| Name | David |
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| Location | Seattle, WA, USA |
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| Age | 66 |
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| Diagnosed condition | lone paroxymal atrial fibrillation |
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| Years with condition | 6.5 |
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| Frequency of episodes | average 13 days, (range 1 to 55 days) from 3 yrs. of data |
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| Duration of episodes | average 12 hours (range 10 minutes to 34 hours) from 3yrs. of data |
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| Event preceding first AF | none |
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| General health | active, athletic, daily exercise, no health problems except PAF, below average blood pressure and pulse rate |
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| Triggers | evening meal, over eating, repeated belching, relaxing several hours after exercise |
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| Preventions | I am very physically active and have never had an episode of AF start during or immediately after strenuous exercise. A few years ago I could even terminate an episodes by moderate exertion but this no longer works, it just causes extreme pulse rate and near fainting. |
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| Current medications/side effects | disopyramide
Toprol (very low dose)
coumadin |
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| Past medications/side effects | Toprol/ severe fatigue/ not very effective
Atenolol/ severe fatigue/ not very effective
verapamil/tripled my amount of AF until withdrawn
verapamil+digoxin/ same as verapamil alone
sotalol+digoxin/ minor side effects/ reduced AF for 5 mo. then it lost effectiveness (i.e. big AF increase)
Rythmol(+digoxin??) put me in near full time AF and kept me there for four days until withdrawn.
flecainide+digoxin /minor side effects/worked reasonably well for 7 mo. then lost effectiveness |
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| History of surgery | none |
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| Future plans | My experience with drugs is that they may work for a time but then lose effectiveness. For now disopyramide is working better than any past drugs. When it fails I may try going back to sotalol which worked pretty well for me in the past but then lost effectiveness. Maybe it will work again after being off of it for over a year. My doctor says I am a candidate for a fairly new pacing device but I haven't read up on this yet. I am trying to follow the progress of ablation treatments. The U. of Mich. has published a paper reporting pretty good success rates. |
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| Personal comments | My pattern of PAF is strongly vagal.I was on digoxin, in combination with various antiarrhymathics, for over 2 years and then read that digoxin can aggravate vagal A-fib. I therefor stopped taking digoxin (but continued with flecainide). The effect was dramatic but temporary. I had no A-fib for 74 days after I stopped the digoxin (by comparison I had been averaging about one event every 3 days before). Unfortunately after the 74 days my A-fib returned with a vengence. |
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| Check list |  acebutolol | amiodarone (cordarone,pacerone) | anisindione (miradon) |  atenolol (tenormin) | aspirin | azimilide | | bepridil | betaxolol | bisoprolol (monocor,emconcor) | | bretylium | bucindolol | carvedilol | | cibenzoline | dicumarol | digitoxin | | digoxin (lanoxin) | diltiazem (cardizem) | diphenylhydantoin | | disopyramide (norpace) | dofetilide (tikosyn) | dronedarone | | encainide | esmolol (brevibloc) | ersentilide | | flecainide (tambocor) | gallopamil | ibutilide (corvert) | | lidocaine | mibefradil | metoprolol (lopressor,toprol xl) | | mexiletine | moricizine | nadolol | | phenytoin | procainamide | propafanone (rythmol) | | propranolol (inderal) | quinapril (accupril) | quinidine (quinaglute) | | sotalol (betapace) | tedisamil | timolol | | tocainide | trandolapril (mavik) | valsartan (diovan) | | verapamil (calan,isoptin) | warfarin (coumadin) | asthma | | diabetes | GERD/acid reflux | hypertension | | hypotension | hyperthyroidism | hypothyroidism | | adrenergic | vagal | familial | | idiopathic/lone | paroxysmal | permanent/chronic | | atrial flutter | cardiomyopathy | CHF | | PAC | PVC | SVT | | syncope | bradycardia | tachycardia | | heart block | myocardial infarction | rheumatic heart diease | | sick sinus syndrome | stroke | WPW | | electrical cardioversion | defibrillator | pacemaker | | ablation | bypass | maze | | Male | Female | |
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