone from Tambocor to

something simpler (for lack of a better term) and benefited from it?

I forget if I already posted my answer to this. When I was first

diagnosed, the cardio wanted ot put me on an antiarrhythmic. I

forget if it was solatol or rhythmol, I think the latter. However,

he decided this on the basis of a few telephone conversations I had

with his nurse after the initial exam. He doesn't deign to speak to

patients on the phone himself. This was a scary time, because

besides my freaking out as a newly diagnosed person, the nurse

insisted it was crucial I go on the stronger med, but there was no

way she would let me speak to the cardio for several weeks due to his

being booked up. I knew stronger meds had significant risks, thanks

to this group.

My internist of the time said, let's do a holter monitor first and

see what's actually happening. The answer was, not afib, rather

ectopics, etc. So he kept me on toprol, and I am still on toprol, and

having an episode every few months. I am happy to not be on the

stronger meds.

Of course, your situation may differ. Also, I have a new

cardiologist :-)

[Guest guest]

>

> I just returned from my second trip to the er in the past

week....they kept me for a couple days the first time, and sent me

home tonight....nothing wrong...anxiety. Yeah I have anxiety...the

doctors dont tell me anything, I dont know what to ask really...all I

really want to know is how to make this stop, and how to do it

fast....I am supposed to do the cardioversion thing soon, I guess

they needed to wait for the blood thinners etc. I was just diagnosed

with afib and really cant believe this ...does anyone have any info

on the likelyhood of getting back to normal from the cardioversion.

Avery, I totally understand your anxiety. I get very anxious when I

am in afib, and I struggled with anxiety and not understanding and

struggling against the whole problem after I was diagnosed.

I think the news is good. It takes awhile to find out the best

treatment after the initial diagnosis. But most people in here,

whether thru medication or ablation or from learning and avoiding

their triggers, reach a state where they are (correct me if I'm wrong

here, folks) most of the time in a normal heart rhythm.

I was going nuts initially but now I only go nuts when I'm in afib or

multiple ectopics a minute.

And keep in mind that ablation techniques really are improving in

leaps and bounds, and that they and some of the meds for some of hte

people relly are cures.

I try to do relaxtion stuff when I get particularly freaked out.

Just lying on the sofa (prop yourself up if lying down makes the afib

worse) and trying to relax helps.

You might ask your internist about anti-anxiety medication. I have

had problems with that medication myself, but many people find it

helpful.

[Guest guest]

I had my first afib episode on Sunday June 16. Had no idea what was happening

but the rapid heart rate frightened me. I went to the ER and was diagnosed and

after spending five hours in ER was sent home.

On Monday I saw a cardiologist. He wanted to do the cardioversion then after

doing an ultrasound of the heart (through the esopophagas--I think its called a

TEE) to see if there were any blood clots. I said no. I had no choice in

choosing this doctor I got him by default, the hospital recommended him. I

needed time to think this over. The next 10 days were the worst I ever had. My

heart rate stayed between 100 and 180 (Holter Monitor).

Drugs didn't help. The warfarin wasn't thinning my blood. I was tired, short of

breath, night sweats, and scared. On June 26 I had the TEE and cardioversion.

The day after I felt great. All my concerns were for nothing. Currently I am

off warfarin and on Plavix because I am allergic to aspirin, the doctors first

choice. Been NSR since. My message to you is there is nothing to it. I know

it has only been 4 weeks since the cardioversion but I may be one of the lucky

ones that has had an unexplained episode. If I had to do it again I would have

had the cardioversion on June 17. My doctor turned out OK. Somewhere I read

that an average cardiologist can do a cardioversion. I had a stress test and

Holter last week and every thing was OK. (85000 heart beats and only 8 extra

beats) . Personally I really don't like drugs. I take enough for the asthma and

hypertension I have. This support group played a large part in helping me

understand afib. Thanks to all of you and I wish you all the best.

