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In a message dated 3/15/04 4:21:46 PM Eastern Standard Time,

regasega@... writes:

> Went to ER. Tried Corvert 1mg

> twice with no conversion. As of today, no conversion. I will return

> Friday for an echo just to make sure heart is ok.

>

A quick question. Through this whole episode, are you consuming, taking or

experiencing any triggers?

Caffeine (tea, de-caf anything, chocolate), alcohol, MSG, stress, fatigue?

In other words are tou feeding the fire.

Rich O

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> In a message dated 3/15/04 4:21:46 PM Eastern Standard Time,

> regasega@o... writes:

>

> > Went to ER. Tried Corvert 1mg

> > twice with no conversion. As of today, no conversion. I will

return

> > Friday for an echo just to make sure heart is ok.

> >

>

> A quick question. Through this whole episode, are you consuming,

taking or

> experiencing any triggers?

> Caffeine (tea, de-caf anything, chocolate), alcohol, MSG, stress,

fatigue?

> In other words are tou feeding the fire.

> Rich O

>

>

>

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What's your dosage of cardizem?

Debbi

> In a message dated 3/15/04 4:21:46 PM Eastern Standard Time,

> regasega@o... writes:

>

> > Went to ER. Tried Corvert 1mg

> > twice with no conversion. As of today, no conversion. I will

return

> > Friday for an echo just to make sure heart is ok.

> >

>

>

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> > In a message dated 3/15/04 4:21:46 PM Eastern Standard Time,

> > regasega@o... writes:

> >

> > > Went to ER. Tried Corvert 1mg

> > > twice with no conversion. As of today, no conversion. I will

> return

> > > Friday for an echo just to make sure heart is ok.

> > >

> >

> >

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Larry: when I go to the ER.........they convert me chemically with

cardizem. I think they all have different ideas as what do to with

us. I read on an earlier post that some they convert with digoxin.

Debbi, OU Alum in OKC

**********************************************************

> 240mg. per day ... delayed release. But I wasn't under the

impression

> that Cardizem was going to convert me. Just slow down my heart rate.

>

> Am I wrong about this?

>

> Larry

>

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4. Do I need to use an electric shaver on Coumadin. Seems to me that

> I end up cutting myself every so often with a regular blade.

>

> Thanks for your help!

>

> Larry

.....................................................

Larry just have a syptic pencil on hand for those shaving nicks. I

nick myself occasionally and it works just fine. I've even used it

after I brushed my teeth too hard and had a bleeding tooth......it

tasted really bad but it worked along with direct pressure.

And I certainly wouldn't worry about a cardioversion. I've had

several and they're no big deal. It sounds like you doctor in giving

you sound advice. If you're really worried about the very small

chance of a stroke during the conversion ask the doctor if he could

do a TEE before the procedure.

P <MI>

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In a message dated 3/15/2004 1:21:38 PM Pacific Standard Time,

regasega@... writes:

<< 2. Would you give the other drugs a shot prior to cardioversion?

3. Does this seem like good medical guidance?

4. Do I need to use an electric shaver on Coumadin. Seems to me that

I end up cutting myself every so often with a regular blade.

>>

Larry,

After more than twenty years of afib with no cardioversions in which I have

always converted spontaneously without chemical or electrical intervention, I

would give other drugs a chance in your position. Your afib history seems to

indicate that afib is not likely to become a permanent state for you at this

point since you have had very little afib compared with many of us. Chances are

very good that you will convert spontaneously (on your own) before the end of

the three weeks on Coumadin required for the cardioversion. That's what

happened to me when I started Coumadin so that I could have a cardioversion in

three weeks. I converted on my own long before the three weeks had passed.

However, I was taking Atenolol and Verapamil, two drugs which slow and regulate

the heart rate. Perhaps you could ask your doctor if you might try drugs such

as these because they do not require hospitalization to start and are

relatively simple and safe. If these do not work, I still would try other drugs

such

as Flecainide or Dofetilide, but only if you remain in afib for a longer period

of time. During my afib career, I have frequently been in afib as long as

eight to ten days before I spontaneously converted. Now I am rarely in afib.

