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I Am 75 Years Old 2 Years Ago While Exercising
Question: I am 75 years old 2 years ago while exercising
at Diablo CrossFit ,I developed an episode of atrial fibriation , secondary to hypokaliémie and hyponatremia .
I was immediately placed on Eliquis and 80 mgm if Diltiazem . All the other tests, echo and stress test were oK. Also Halter monitor had normal findings . I had only few short episodes of A Fib . I have significant side effects,( legscand ankle swelling, muscle, joints pain, muscle weakness , brain fog and fatigue .
I would like to stop Diltiazem, continue Eliquis .i am also treated for hypothyroidism, that went on , unrecognized , for years.
I still exercise 2-3 times a week, rowing, biking
Is it Ok to stop Diltiazem suddenly or is there some tapering needed ( how?).
Thank you XXXXXXX K
at Diablo CrossFit ,I developed an episode of atrial fibriation , secondary to hypokaliémie and hyponatremia .
I was immediately placed on Eliquis and 80 mgm if Diltiazem . All the other tests, echo and stress test were oK. Also Halter monitor had normal findings . I had only few short episodes of A Fib . I have significant side effects,( legscand ankle swelling, muscle, joints pain, muscle weakness , brain fog and fatigue .
I would like to stop Diltiazem, continue Eliquis .i am also treated for hypothyroidism, that went on , unrecognized , for years.
I still exercise 2-3 times a week, rowing, biking
Is it Ok to stop Diltiazem suddenly or is there some tapering needed ( how?).
Thank you XXXXXXX K
Brief Answer:
I would recommend as follows:
Detailed Answer:
Hello Jana!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that stopping diltiazem cold turkey can trigger cardiac arrhythmia and even episodes of atrial fibrillation.
For this reason, I would recommend switching to a betablocker, in order to help prevent cardiac arrhythmia, especially considering the fact that you have been treated for hypothyroidism.
In this regard, low dose of atenolol, or metoprolol succinate or bisoprolol would help prevent cardiac arrhythmia.
You can switch directly from diltiazem to atenolol, at a dose of 25mg twice daily or bisoprolol 2.5mg daily and increase the dose slowly as needed after a week.
Continuing Eliquis is necessary in order to prevent possible future cardio-embolic events.
You should discuss with your doctor on the above treatment option!
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
I would recommend as follows:
Detailed Answer:
Hello Jana!
Welcome to Ask a Doctor service!
I passed carefully through your question and would explain that stopping diltiazem cold turkey can trigger cardiac arrhythmia and even episodes of atrial fibrillation.
For this reason, I would recommend switching to a betablocker, in order to help prevent cardiac arrhythmia, especially considering the fact that you have been treated for hypothyroidism.
In this regard, low dose of atenolol, or metoprolol succinate or bisoprolol would help prevent cardiac arrhythmia.
You can switch directly from diltiazem to atenolol, at a dose of 25mg twice daily or bisoprolol 2.5mg daily and increase the dose slowly as needed after a week.
Continuing Eliquis is necessary in order to prevent possible future cardio-embolic events.
You should discuss with your doctor on the above treatment option!
Hope you will find this answer helpful!
I remain at your disposal for any further questions whenever you need!
Kind regards,
Dr. Ilir Sharka, Cardiologist
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
I did call my cardiologist, he suggested that I can stop it,and to take Diltiazem as/if needed for recurrent , sustained, bothersome palpitations episodes ( his words)
To take Diltiazem on days I take Propafenon, as I need it ( I do not take Propafenon regularly, i used it on few occasions only). and take Diltiazem at least 30 minutes before taking first dose of
Propafenon
To take Diltiazem on days I take Propafenon, as I need it ( I do not take Propafenon regularly, i used it on few occasions only). and take Diltiazem at least 30 minutes before taking first dose of
Propafenon
Brief Answer:
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
I agree on the fact that propafenon can be used occasionally in case of re-occurrence of episodes of atrial fibrillation, but this is not recommendable for diltiazem.
So, I would not agree with your doctor to take it occasionally. If you do not tolerate it because of its adverse effects, I would recommend switching to a betablocker to help prevent possible cardiac arrhythmia.
You should know that patients treated for hypothyroidism should take betablockers to help also reduce thyroid hormones adverse effects.
So, it would be very reasonable to switch from diltiazem to low dose of betablocker (atenolol, bisoprolol), which do not have the same adverse effects of diltiazem, as they do not belong to the same pharmaceutical class of drugs.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
My opinion as follows:
Detailed Answer:
Hello again!
Thank you for the additional information!
I agree on the fact that propafenon can be used occasionally in case of re-occurrence of episodes of atrial fibrillation, but this is not recommendable for diltiazem.
So, I would not agree with your doctor to take it occasionally. If you do not tolerate it because of its adverse effects, I would recommend switching to a betablocker to help prevent possible cardiac arrhythmia.
You should know that patients treated for hypothyroidism should take betablockers to help also reduce thyroid hormones adverse effects.
So, it would be very reasonable to switch from diltiazem to low dose of betablocker (atenolol, bisoprolol), which do not have the same adverse effects of diltiazem, as they do not belong to the same pharmaceutical class of drugs.
Hope you will find this answer helpful!
Wishing all the best,
Dr. Iliri
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
Thank you very much for your advice. Truly appreciated XXXXXXX K
Brief Answer:
You are welcome!
Detailed Answer:
Dear XXXXXXX
I am glad to have been helpful to you!
If you have any other questions in the future, please don't hesitate to ask me directly at anytime!
I would be glad to answer to all of your questions!
Wishing good health,
Dr. Iliri
You are welcome!
Detailed Answer:
Dear XXXXXXX
I am glad to have been helpful to you!
If you have any other questions in the future, please don't hesitate to ask me directly at anytime!
I would be glad to answer to all of your questions!
Wishing good health,
Dr. Iliri
Note: For further follow up on related General & Family Physician Click here.
Above answer was peer-reviewed by :
Dr. Chakravarthy Mazumdar
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