fatigue flecainide beta-blocker pacemaker

I received a pacemaker 2/1/2013 after four years of paroxysmal a fib that emerged as sick sinus syndrome. I had a low heart rate, and
am now paced at 55 b.p.m. almost all of the time. I take 50mgs
flecainide twice and day and atenolol 12.5 mgs once a day. I
continue to be fatigued (e.g. need afternoon nap to function, wake
up tired). Also have aortic regurgitation mild which is considered
minimal…..Would like responses re potential causes of my fatigue from others with similar experiences and/or diagnosis. Am doing
well on meds---no a fib except occasional for c. a minute. May be more than one cause of my fatigue: I have celiac disease, diagnosed c. 4 years ago and may be very mildly hypothyroid (unclear)…Hoped that a life without a fib would end the fatigue.

9 Comments

Or. . .

by SteveE - 2014-01-03 09:01:44

Fatigue could be due to how your meds affect you. We're all different. Some folks do just fine with certain meds at certain doses, while others are heavily affected. It might be worth a discussion with your cardio to see if any of your meds might be causing fatigue. If so, maybe experiment with changing dosage or other meds.

My own experience was with metoprolol. I had valve surgery and was prescribed 100 mg/day of timed release metoprolol. I felt like I was towing a sled full of rocks all day. I convinced my cardio to try a reduced dosage. We went from 100 mg/day to 50 and I felt near-immediate improvement. Then we went from 50 to 25 and I feel almost "normal" again (what means normal?). We did monitor for symptoms at each reduction, but as long as I stayed out of afib and my blood pressure stayed within range, all was well.

You may not be as lucky in this as I, but at least it may be worth the time to discuss with the doc.

Hear you

by Theknotguy - 2014-01-03 09:01:53

I had bad a-fib that put me in the hospital in an induced coma for six days. I was on Flecainide and Metoprolol prior to my collapse.

Since the collapse they have me on Metoprolol and Cardizem. Both are holding my a-fib down by keeping my heart at a slow speed. The PM is being used to bring my heart rate up to a normal speed. Max rate on my heart is above 120 BPM.

The main difference I see between you and myself is the speed of the PM. I'm at 60 BPM - a minor difference. I feel energetic most of the time. Perhaps some of your fatigue may be due to celiac disease?

This is my best guess.

Theknotguy

I take the same ...

by donr - 2014-01-04 01:01:35

...amount of Flecainide daily & 200 MG of Acebutolol (another Beta Blocker) daily. This is the minimum I can take & not feel debilitated by my arrhythmia. Take any more & I turn into a zombie from the side effects of the meds. Slow, shuffling gait, cannot think very fast, slur my speech, want to nap all the time, drool out of both sides of my mouth at the same time (That's because I'm level-headed). Not fun

The Beta blocker/Flecainide combo is famous for this side effect.

Don

Don - That sounds like my husband..

by Harrie - 2014-01-04 04:01:39

Who has Parkinson's. Wonder if some of his symptoms are exacerbated by his heart meds?

Who Knows, Royale?

by donr - 2014-01-04 05:01:31

Hi! Welcome back - haven't heard from you in a while.

It may not be exacerbating Parkinsons' symptoms, but merely laying on top of his current symptoms similar symptoms.

I know several men w/ Parkinsons & they have a pronounced shuffling of the feet, w/ very short advancement w/ each step. Mine was more of a normal length step, but I kind of did not lift my feet as high as normal. Net result was that I tended to drag my feet & it was difficult lifting them over obstacles.

Don

Royale / Don

by IAN MC - 2014-01-04 06:01:21

Apologies for carrying on with the Parkinson's theme which wasn't the original topic but

I know a guy with Parkinson's whose symptoms appeared to be worsening VERY rapidly, particularly the shuffling gait which Don described, until his Dr discontinued the statin which he was taking when there was a marked improvement.

Apparently the statin had been causing rhabdomyolisis, ( a breakdown in muscle fibre, which can be fatal.) and this was exacerbating the Parkinson symptoms as well as leading to a confusing diagnosis for the doctor

Probably a rare set of circumstances but it confirms that when anyone has suddenly changing symptoms one of the first things to consider should be the possibility of drug side-effects.

Ian

Snap..

by Harrie - 2014-01-05 05:01:08

That's really interesting Ian. You may be aware that last year our esteemed national broadcaster here in Australia caused a stir by airing a story on cholesterol lowering meds that suggested their use was based on a single discredited study, and suggesting an alternative theory about why cholesterol is found in arteries of heart attack victims. It's a bit too involved to go into here but cardiologists all over Australia were up in arms about it. My husband's very lovely cardio said that 80% of cardiologists in Australia take statins because they know the benefits. The second part of the story examined the use of cholesterol lowering meds and resulted in people discontinuing their meds, and a least one death. There are now at least 4 lawsuits pending I believe. If you're interested do a search for ABC Catalyst and look for the story on cholesterol. Follow the links to the journalist's blog, and the link to the group in America which examines the efficacy of medical treatments - all very interesting.
For my husband, he has had neurostimulators implanted for his Parkinson's. he has adjustments at the neurologist's office and walks fine but within a few days is back to shuffling - I know that lots of people suffer side effects from statins. I'd like to suggest he stops his. He doesn't tolerate the Parkinson's meds so there's a good chance the statins don't agree with him either. Next time we're at the neurologist I'll mention the case you referred to, I'll even speak to the cardiologist about it but expect a frosty response in view of the foregoing!
Thanks for the info!

Royale /Statins

by IAN MC - 2014-01-06 02:01:10

I've had a quick look at some of the ABC Catalyst stuff; it makes interesting reading. I read somewhere else that only Australia has a higher level of "statination" ( yes, there's even a new noun now ! ) than the UK, apparently 13.7 % of people in Oz take statins. They will be adding it to your drinking water next !

I detect , here in the UK, that there is something of a backlash against the over-prescribing of statins with a newspaper headline last week stating " A third of all statin users take the drug unnecessarily " . So statins are going out of fashion somewhat and the latest craze is to have a scan to determine the build-up of calcium in the arteries; apparently this is now considered to be far more of a risk-factor than cholesterol levels.

I took myself off statins and had quite an interesting argument with the cardiologist ; I have a scientific background and I simply don't think that the pro-statin science stacks up; I almost talked him round but I don't care what he thinks to be honest; I refuse to take statins !

In your husband's case I would have thought that any drug which can adversely affect the muscles is best avoided in Parkinson's but if he has a history of heart disease, statins MAY be justified ; if he hasn't such a history I see no justification in him taking them !

I would be interested to know how the neurologist reacts.

Best of luck

Ian

Statinisation.

by Harrie - 2014-01-09 05:01:12

I love it! I sympathise with doctors who have been trained to believe that statins are wonder drugs, but the evidence does seem to indicate that they only benefit those with an existing condition.
There does seem to be a shift in the wind with more emphasis on dietary changes, rather than straight in with medication on the basis of a routine blood test showing high cholesterol.
I'll let you know how we get on with the neurologist.
We tend to think medical science has all the answers, but in my work as a science librarian I am constantly amazed by the research that is being done in all sorts of areas. We still have a lot to learn.
Thanks for the discussion
Royale

You know you're wired when...

You have a high-tech ticker.

Member Quotes

I am just thankful that I am alive and that even though I have this pacemaker it is not the end of the world.