Similarly, your afib will not necessarily grow worse, especially since afib has

been relatively rare in your background.

Although cardioversions are not risky, I understand, I often wonder if I

would be enjoying my current afib-free status if I had experienced a

cardioversion. I can't help but suspect that such a trauma to the heart could

have long

lasting effects that are not fully known at the present time. This is pure

theory on my part, but my idea is based on the number of people whom I know of

that have had cardionversions only to return ultimately to afib. One of these

people was my own father. I would not be hasty to jump into a cardioversion

until you have seen whether or not your afib pattern is changing from short and

infrequent to chronic. You have time to wait especially if you are taking

Coumadin. Also, regarding the Coumdin, if your INR is right, you will probably

find that you won't bleed dangerously from a small razor cut. However, if you

feel more comfortable using an electric razor, why not do it?

Good luck,

in sinus in Seattle

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> If you're really worried about the very small

> chance of a stroke during the conversion ask the doctor if he could

> do a TEE before the procedure.

>

> P <MI>

Actually ... I'm pretty convinced that being on Coumadin for 3 weeks

will reduce the risk of stroke. But I'm just very uncomfortable with

the procedure itself. It seems so drastic to put someone out and

apply electric shock to them. It seems more natural to me to try

several different drugs first ... even if it means being

hospitalized. But I guess that's wrong because the guidelines seem to

dictate cardioversion.

Larry

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Hi Larry, I use an electic shaver anyway but I think this

thing on Wafarin depends how old you are,

I was on the drug for some years and then I was under 50 and

had no problems except for wind that I thought sometime was a

heart attack.

I saw many of our senior citizens in the clinic and they were

all having problems with their INR ratios and brusining.

I met a women wh was under 30 wh had a problems with lung

clots through the pill and she was on 30 mg a day YES 30 Mg a

day. Poor thing she had to have tests once a week and all she

compalined aobut was the cold.

In summary it depens how much you bleed I was able to carry

on as normal..

JOHN C UK

>4. Do I need to use an electric shaver on Coumadin. Seems to

me that

>> I end up cutting myself every so often with a regular

blade.

>>

>> Thanks for your help!

>>

>> Larry

>....................................................

>Larry just have a syptic pencil on hand for those shaving

nicks. I

>nick myself occasionally and it works just fine. I've even

used it

>after I brushed my teeth too hard and had a bleeding

tooth......it

>tasted really bad but it worked along with direct pressure.

>And I certainly wouldn't worry about a cardioversion. I've

had

>several and they're no big deal. It sounds like you doctor

in giving

>you sound advice. If you're really worried about the very

small

>chance of a stroke during the conversion ask the doctor if

he could

>do a TEE before the procedure.

>

>P <MI>

>

>

>

Codling

Hornchurch Essex England

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> Actually ... I'm pretty convinced that being on Coumadin for 3

weeks

> will reduce the risk of stroke. But I'm just very uncomfortable

with

> the procedure itself. It seems so drastic to put someone out and

> apply electric shock to them. It seems more natural to me to try

> several different drugs first ... even if it means being

> hospitalized. But I guess that's wrong because the guidelines seem

to

> dictate cardioversion.

>

> Larry

I recently was hospitalized for 3 days to attempt to get back into

nsr (after 7 weeks of chronic afib) using Flecainide. It worked

(took about 36 hours) and I've been in nsr for about a month now. My

cardio told me that if the drug had not worked he then would have

tried electro-cardioversion. I told him I preferred to go this

route.

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> Actually ... I'm pretty convinced that being on Coumadin for 3

weeks

> will reduce the risk of stroke. But I'm just very uncomfortable

with

> the procedure itself. It seems so drastic to put someone out and

> apply electric shock to them. It seems more natural to me to try

> several different drugs first ... even if it means being

> hospitalized. But I guess that's wrong because the guidelines seem

to

> dictate cardioversion.