Re: Re: Tambocor and other drugs

I just returned from my second trip to the er in the past week....they kept me

for a couple days the first time, and sent me home tonight....nothing

wrong...anxiety. Yeah I have anxiety...the doctors dont tell me anything, I dont

know what to ask really...all I really want to know is how to make this stop,

and how to do it fast....I am supposed to do the cardioversion thing soon, I

guess they needed to wait for the blood thinners etc. I was just diagnosed with

afib and really cant believe this ...does anyone have any info on the likelyhood

of getting back to normal from the cardioversion.

trudyjhagain wrote:

> 3) Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay? Has anyone gone from Tambocor to

something simpler (for lack of a better term) and benefited from it?

I forget if I already posted my answer to this. When I was first

diagnosed, the cardio wanted ot put me on an antiarrhythmic. I

forget if it was solatol or rhythmol, I think the latter. However,

he decided this on the basis of a few telephone conversations I had

with his nurse after the initial exam. He doesn't deign to speak to

patients on the phone himself. This was a scary time, because

besides my freaking out as a newly diagnosed person, the nurse

insisted it was crucial I go on the stronger med, but there was no

way she would let me speak to the cardio for several weeks due to his

being booked up. I knew stronger meds had significant risks, thanks

to this group.

My internist of the time said, let's do a holter monitor first and

see what's actually happening. The answer was, not afib, rather

ectopics, etc. So he kept me on toprol, and I am still on toprol, and

having an episode every few months. I am happy to not be on the

stronger meds.

Of course, your situation may differ. Also, I have a new

cardiologist :-)

[Guest guest]

<<Anyway, my questions are as follows:

1) Has anyone else experienced bad side effects from Tambocor?

(Zombie like state, insomnia, fatigue, etc.) >>

yep, but I've tried 5 other meds that don't really work too. My cardiologist

reckons around a 30% success rate with each med so if this one isn't

working/making things worse try another.

<<2)[snip] have there been any studies to

confirm or deny their links to possibly causing A-fib, etc.? >>

searching for

flecainide proarrhythmic

at pub med (http://www.ncbi.nlm.nih.gov/entrez/query.fcgi) might be a good

place to start

<<3) Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay?>>

I believe it's one of the first meds they try here in the uk - and I'm not

sure there is such a thing as a simple drug when it comes to fixing the

rhythm or controlling the rate.

<<Has anyone gone from Tambocor to

something simpler (for lack of a better term) and benefited from it?>>

I'm currently taking a beta-blocker for rate control if you think that is

simpler (I would much prefer to have my rhythm controlled). Flecainide

(tambocor) was the second med I tried and I'm now on number 6. The first 4 I

tried would be considered antiarrhythmic and the last 2 probably only

considered as rate control meds.

Not all meds work for all people and some people appear to be resistant to

drug intervention. If you've given it a good shot and don't see any

improvement, try something else.

All the best

--

D (33, Leeds, UK)

Paroxysmal AF for 29 hours every 16 days

[Guest guest]

Dear Avery,

Don't get your hopes up about Electrical Cardioversion. The A-Fib

often returns sooner or later. I'm surprised your EP wants you to do an

Electrical Cardioversion. It is most often used when your heart beat is

life threatening.

Current medications aren't very effective either and often have bad

side effects.

The only treatment to date that completely cures A-Fib is Focal

Catheter Ablation, But most EPs don't do it or won't try it unless

you've been on at least two different medications without success. I

don't know why. It may be an insurance or liability thing. I have

attached a list of Medical Facilities performing Focal Catheter Ablation

in the US.

Good luck. We've all been where you are and know what you're going

through.

Steve---cured of A-Fib, 1998

avery cutts wrote:

>

> I just returned from my second trip to the er in the past week....they

> kept me for a couple days the first time, and sent me home

> tonight....nothing wrong...anxiety. Yeah I have anxiety...the doctors

> dont tell me anything, I dont know what to ask really...all I really

> want to know is how to make this stop, and how to do it fast....I am

> supposed to do the cardioversion thing soon, I guess they needed to

> wait for the blood thinners etc. I was just diagnosed with afib and

> really cant believe this ...does anyone have any info on the

> likelyhood of getting back to normal from the cardioversion.

