A-fib meds: Sotalol vs. Tikosyn?

[mattwisconsin]

I know that this has been discussed here in the past but thought I would start a new discussion about people?s experiences on different drugs for A-fib. I recently saw the electophysiologist and depending on a forthcoming TEE, I will either have a Maze added onto an AVR or will start drug therapy for the intermittent A-fib I have been experiencing. The two medications he is thinking about using are Sotalol and Tikosyn. He mentioned a third but did not want to use this because of side effects. I am pretty sure this was Amiodarone, but can?t remember for sure. I know people here suggest using Sotalol instead of Amiodarone, but how does it stack up against Tikosyn in people?s experience.

This is due to A-fib, which developed during treatment for endocarditis. Started out happening about once a week but now seems to go in and out about every half hour. My pulse before this was usually 55, now it is normally 75, but got up about 105 this past weekend. I realize this is still a lot slower than some people experience but it is still not fun.

 

[laurad37]

Hi Matt, I have taken both Sotalol and Tikosyn. Not at the same time obviously. I didn't do to well on the Sotalol. It seems that some beta blockers cause really bad side effects with me. Mostly psycological side effects. Strange thoughts, depression, hollusinations, voices, etc. This might affect others differently though. I have been on the Tikosyn for 2 years now and really haven't had any problems with it. The only thing with the Tikosyn is you have to be in the hospital for 3 days while you start the drug so that they can monitor things and get you on the correct dosage. I hope this helps.

Where in Wisconsin are u?

 

[mattwisconsin]

Thanks for the response. I grew up in Green Bay, but have lived in Hartford, Oshkosh, and Madison. Currently I am staying in Chicago while I deal with these issues. Once they are straightened out to some degree I will probably move back to Athens, Greece and then Columbus, OH so that I can finish school, before settling in Chicago.

 

[laurad37]

I am in Belgium, WI. Not for from Hartford. But I bet you have been to the Mineshaft?

 

[mattwisconsin]

Unfortunately I don't think so. We moved from Hartford up to Green Bay when I was 7. Although I have to admit I am intrigued by the name.

 

[patchycat]

the 3d dreams

the 3d dreams

I've been taking Sotalol for 7 or 8 yrs now when I started I had been to hospital and some student had been belting my chest with lumps of metal doing an echo cardiogram. Then some one who knew what they were doing had a go and I didn't sleep for 3 days after it. The specialist wanted me to have some other tests but I said I wanted to see him first. I had not been in touch with the cardiac mob for about 20yrs and I had no idea of the drugs available.
When I was 10 in 1963 I was in children's hospital I had Rheumatic Fever and I was given Phenobarbitone to keep me quiet while my hart grew enough to cope with Mitral Regurgitation and I survived. I kept away from specialists till it all started going pear shaped about 8 years ago Age 48.
When I first started taking sotolol I found the 3d dreams and the voices the best bit. When they started to get weird I started to lock the bed room door that way I could be sure that I was in a dream. So if the content was a bit over the top I was sure about my reality and I could relax.
"Careful with that axe Eugene".

 

[ALCapshaw2]

I never heard of Tikosyn before your post.

The information sheet for Sotalol recommends a short stay in the Hospital when started 'just in case' it triggers unstable arrhythmias.

Once your body adjusts to Sotalol, side effects often disappear or at least become less apparent. Since it is NOT a time release drug, it is recommended to take it twice a day. A *small* dose works well for me and I am not aware of any side effects... but had some *slight* dizzyness in the first few weeks.

 

[Gail in Ca]

When I went into a-fib for the 1st time during my endocarditis, I was given metoprolol and diovan. I was lucky, it went away on it's own after about 8 days.
Gail

 

[Kathleen]

Make sure they know exactly what rhythm issues they are medicating you for. Tikosyn is supposed to be started in the hospital doing time sensitive EKG's. Tikosyn is only dispensed by certain pharmacies and is a non-formulary drug and expensive. My copay was over a hundred dollars for it. Normal cost was well over 400. Have you had an event monitor to catch the afib so they can see which med should be the one to use? If the afib slightly disrupts your day you may want to go into surgery with not meds on board so they can produce the afib during the Maze procedure. Amnio would not be the one to use since you would need to go off it and not have it in your system when they do the Maze. Good luck
Kathleen

 

[mattwisconsin]

Right now I am being tossed between the doctors. There seems to be some question whether I will need surgery for a AVR. They have not completely determined the damage to my valve yet. I finished my antibiotics for endocarditis last week. I am going for an echo next week. Then there may be a TEE after that. The electrophysiologist doesn't want to start medication if they are going to do an AVR and would rather they just do a Maze with the AVR. He also said with my mechanical valve, he would not suggest doing it with a cath, since the cath could get stuck in the valve. Therefore, if the cardiologist says no to surgery, then he is going to go forward with medication. I think his plan is to go with Sotolol first and then Tikosyn. He also seemed to ask me if there were any reasons I would want one or the other. He did not want to use Amiodarone. I think they were hoping the A-fib would just go away, but it seems to be getting worse.

When the A-fib started, I would feel it once every week or two. I got a heart monitor twice and went to the hospital twice. Never happened during any of those four times. However, now it has happened many times a day for the last week or so. I am getting sick of it. I started on Metoprolol Tartrate about 3 weeks ago, could this be affecting the A-fib? At this point I am eager to just get it sorted out.

 

[mattwisconsin]

Also I have read some posts on here about regurgitation associated with the aorta causing irregular heart beats. Is this really possible? This is something I am interested in since the damage they are worried about is leaking around my mechanical valve. I just hope to have some more answers next week. With the A-fib I almost feel worse than I did with the endocarditis when all this started months ago.

 

[patchycat]

Important info

Important info

I have had a-fib for almost 50 yrs. I started taking Sotolol about two years before surgery and I was seeing the best heart specialist in Australia. I was and still take 1 80mg tablet which I break in half down the line in the middle.
My guy said to take it on an empty stomach, at least 2 hours after eating. In hospital they tried to get me to take it with the other meds at dinner time. I just took it out and took it during the night. I always wake up with some strange rhythm going on and usually twice.