>

> Larry

I recently was hospitalized for 3 days to attempt to get back into

nsr (after 7 weeks of chronic afib) using Flecainide. It worked

(took about 36 hours) and I've been in nsr for about a month now. My

cardio told me that if the drug had not worked he then would have

tried electro-cardioversion. I told him I preferred to go this

route.

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> Larry,

> After more than twenty years of afib with no cardioversions in

which I have

> always converted spontaneously without chemical or electrical

intervention, I

> would give other drugs a chance in your position. Your afib

history seems to

> indicate that afib is not likely to become a permanent state for

you at this

> point since you have had very little afib compared with many of

us. Chances are

> very good that you will convert spontaneously (on your own) before

the end of

> the three weeks on Coumadin required for the cardioversion. That's

what

> happened to me when I started Coumadin so that I could have a

cardioversion in

> three weeks. I converted on my own long before the three weeks had

passed.

> However, I was taking Atenolol and Verapamil, two drugs which slow

and regulate

> the heart rate. Perhaps you could ask your doctor if you might try

drugs such

> as these because they do not require hospitalization to start and

are

> relatively simple and safe. If these do not work, I still would

try other drugs such

> as Flecainide or Dofetilide, but only if you remain in afib for a

longer period

> of time. During my afib career, I have frequently been in afib as

long as

> eight to ten days before I spontaneously converted. Now I am

rarely in afib.

> Similarly, your afib will not necessarily grow worse, especially

since afib has

> been relatively rare in your background.

>

> Although cardioversions are not risky, I understand, I often wonder

if I

> would be enjoying my current afib-free status if I had experienced

a

> cardioversion. I can't help but suspect that such a trauma to the

heart could have long

> lasting effects that are not fully known at the present time. This

is pure

> theory on my part, but my idea is based on the number of people

whom I know of

> that have had cardionversions only to return ultimately to afib.

One of these

> people was my own father. I would not be hasty to jump into a

cardioversion

> until you have seen whether or not your afib pattern is changing

from short and

> infrequent to chronic. You have time to wait especially if you are

taking

> Coumadin. Also, regarding the Coumdin, if your INR is right, you

will probably

> find that you won't bleed dangerously from a small razor cut.

However, if you

> feel more comfortable using an electric razor, why not do it?

> Good luck,

> in sinus in Seattle

,

Thanks ... this is very helpful. Atenolol and Verapamil are beta and

calcium channel blockers I believe. I have been on Cardiazem since

the Afib began. So the rate is being controlled. But no anti-

arythmics. For that I would have to be hospitalized ... and I hear

that the potential side effects of these anti-arythmics can be worse

than that of the cardioversion ... as the drugs can affect

ventricular function.

Are you saying that you normally convert in 8-10 days with only rate

regulation? They seem to indicate that if I didn't convert in 48

hours, it is not too likely that I will convert on my own. But I

guess this kinda gives me some hope.

Larry

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> Larry,

> After more than twenty years of afib with no cardioversions in

which I have

> always converted spontaneously without chemical or electrical

intervention, I

> would give other drugs a chance in your position. Your afib

history seems to

> indicate that afib is not likely to become a permanent state for

you at this

> point since you have had very little afib compared with many of

us. Chances are

> very good that you will convert spontaneously (on your own) before

the end of

> the three weeks on Coumadin required for the cardioversion. That's

what

> happened to me when I started Coumadin so that I could have a

cardioversion in

> three weeks. I converted on my own long before the three weeks had

passed.

> However, I was taking Atenolol and Verapamil, two drugs which slow

and regulate

> the heart rate. Perhaps you could ask your doctor if you might try

drugs such

> as these because they do not require hospitalization to start and

are

> relatively simple and safe. If these do not work, I still would

try other drugs such

> as Flecainide or Dofetilide, but only if you remain in afib for a

longer period

> of time. During my afib career, I have frequently been in afib as

long as

> eight to ten days before I spontaneously converted. Now I am

rarely in afib.

> Similarly, your afib will not necessarily grow worse, especially

since afib has

> been relatively rare in your background.