> trudyjhagain wrote:

> > 3) Is it the usual course of action for cardiologist to simply jump

> right to drugs like Tambocor that require hospital stays to monitor

> your reaction to the drug, as opposed to other simpler drugs first

> that don't require a hospital stay? Has anyone gone from Tambocor to

> something simpler (for lack of a better term) and benefited from it?

>

> I forget if I already posted my answer to this. When I was first

> diagnosed, the cardio wanted ot put me on an antiarrhythmic. I

> forget if it was solatol or rhythmol, I think the latter. However,

> he decided this on the basis of a few telephone conversations I had

> with his nurse after the initial exam. He doesn't deign to speak to

> patients on the phone himself. This was a scary time, because

> besides my freaking out as a newly diagnosed person, the nurse

> insisted it was crucial I go on the stronger med, but there was no

> way she would let me speak to the cardio for several weeks due to his

> being booked up. I knew stronger meds had significant risks, thanks

> to this group.

>

> My internist of the time said, let's do a holter monitor first and

> see what's actually happening. The answer was, not afib, rather

> ectopics, etc. So he kept me on toprol, and I am still on toprol, and

> having an episode every few months. I am happy to not be on the

> stronger meds.

>

> Of course, your situation may differ. Also, I have a new

> cardiologist :-)

>

>

>

>

>

>

>

[Guest guest]

It may be a bit premature to recommend ablation at this stage.

Cardioversion is reasonable (assuming Avery and his doc are going the

rhythm control route). It worked for me.

I disagree with the statement that it is used most often when your

heartbeat is life threatening.

Bobby

Atlanta

Re: Re: Tambocor and other drugs

Dear Avery,

Don't get your hopes up about Electrical Cardioversion. The A-Fib

often returns sooner or later. I'm surprised your EP wants you to do an

Electrical Cardioversion. It is most often used when your heart beat is

life threatening.

[Guest guest]

on Sun, 4 Aug 2002 at 23:38:02, Steve

wrote :

>The only treatment to date that completely cures A-Fib is Focal

>Catheter Ablation

or the Maze, for chronic AF as well as PAF

Best of health to all,

Vicky

[Guest guest]

> I forget if I already posted my answer to this. When I was first

> diagnosed, the cardio wanted ot put me on an antiarrhythmic. I

> forget if it was solatol or rhythmol, I think the latter. However,

> he decided this on the basis of a few telephone conversations I had

> with his nurse after the initial exam. He doesn't deign to speak to

> patients on the phone himself. This was a scary time, because

> besides my freaking out as a newly diagnosed person, the nurse

> insisted it was crucial I go on the stronger med, but there was no

> way she would let me speak to the cardio for several weeks due to

his

> being booked up. I knew stronger meds had significant risks, thanks

> to this group.

I too have had the experience of not seeing a cardiologist until the

nurse at the hospital insisted that one come to see me. He was

actually pulled out of a meeting to speak to me and I was very

grateful to both of them as the Consultant I am under just said it

was too mild a condition to need to see him. Well, I don't have any

of the terrible symptoms you have, but it's still very scary to have

anything wrong with your heart and no reason for any of the treatment

given.

Why don't you go to your clinic/hospital and demand to see someone?

It's your right. Especially if you are in the US and paying a heck

of a lot of money.

[Guest guest]

In a message dated 8/3/2002 8:14:50 AM Pacific Daylight Time,

bruceboulanger@... writes:

<< Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay? >>

I think that more conservative doctors will start patients on beta or calcium

channel blockers and move to the proarrhythmic drugs if the blockers fail to

produce adequate results. Jumping immediately to proarrhythmic drugs is

apparently not just a recently advocated strategy because my current

electrophysiologist, fresh out of training, concurs with my previous

cardiologist who, retired, in his opinion that I have been doing well on

Atenolol for thirteen years and should stay with it rather than switching to

Tambocor. On the other hand, less conservative doctors may be less concerned

about proarrhythmic effects or are unconvinced that such effects are

prevalent enough to even warrant a hospital stay at the beginning to ensure

that dangerous rhythms such as Torsades Des Pointes do not occur. The less

conservative doctor is more likely to jump to the proarrhythmic drug first

and simply send the patient home with a prescription rather than admitting

him or her to a hospital. I would prefer the conservative approach. If a

doctor sent me home with a prescription for Tambocor without providing for

hospital monitoring, I would find a new doctor.

