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What Is The Role Of Carvedilol In Atrial Fibrillation?

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Posted on Tue, 24 Nov 2015
Question: I am 72 female who started with a-fib 2/1/2 years ago. I was on Diltiazem at first and amiodarone with we quickly got off, thyroid numbers tripled. Also was on warfarin. We moved from XXXXXXX to Florida aboout 18 months ago and I had a bad attack and was put on Sotalol which worked for 14 months, then bad attack (I stress easily but am getting this under control. They put me on Carvedilol, lisinopril (my b.p. went up) I am now taking Carvedilol 25 mg x2 and lisinopril 20 mg x 2. I am now in permanent a-fib after the sotalol and doing pretty good except h.r. was difficult to control. So my current meds are the Carvedilol and Lisinopril along with Sertraline and Eliquis. Because my h.r. was still a little high my e.p.he put me on 120 mg. of diltiazem also. My cardiologist concurred. All my heart tests are normal and I am wondering now why I am on Carvedilol for a-fib? I would like to just take a h.r. drug and eliquis. My pharmacist said Carvedilol has a major side effect with diltiezem. He called my Cardiologist and both he and the e.p still want me on it. What do they do together? I am scared of all this medication and wanting to get off some of it. They also added 100 mg of Sertraline but that was in XXXXXXX Now I am starting to worry after being confident with my low blood pressure and now lower h.r.
Sincerely,
XXXXXXX XXXX
Thank you! DO I NEED THAT MANY MEDICATIONS? IS CARVEDILOL USED FOR A-FIB. MY A-FIB DOESN'T BOTHER ME AS IT DID WITH THE "ATTACKS."
doctor
Answered by Dr. Benard Shehu (2 hours later)
Brief Answer:
Following advice.

Detailed Answer:
Hi and thank you for asking!
I read your query and understood your concerns.

Carvedilol is essential for controlling HR especially during physical activity. Carvedilol is one of the most important betablockers and is a first line treatment in patients with atrial fibrillation.

Since your HR isn't stabilized with the maximal dose of carvedilol your doctor has added diltiazem. This is why the combination is needed in order to better control HR.

However the combination increase the risk for unwanted side effects and they should be used under medical control (take them exactly as prescribed by your doctor). You shouldn't stop them because severe complications may occur (rebound effect).

If you were my patient I would recommend to use digoxin in stead of diltiazem. However, you should discuss with your doctor about this change.

Hope this will be of help!
Wish you health!
Dr. Shehu
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Benard Shehu (1 hour later)
Thank you for your informative reply. Whenever I ask my Dr. "do I have heart failure" because I read that it was for heart failure and also lisinipril, he says "no you do not have heart failure, you ask me that all the time". He says my heart is strong. Does it weaken the heart to stay in permanent a-fib? and are the meds worse taken long term. My Dr. doesn't like Digoxin for some reason - they gave me it a drip in the E.R. and he took it away, said he didn't like it for me.
Thank you so much.
Sincerely, XXXXXXX
doctor
Answered by Dr. Benard Shehu (8 hours later)
Brief Answer:
Following advice.

Detailed Answer:
Hi back,

You have partially right, Carvedilol is maybe the best betablockers for treating HF, but it is effective in patients with atrial fibrillation to.

Atrial fibrillation doesn't weak your heart and you shouldn't worry about that to.

Since your doctor doesn't like digoxin you may contact another doctor (cardiologist or EP) for a second opinion.

Hope this will be of help!
Wish you health!
Dr. Shehu
Note: For further queries related to coronary artery disease and prevention, click here.

Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
Answered by
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Dr. Benard Shehu

Cardiologist

Practicing since :2004

Answered : 2257 Questions

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What Is The Role Of Carvedilol In Atrial Fibrillation?

Brief Answer: Following advice. Detailed Answer: Hi and thank you for asking! I read your query and understood your concerns. Carvedilol is essential for controlling HR especially during physical activity. Carvedilol is one of the most important betablockers and is a first line treatment in patients with atrial fibrillation. Since your HR isn't stabilized with the maximal dose of carvedilol your doctor has added diltiazem. This is why the combination is needed in order to better control HR. However the combination increase the risk for unwanted side effects and they should be used under medical control (take them exactly as prescribed by your doctor). You shouldn't stop them because severe complications may occur (rebound effect). If you were my patient I would recommend to use digoxin in stead of diltiazem. However, you should discuss with your doctor about this change. Hope this will be of help! Wish you health! Dr. Shehu