afib and diltiazem

I had an afib episode Thursday. I called my cardiologist's office, they sent me to the ER. They gave me diltiazem IV until they got my heart rate down, then prescribed oral diltiazem XR 300 mg to replace Diovan for HBP. Since then, I've had sensations in my chest that vary from pounding to fluttering. My pulse has ranged from 48-51 (pacemaker is set at 50), and my bp has ranged from 107/60 to 148/84 but just a little exertion (e.g. taking out the garbage) causes my chest to feel uncomfortable and almost out of breath. I have also had moments of feeling lightheaded or giddy. Input, anyone?

Vonnie

2 Comments

Side Effects of Diltiazem

by SMITTY - 2009-05-30 03:05:18

Hi Vonnie,

What you are describing is a very common side effect for some of us taking diltiazem. I have always been puzzled about why some doctors prescribe diltiazem and other calcium channel blockers for A-Fib, or other irregular heart rhythms. But they are the doctors so I have never really questioned one on the reasons.

I do know that a couple of years ago my cardiologist stopped me from taking diltiazem and then about a year later a new EP got into the picture and he started me back. For me diltiazem has been a love/hate relationship. It does an excellent job of keeping my BP at levels that pleases everyone, and apparently it stops me from having angina, but I'm not sure it has ever helped my heart rhythm.

I had diltiazem first prescribed (30mg 1/day) in 1985. I was having minor chest pain and BP was a little higher than it should be. The diltiazem worked wonders. But I had to change doctors (to meet insurance requirements) and the first thing the new one did was increase my diltiazem to 60mg 2/day. That was really when my minor palpitations started and every time I complained to my doctor he would up the diltiazem, It got to the point I was taking 120mg 4/day. I was a basket case. The least activity or excitement would cause the dangedest palpations and skip beats you can imagine. Then I decided that fourth dose each day (I'm not very good at following doctors orders when it comes to meds) was not necessary. It didn't take me long to realize that when I got up each morning I (I always take meds the very first thing when I get up) I felt reasonably good but a few hours after my first dose of diltiazem my day would start going down hill. Over the next 6 months I reduced my diltiazem from the 480mg/day to 60mg/day. Got my life back. The only problem I had was when I had to confess to my doctor what amount of diltiazem I was taking. He just shrugged it off, but I was referred to another doctor before long. I have always wondered if that was the cause for the change. But, I'm convinced that diltiazem and other calcium channel blockers are excellent meds, but not everyone can handle the same dose.

Now, let me very clear about this, I'm not recommending that you change your diltiazem dosage without the consent of your doctor. I have always thought that I played what amounts to Russian roulette and won. Not everyone that tries that game is so lucky. But this may provide you food for thought.

Got a question for you. Are you having vivid dreams since taking the diltiazem. Mine are out of this world on the higher doses of diltiazem. I'm not talking nightmares, just wild and very vivid dreams.

Good luck,

Smitty

Diltiazem

by VonnieVern - 2009-05-30 06:05:51

Smitty,
Thanks for your response. I don't recall my dreams being any dirrerent for the past two nights. After doing some reading, I just wondered why I was started at 300 mg daily, that seems like a lot to me. (I intend to ask at my next visit, or sooner if my symptoms warrant it.)

I have my own theory, maybe my next PM check will confirm or refute it: the diltiazem keeps my rate down, but doesn't actually stop the afib. Whether the giddiness is from diminished blood suppy from the afib, or from the diltiazem is what I'd like to be able to draw a conclusion about.

By the way, I often question doctors' orders in order to get them to give me more information about what has been prescribed. That doesn't set well with many of them, but I think that it gives me a better chance of getting the treatment option/medication dosage that will work best for my case.

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