>

> Although cardioversions are not risky, I understand, I often wonder

if I

> would be enjoying my current afib-free status if I had experienced

a

> cardioversion. I can't help but suspect that such a trauma to the

heart could have long

> lasting effects that are not fully known at the present time. This

is pure

> theory on my part, but my idea is based on the number of people

whom I know of

> that have had cardionversions only to return ultimately to afib.

One of these

> people was my own father. I would not be hasty to jump into a

cardioversion

> until you have seen whether or not your afib pattern is changing

from short and

> infrequent to chronic. You have time to wait especially if you are

taking

> Coumadin. Also, regarding the Coumdin, if your INR is right, you

will probably

> find that you won't bleed dangerously from a small razor cut.

However, if you

> feel more comfortable using an electric razor, why not do it?

> Good luck,

> in sinus in Seattle

,

Thanks ... this is very helpful. Atenolol and Verapamil are beta and

calcium channel blockers I believe. I have been on Cardiazem since

the Afib began. So the rate is being controlled. But no anti-

arythmics. For that I would have to be hospitalized ... and I hear

that the potential side effects of these anti-arythmics can be worse

than that of the cardioversion ... as the drugs can affect

ventricular function.

Are you saying that you normally convert in 8-10 days with only rate

regulation? They seem to indicate that if I didn't convert in 48

hours, it is not too likely that I will convert on my own. But I

guess this kinda gives me some hope.

Larry

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>

> 1. Is cardioversion risky? I have been told that 1% of people on

AFib

> throw clots and that clots is a risk of the procedure. I have to

> admit that the thought of it is a bit frightening. What if this has

> some unknown affect on my ventricles?

> 2. Would you give the other drugs a shot prior to cardioversion?

> 3. Does this seem like good medical guidance?

> 4. Do I need to use an electric shaver on Coumadin. Seems to me

that

> I end up cutting myself every so often with a regular blade.

>

> Thanks for your help!

>

> Larry

Larry - You are getting almost the exact treatment I got a year ago

when diagnosed with afib -- cardizem and coumadin. I too was leary

of a cardioversion, but finally had it in August. (Took me a long

time to get blood INR in the right range, then vacations kicked in.)

Now a cardioversion would be my treatment of choice. Better, from my

perspective, than being on medication. I say go for the

cardioversion and worry about drugs later if it doesn't hold you in

nsr. I was advised to use an electric razor but didn't. Cut my self

a few times and had to spend extra time getting the bleeding to

stop. I'm on coumadin again, this time for atrial flutter, and I'm

still using the blade. Your choice.

Ed in VA

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>

> 1. Is cardioversion risky? I have been told that 1% of people on

AFib

> throw clots and that clots is a risk of the procedure. I have to

> admit that the thought of it is a bit frightening. What if this has

> some unknown affect on my ventricles?

> 2. Would you give the other drugs a shot prior to cardioversion?

> 3. Does this seem like good medical guidance?

> 4. Do I need to use an electric shaver on Coumadin. Seems to me

that

> I end up cutting myself every so often with a regular blade.

>

> Thanks for your help!

>

> Larry

Larry - You are getting almost the exact treatment I got a year ago

when diagnosed with afib -- cardizem and coumadin. I too was leary

of a cardioversion, but finally had it in August. (Took me a long

time to get blood INR in the right range, then vacations kicked in.)

Now a cardioversion would be my treatment of choice. Better, from my

perspective, than being on medication. I say go for the

cardioversion and worry about drugs later if it doesn't hold you in

nsr. I was advised to use an electric razor but didn't. Cut my self

a few times and had to spend extra time getting the bleeding to

stop. I'm on coumadin again, this time for atrial flutter, and I'm

still using the blade. Your choice.

Ed in VA

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> 240mg. per day ... delayed release. But I wasn't under the

impression

> that Cardizem was going to convert me. Just slow down my heart rate.

>

> Am I wrong about this?

>

> Larry

Larry - You are right. Cardizem is a rate control drug. Dosage

depends on what works to keep your heart rate under control.