Regarding the side effects of Tambocor, I would say that the same side

effects are possible with one of the so-called simpler drugs. When I first

started Atenolol thirteen years ago, I experienced fatigue and lethargy at

first. The symptoms lessened after about two months on the drug. Then each

time my dose has been raised, I have experienced renewed fatigue and lethargy

along with a kind of breathlessness while exercising. Each time the symptoms

have lessened after two to four months at the dose level. Now on 150 m.g. of

Atenolol, I have plenty of energy and feel very good most of the time. My

experience with Atenolol tells me that it may take time to adjust to the

effects of any drug, but many people may give up before they reach the

adjustment phase.

The insomnia could be due to the effects of the afib itself or to your worry

about it. In the beginning of my afib nineteen years ago, I simply could not

sleep at all while having an afib episode because of the feeling that a caged

animal was trying to break out of my chest and also because I was so

terrified by the feelings. I was taking no drugs and didn't even know I had

afib. After a few years of experiencing this two-four times a year, I

figured it would have killed me by now if it were going to do so; and I was

able to settle down to sleep a bit but not well. Atenolol really helped with

sleep when I started it in the sixth year of my afib career because it tamed

and calmed the caged animal.

However, the bottom line here seems to be that Tamobocor is causing an

increase of afib rather than a decrease for you. Tambocor is a PRO

arrhythmic drug, with the prefix meaning " for or supporting " arrhythmia. In

some individuals it does not have that effect, but it seems that for you it

is truly " pro " rather than " anti " arrhythmic. If Tambocor had eliminated

your afib, I would say, " Stick with it and get used to the fatigue which will

pass. " However, I don't see the point of sticking with a drug which makes

the condition worse. That's obviously not the point of taking a drug, to

make the condition worse. If I were in your position, I would ask my doctor

about stopping Tambocor and trying another drug. I wouldn't stop it on my

own, though, because I understand that practice can be dangerous.

Since you also have a genetic tendency toward afib, I would also look at

other aspects of your life and keep a record of food, drinks, and activities

that preceded afib episodes so that you can avoid those triggers in the

future. By cutting triggers you can help any drug to be more effective. I

believe that a genetic afib tendency makes a person vulnerable to many

activities and substances that would be absolutely innocuous to the normal

person. As a person with genetic afib tendencies, I see that modifying my

life has helped me to stay paroxysmal rather than permanent for the whole of

my nineteen year afib career. My older brother with the same genetic

tendency, who used no trigger identification or avoidance strategies, has

been in permanent afib for an unknown but very long time, possibly twenty to

thirty years. For some people apparently only ablation or surgery is the

answer, but I think it's worth trying medications and trigger avoidance

before submitting to procedures. Good luck.

in sinus in Seattle (76th day)

[Guest guest]

----- Original Message -----

To: <AFIBsupport >

>

> The insomnia could be due to the effects of the afib itself or to your

worry

> about it

There is another reason for insomnia on heart meds. This is what my GP said

had happened to me. In the end after 11 years on meds I was lucky if I could

get to sleep by 5 or 6 each morning. I would then wake up an hour or so

later to get the kids off to school. It was waring me out. No matter how

hard I tried to fdall asleep during the day it just would not happen.

Seemingly many of the heart meds we take/ or have taken cause a problem with

seratonin production in the body. It is seratonin that becomes melatonin

when it gets dark and tells our bodies to sleep. So if you are having a

problem with sleep then this could be part of the problem.

Fran

[Guest guest]

Long post so I shall hack a bit:

Re: Tambocor and other drugs

8<

him or her to a hospital. I would prefer the conservative approach. If

a

doctor sent me home with a prescription for Tambocor without providing

for

hospital monitoring, I would find a new doctor.

8<

Hospital monitoring is recommended if the patient has sustained

ventricular tachycardia. I studied Tambocor tremendously before I began

taking it as well as after. If my electrophysiologist sent me to the

hospital for monitoring, I would consider finding a new doctor.

