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Suggest Treatment For Atrial Flutter While On Pradaxa
Question: I have atrial flutter was on Pradaxa which hurt very badly my stomach so when bach to baby aspirine and digoxin. Now mainly in the evening I have strange feeling over my upper body and heart beats very strong
should I change the digoxin to metrafolo?
should I change the digoxin to metrafolo?
Brief Answer:
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
- Regarding your concern I would like to explain that you are right when raising suspicions on Digoxin.
Digoxin has been traditionally and widely used in treating heart failure and atrial fibrillation patients.
As you are treated for atrial fibrillation other options like beta- blockers (example metoprolol, etc) or calcium-channel blockers should be tried first (unless contraindications for their use exist) before considering Digoxin an option.
Recently Digoxin proarrhythmic adverse effects has been reviewed and its use as an optimal alternative for atrial fibrillation treatment has been questioned.
Only if a severely reduced cardiac function and if contraindications to beta-blockers and calcium-channel blockers exist, could digoxin be a rationale alternative.
So you need to discuss with your attending doctor on other option then Digoxin. The cardiac ultrasound (ECHO) result and possible co-morbidities should be reviewed before deciding on the optimal atrial fibrillation therapy.
- Regarding anticoagulation, I would like to explain that in case you have heart failure symptomatology, hypertension, diabetes, peripheral vascular disease, history of stroke/ TIA or thromboembolic disease then anticoagulation would be better then aspirin alone in preventing the risk of stroke.
Furthermore you are a female and >75 years old (CHA2DS2-vasc score).
But, if you can't modulate accordingly the appropriate dosing of Warfarin and other anticoagulants are not well tolerated, then Aspirin remains a good option.
I agree with the beneficial effects of CoQ10 use, Atorvastatin, Resveratrol, and Hawthorn tea and encourage you to continue using them (of course under close supervision of the prescribing doctor).
So, the only drug that needs to be revised seems to be Digoxin.
Just discuss with your attending doctor on another more safe alternative.
Please let me know how are things going on; and in case you possess any medical tests possibly upload them here for a direct review.
Hope to have been helpful to you!
Wishing all the best for this New Year!
Kind regards,
Dr. Iliri
I would explain as follows:
Detailed Answer:
Hello,
Welcome and thank you for asking on HCM!
- Regarding your concern I would like to explain that you are right when raising suspicions on Digoxin.
Digoxin has been traditionally and widely used in treating heart failure and atrial fibrillation patients.
As you are treated for atrial fibrillation other options like beta- blockers (example metoprolol, etc) or calcium-channel blockers should be tried first (unless contraindications for their use exist) before considering Digoxin an option.
Recently Digoxin proarrhythmic adverse effects has been reviewed and its use as an optimal alternative for atrial fibrillation treatment has been questioned.
Only if a severely reduced cardiac function and if contraindications to beta-blockers and calcium-channel blockers exist, could digoxin be a rationale alternative.
So you need to discuss with your attending doctor on other option then Digoxin. The cardiac ultrasound (ECHO) result and possible co-morbidities should be reviewed before deciding on the optimal atrial fibrillation therapy.
- Regarding anticoagulation, I would like to explain that in case you have heart failure symptomatology, hypertension, diabetes, peripheral vascular disease, history of stroke/ TIA or thromboembolic disease then anticoagulation would be better then aspirin alone in preventing the risk of stroke.
Furthermore you are a female and >75 years old (CHA2DS2-vasc score).
But, if you can't modulate accordingly the appropriate dosing of Warfarin and other anticoagulants are not well tolerated, then Aspirin remains a good option.
I agree with the beneficial effects of CoQ10 use, Atorvastatin, Resveratrol, and Hawthorn tea and encourage you to continue using them (of course under close supervision of the prescribing doctor).
So, the only drug that needs to be revised seems to be Digoxin.
Just discuss with your attending doctor on another more safe alternative.
Please let me know how are things going on; and in case you possess any medical tests possibly upload them here for a direct review.
Hope to have been helpful to you!
Wishing all the best for this New Year!
Kind regards,
Dr. Iliri
Note: For further queries related to coronary artery disease and prevention, click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Answered by
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