Ed in VA

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In a message dated 3/16/2004 6:49:18 AM Pacific Standard Time,

regasega@... writes:

<< Are you saying that you normally convert in 8-10 days with only rate

regulation? They seem to indicate that if I didn't convert in 48

hours, it is not too likely that I will convert on my own. But I

guess this kinda gives me some hope. >>

Larry,

Ten days was my longest episode, but I have had episodes of various lengths

over my twenty years of afib: 15 minutes (the shortest) 20 minutes, six hours,

ten hours, 18 hours, 24 hours, 30 hours, 36 hours, 42 hours, 48 hours, 60

hours, 72 hours, four days, six days, eight days and I guess you get the idea!

My experience has been that no one, including me, could predict when I would

convert to sinus but I always have converted with no assistance other than my

Atenolol and Verapamil meds. For the first six years of my afib, I didn't even

take any meds, but I usually converted within 24 to 48 hours. If I had

rushed off for cardioversion the first time I had a 48 hour episode, I would

never

have known that I could convert spontaneously after being in afib for longer

periods of time.

My older brother who is in permanent afib had the same experience. He said

that he would be in afib for weeks and even months at a time and then convert

spontaneously to afib, never going to a hospital or even having drug

intervention. He did end up in permanent afib before he was my current age, but

he

believes that is because he was into things that I have never done: smoking and

drinking excessive alcohol. He believes that he could have avoided permanent

afib if he had taken medication earlier and if he had never drunk alcohol or

smoked. He also thinks that I will probably avoid permanent afib because of my

lifestyle. My cardiologist confirmed that when he said he thinks that it is

unlikely that I will go into permanent afib, that I would be there by now if I

were going to be after more than twenty years in which I have always converted

on my own.

So do have hope! There are many different opinions out there among many

different doctors. Some seem to have the fatalistic attitude that afib will

necessarily grow worse without drastic interventions like cardioversion,

ablation,

or antiarrhythmic drugs. This has certainly not been my experience.

Currently my afib episodes are far less frequent and symptomatic than they were

20

years ago. Of course, it doesn't happen that way for everyone, but one never

knows if afib can be stopped in a more natural way, without cardioversions and

risky drugs, unless one has patience and tries to wait for spontaneous

cardioversion. If you have no other underlying heart or health problems, it's

very

possible that you will always convert spontaneously as I have done. Good luck,

in sinus in Seattle

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I used to convert simply by taking an extra cardizem when I went into a new

session.. didn't work the last two times, though.. so I'm on to bigger and

better drugs, which also don't work so far....

Stef

traveler3406 wrote:

> 240mg. per day ... delayed release. But I wasn't under the

impression

> that Cardizem was going to convert me. Just slow down my heart rate.

>

> Am I wrong about this?

>

> Larry

Larry - You are right. Cardizem is a rate control drug. Dosage

depends on what works to keep your heart rate under control.

Ed in VA

Backup web page - http://afibsupport.proboards23.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

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Stef:

What new drugs have you added? I'm considering an antiarrythmic. Am

now on cardizem 360 mg and toprol XL 25 mg bid.

Debbi, OU Alum in OKC

didn't work the last two times, though.. so I'm on to bigger and

better drugs, which also don't work so far....

>

> Stef

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> I used to convert simply by taking an extra cardizem when I went

into a new session.. didn't work the last two times, though.. so I'm

on to bigger and better drugs, which also don't work so far....

>

> Stef

Same here. I could pop a Cartia XT 180mg or two and almost always

expect to return to nsr a few hours later. Then it just stopped

working... Now I'm on flecainide and the interesting thing is that I

experience less side effects on this med than I did on the Cartia. I

always remember feeling very dragged-out and headachey (!) on the

Cartia. I'm hoping that the flec will maintain me for a while.

I'm sorry to hear of your setback - I send all my good nsr thoughts

to you.

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Debbi - I was just on cardizem (120 per day) until I went into afib in early Jan

that lasted 6 weeks until cardioversion (I always used to convert on my own..

sometimes with drugs, sometimes not)... then they put me on Tikosyn 250 twice a

day, and Cardizem 120 once a day...

