cantom

My doc told me I'd have to take Xarelto every day for the rest of my life. It's either that or the risk of stroke.

BTW, one of the meds they had me on was Amlodipine. I had to discontinue that as it led to other issues.

OldCruiser

I’ve been taking Amlodipine for a couple of years , what kind of issues were you experiencing? If you don’t mind me asking .?

cantom

My lower legs were turning red/purple. Circulation problem, particularly on the left leg. And the skin was getting bad.

Doc diagnosed me with Stasis Dermatitus. So I looked it up and

https://pubmed.ncbi.nlm.nih.gov/19213228/

Discontinued Amlodipine and several months later, left leg is back to normal size and skin is way better.

Cardiologist put me on a water pill to replace it.

cantom

Many meds are like that. They fix one thing and create another problem. It's like a balancing act.

philbob57

A comment and 2 questions....

Xarelto is pretty scary. It apparently does a good job of preventing the most common strokes (ischemic), but the incidence of the less common but more catastrophic stroke (hemorrhagic) goes up, and the probability of a stroke goes up if you stop it. But it seems like a good choice if you've got a-fib.

*****

I did some - not much - research and believe that moderate- not intense - exercise is very probably good for a-fib. I'm 77; overweight, high BP. My doc has placed no limit on my HR, but he's prescribed metaprolol, which slows down most people's hearts.

I took a 30 mile ride today and my HR was generally between 100 and 125. I saw no evidence of excessive or volatile HR. I probably could have talked with a companion during the ride, but 1) I was solo, and 2) my hearing is lousy, and I probably wouldn't have tried to talk, especially through wind noise. Anyway, I thought I exerted myself to a moderate level. I rode strongly (for me) for the first half of the ride and the last, say, 4 miles, not so strong on miles 15-26.Sunny, mid-70s, 50% relative humidity.

For the 4 hours since I got home, I feel pretty wiped out, and I've been getting dizzy when I stand up. Has anyone here with a-fib any similar experience?

I'm not asking for a medical diagnosis below; rather, I'm asking for feedback on my logic. If anyone offers advice that I follow, I won't came back with a complaint if it doesn't work out.

As far as I can see, the dizziness could be due to:

1) dehydration - I lost 2 lbs over the ride, and I drank about 48 oz water, ate a sandwich (almond butter), had a brownie and a lime pop when I got home ... so I lost a lot of water, and I'm on a diuretic.

2) Longest ride this year for me. Last bunch of rides were about 20 miles. I could just be tired.

3) A-fib. I had an appt with pacemaker tech who rides; she argues that a-fib is likely to be the prime culprit in tiredness and light-headedness.

4) the diuretic, which I started taking last Thursday. I'm an old IT tech, and I learned long ago that the last change probably caused a new problem, no matter how tenuous the connection between the change and problem. Also, I had a very bad experience with the diuretic a few months ago, before I dropped a BP med, and I had a bad experience with it on July 3. In fact, I dropped the diuretic and went back to amlodipine twice a day starting on July 4. In talking with the pacemaker tech, I realized July 3 was the first really hot and humid day in weeks, and my bad experience (5 minutes of a-fib while on the ride and debilitation after getting home from a 20 mile ride) could easily have been due to that.

Any other likely causes that you can think of? Any thoughts on my reasoning? Any thoughts on experiments to identify the cause?

One thing I plan to do is to ride 20-25 miles Tuesday and 30 miles on Thursday. If my tiredness is due to lack of conditioning for that distance, I probably won't experience a problem.

Thanks.

Richard Cranium

Technically exercise does nothing to alleviate A-fib, but systemically - exercise helps maintain healthy blood vessels and other vascular factors that play in to overall health and longevity. Focusing on, and doing what you can to avoid heart arrhythmia is an important aspect of maintaining good heart health.

But the real devil is the details surrounding reduced cardiac output, which contribute to kidney, liver and essentially all organ failure. My experiences - suggest that purposely limiting high heart rate during exercise is a favorable method of maintaining organ health without contributing to further heart health decline. (lowest stroke potentials by not triggering arrhythmia)

Most doctors probably weigh a variety of heart health blood test values along with vascular health and other competing morbidity to determine a course of action. In other words - do what kills you the least. :-)

pdlamb

Like your pacemaker tech, I'm not a cardiologist, so factor that in as you read my response.

I had a friend who triggered a week-long episode of Afib the first day of a week long (supported) tour. His consumer grade HRM (probably Polar or Garmin) verified the wonky heart rate that his fatigue made him suspect. Point is, if you didn't see any spikes much above a pulse of 125, it probably wasn't Afib in your case.

Was this ride much longer or hotter than you've been doing recently?

philbob57

I use a TickrFit at my elbow. It's quite good, though obviously not medical-grade. The reason I say a-fib is that I experienced a number of episodes of irregularity (bouncing between(about) 140-150 and 90-100 for a minute or 2. My doc said the irregularity was a sign of a-fib. I felt fine, but IIRC I went through 3 such episodes in about 10 minutes, so I hung it up and started researching.

Really pissed me off, because I was riding with my son and grandson on a beautiful day.

afm199

Talk to your doctor about Sub Clavian steal. I have had many episodes of atrial flutter, now gone thanks to ablation. They had me on two or three meds, metoprolol, Amiodarone, and coumadin. I would get HORRIBLE episodes of dizziness on those drugs. Crippling, get out of the car, stand up, and almost faint. Eventually, after reading the drug literature, I began to realize that it was contributing. Then I had some scans and it turned out that I have one of my internal cranial carotid arteries completely blocked. That results in blood being "stolen" when you suddenly exert yourself or stand up from lying down or sitting. The combo of Sub Clavian steal, amiodarone and metoprolol was the problem. Cut back on the metop and got off the amiodarone after the ablation. I dizzy every now and then, but it's only under extreme circumstance, like getting up suddenly from lying down for an hour.

roadsnakes

'

That`s the heart rate I`d get on a 20 mile ride with plenty of hills. Sometimes I couldn`t get it passed 105BPM.
I told my Dr. I didn`t like the feeling of struggling on a ride when I didn`t have that problem before Metoprolol.

He had me cutting the pills in half. That seemed to work for me..

One of my Heart Drs. wanted me on Xarelto. The other DR. an electrophysiologist took me off it, and went with low dose aspirin. He didn`t like the cons of Xarelto for me at this time. He said in a couple years when I`m more into my 70s we might start it.
Even with the low dose Aspirin I bruise if a fly lands on me! LOL