Everyone is different. I had no underlying conditions. Perfect health

except for afib. Perfect x-ray, echocardiogram and stress test. There

are others in this forum like me, many who have just recently joined and

are in the process of making very important decisions. I would hate for

them to " walk away " from a doctor like mine who is a specialist in his

field, prescribes Tambocor for a patient like me, and does not require

several days in the hospital. There are many others who are not quite

as healthy, and monitoring might be a good idea. But lets not imply that

the doctor that follows the protocol should be let go.

One of our polls back in 2000 asked about conditions under which people

started their Tambocor. Most did not have to undergo monitoring.

8 out of 13 had no monitoring, 5 had 1 to 3 days.

___________________________

Bobby

Atlanta

NSR with Tambocor/Lopressor - 6 years

[Guest guest]

In a message dated 8/6/2002 2:28:42 PM Pacific Daylight Time,

bobbyrgroups@... writes:

<< But lets not imply that

the doctor that follows the protocol should be let go.

>>

I did not intend to advocate that everyone and anyone should abandon a doctor

who does not provide for hospital monitoring of a patient who is beginning a

proarrhythmic drug. I have taken the liberty of copying a not-quite-so

hacked version of what I said, and I shall interpret the meaning since it

apparently was obscure. I said:

<>

By this statement, I meant that I personally would prefer to begin a

proarrhythmic drug in the hospital with monitoring and would, therefore,

prefer to work with a doctor who would take that approach. If my current

electrophysiologist would not agree to hospital monitoring, I would try to

find a new doctor who would allow hospital monitoring. At least I would get

a second opinion. When I have discussed the possibility of proarrhythmic

drugs with my past and present cardiologists, both have indicated that they

would prefer the hospital monitoring approach but they also stated that some

doctors do not believe monitoring is necessary. Their opinion is also my

personal opinion and preference, undoubtedly influenced by them, and it's

also my right to express that opinion and to follow that preference, I think.

I can find no connotation in the above statement, either implicit or direct,

which advises others to " let go " of a doctor who does not require

hospitalization to begin a proarrhythmic drug. I certainly agree that

everyone is different and, therefore, requires different approaches in

treatment. I was merely expressing the course of treatment which I as an

individual would prefer to follow if it becomes necessary for me to try a

proarrhythmic drug. I can find no statements in my " long post " which advise

anyone else to follow my preferred course of action. Because I am not a

medical professional, I would not presume to advise others to follow a course

of action that seems to work for me because it may not work for everyone.

I think it is certainly a good idea to minimize quotations to save space

here, but in " hacking " the original, let's try to retain the sense of the

original statement. Quoting ideas out of context and misconstruing meaning

are techniques which promote misunderstanding and limit effective

communication.

in sinus in Seattle (76th day)

[Guest guest]

In a message dated 8/6/2002 11:41:12 AM Pacific Daylight Time,

Starfi6314@... writes:

<< I would prefer the conservative approach. If a

doctor sent me home with a prescription for Tambocor without providing for

hospital monitoring, I would find a new doctor. >>

In my immediately previous post, I tried to quote this statement, but it

didn't appear. The quotation marks appeared without the quotation. This is

what I actually said about my preference for hospital monitoring if I were to

begin a proarrhythmic drug.

[Guest guest]

Why would anybody use a proarhythmic drug, Am i not understanding this. What

is a proarrhythmic drug supposed to do in a medical sense? I am not taking this

literally..but why is tambocor a proarrhythmic drug.