My last episode, which started a week ago (and continues) started in Bonaire

(near Venezuala) and I was taken off the cardizem and given .25 dig once a day,

and 75 mg atenelol (25 three times a day), and the Tikosyn (which was supposed

to be the end all and be all of rhythm control) 250 three times a day.

Now that I'm back and have seen my doctor, I'm on 100 mg atenelol (50 x 2) but I

can go higher if my heart races (up to 200), and the Tikosyn 250 x3. Off the

dig, as it contradicts the tikosyn (or can).

I feel pretty ok today.. heart rate mostly lowish, although I do have a

blistering head ache.. that's likely from the atenelol, but I'll give it a few

days, since I didn't notice it earlier, and I'm just back home and we're having

some low cloud cover, so it may just be that. I hope it's just that, as this

does seem to work somewhat!

Does the cardizem not work for you? the anti-arrythmics can cause worse

arrythmias so should not be considered lightly unless there is good reason.. and

the " other " rhythms they cause are usually bad rhythms...

I swear since I started the Tikosyn (dofetilide) I've felt many more " odd " beats

than ever before.. thankfully my doctor is now talking about taking me off,

since it obviously didn't so what it was supposed to, the side effects can be

bad, and it has so many contradictions that it's hard to get out of an afib

session when you're on it, since there are many other drugs that I cannot now

take.

Stef

Debbi wrote:

Stef:

What new drugs have you added? I'm considering an antiarrythmic. Am

now on cardizem 360 mg and toprol XL 25 mg bid.

Debbi, OU Alum in OKC

didn't work the last two times, though.. so I'm on to bigger and

better drugs, which also don't work so far....

>

> Stef

Backup web page - http://afibsupport.proboards23.com

List owner: AFIBsupport-owner

For help on how to use the group, including how to drive it via email,

send a blank email to AFIBsupport-help

Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

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> From: Debbi

> Date: 3/15/04, 7:14 PM -0500

>

> Larry: when I go to the ER.........they convert me chemically with

> cardizem. I think they all have different ideas as what do to with

> us. I read on an earlier post that some they convert with digoxin.

>

> Debbi, OU Alum in OKC

>

>

> **********************************************************

> > 240mg. per day ... delayed release. But I wasn't

> > under the impression that Cardizem was going to

> > convert me. Just slow down my heart rate.

> >

> > Am I wrong about this?

I wonder, why do you go to the ER to take Cardizem?

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> From: Debbi

> Date: 3/15/04, 7:14 PM -0500

>

> Larry: when I go to the ER.........they convert me chemically with

> cardizem. I think they all have different ideas as what do to with

> us. I read on an earlier post that some they convert with digoxin.

>

> Debbi, OU Alum in OKC

>

>

> **********************************************************

> > 240mg. per day ... delayed release. But I wasn't

> > under the impression that Cardizem was going to

> > convert me. Just slow down my heart rate.

> >

> > Am I wrong about this?

I wonder, why do you go to the ER to take Cardizem?

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> From: Debbi

> Date: 3/15/04, 7:14 PM -0500

>

> Larry: when I go to the ER.........they convert me chemically with

> cardizem. I think they all have different ideas as what do to with

> us. I read on an earlier post that some they convert with digoxin.

>

> Debbi, OU Alum in OKC

>

>

> **********************************************************

> > 240mg. per day ... delayed release. But I wasn't

> > under the impression that Cardizem was going to

> > convert me. Just slow down my heart rate.

> >

> > Am I wrong about this?

I wonder, why do you go to the ER to take Cardizem?

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The idea behind upping a rate control is that it slows down your heart enough to

allow it to convert on it's own.. it has trouble converting at 180 beats per

minute, but if you can bring it down to a more normal rate, then often the heart

will simply convert on it's own...

Stef

traveler3406 wrote:

> 240mg. per day ... delayed release. But I wasn't under the

impression

> that Cardizem was going to convert me. Just slow down my heart rate.

>

> Am I wrong about this?

>

> Larry

Larry - You are right. Cardizem is a rate control drug. Dosage

depends on what works to keep your heart rate under control.

Ed in VA

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Nothing in this message should be considered as medical advice, or should be

acted upon without consultation with one's physician.

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