Thanks, Ken

Re: Tambocor and other drugs

In a message dated 8/3/2002 8:14:50 AM Pacific Daylight Time,

bruceboulanger@... writes:

<< Is it the usual course of action for cardiologist to simply jump

right to drugs like Tambocor that require hospital stays to monitor

your reaction to the drug, as opposed to other simpler drugs first

that don't require a hospital stay? >>

I think that more conservative doctors will start patients on beta or calcium

channel blockers and move to the proarrhythmic drugs if the blockers fail to

produce adequate results. Jumping immediately to proarrhythmic drugs is

apparently not just a recently advocated strategy because my current

electrophysiologist, fresh out of training, concurs with my previous

cardiologist who, retired, in his opinion that I have been doing well on

Atenolol for thirteen years and should stay with it rather than switching to

Tambocor. On the other hand, less conservative doctors may be less concerned

about proarrhythmic effects or are unconvinced that such effects are

prevalent enough to even warrant a hospital stay at the beginning to ensure

that dangerous rhythms such as Torsades Des Pointes do not occur. The less

conservative doctor is more likely to jump to the proarrhythmic drug first

and simply send the patient home with a prescription rather than admitting

him or her to a hospital. I would prefer the conservative approach. If a

doctor sent me home with a prescription for Tambocor without providing for

hospital monitoring, I would find a new doctor.

Regarding the side effects of Tambocor, I would say that the same side

effects are possible with one of the so-called simpler drugs. When I first

started Atenolol thirteen years ago, I experienced fatigue and lethargy at

first. The symptoms lessened after about two months on the drug. Then each

time my dose has been raised, I have experienced renewed fatigue and lethargy

along with a kind of breathlessness while exercising. Each time the symptoms

have lessened after two to four months at the dose level. Now on 150 m.g. of

Atenolol, I have plenty of energy and feel very good most of the time. My

experience with Atenolol tells me that it may take time to adjust to the

effects of any drug, but many people may give up before they reach the

adjustment phase.

The insomnia could be due to the effects of the afib itself or to your worry

about it. In the beginning of my afib nineteen years ago, I simply could not

sleep at all while having an afib episode because of the feeling that a caged

animal was trying to break out of my chest and also because I was so

terrified by the feelings. I was taking no drugs and didn't even know I had

afib. After a few years of experiencing this two-four times a year, I

figured it would have killed me by now if it were going to do so; and I was

able to settle down to sleep a bit but not well. Atenolol really helped with

sleep when I started it in the sixth year of my afib career because it tamed

and calmed the caged animal.

However, the bottom line here seems to be that Tamobocor is causing an

increase of afib rather than a decrease for you. Tambocor is a PRO

arrhythmic drug, with the prefix meaning " for or supporting " arrhythmia. In

some individuals it does not have that effect, but it seems that for you it

is truly " pro " rather than " anti " arrhythmic. If Tambocor had eliminated

your afib, I would say, " Stick with it and get used to the fatigue which will

pass. " However, I don't see the point of sticking with a drug which makes

the condition worse. That's obviously not the point of taking a drug, to

make the condition worse. If I were in your position, I would ask my doctor

about stopping Tambocor and trying another drug. I wouldn't stop it on my

own, though, because I understand that practice can be dangerous.

Since you also have a genetic tendency toward afib, I would also look at

other aspects of your life and keep a record of food, drinks, and activities

that preceded afib episodes so that you can avoid those triggers in the

future. By cutting triggers you can help any drug to be more effective. I

believe that a genetic afib tendency makes a person vulnerable to many

activities and substances that would be absolutely innocuous to the normal

person. As a person with genetic afib tendencies, I see that modifying my

life has helped me to stay paroxysmal rather than permanent for the whole of

my nineteen year afib career. My older brother with the same genetic

tendency, who used no trigger identification or avoidance strategies, has

been in permanent afib for an unknown but very long time, possibly twenty to

thirty years. For some people apparently only ablation or surgery is the

answer, but I think it's worth trying medications and trigger avoidance

before submitting to procedures. Good luck.

in sinus in Seattle (76th day)

[Guest guest]

<<Why would anybody use a proarhythmic drug.>>

because an individual doesn't take it expecting it to be proarrhythmic for

them (they are all antiarrhythmic too .

To try to stop your arrhythmia, antiarrhythmic drugs mess with the timing of

the firing of your heart cells.

The upshot of this is that although they are designed to help stop the heart

wobbling they can also throw it in the wrong direction and make your heart

more likely to wobble. Finding the one that works for you is a big battle

All the best

--

D (33, Leeds, UK)

Paroxysmal AF for 29 hours every 16 days