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Ask Dr. Natasha Your Own Question

Dr. Natasha
Dr. Natasha, Board Certified Physician
Category: Cardiology
Satisfied Customers: 12910
Experience:  Training in cardiology emergencies.
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I am 88 years old and have suffered from atrial fibrillation

Customer Question

I am 88 years old and have suffered from atrial fibrillation for very many years In May 2010 my Cardiologist, having tried many other drugs which had proved ineffective, said we would go for what he described as the" last resort" drug AMIODARONE. It worked and for the past
nearly three and a half years I have had no significant episodes of the problem. What a relief it has been! Then in July of this year I went for my annual review to a different Cardiologist and saw a young Registrar whom I didn't like from the start. He arranged for a blood test and nearly 2 months later sent the results to my GP saying that the thyroid reading caused him some concern and I should half my Amiodarone intake from 200 to 100mg per day and arrange another blood test in a month's time. This I did and almost immediately my old symptoms returned - a very fast and/or irregular heart rate of up to 100 per minute. In one case I had to call out a doctor during the night after a 5 hour very worrying episode. The nest day I saw my own GP and he suggested as a compromise we should try 150 mg per day. I have still stuck to 200 mg per day and there has been an improvement to the condition. I would be grateful for your opinion and advice
Submitted: 3 years ago.
Category: Cardiology
Expert:  Dr. Natasha replied 3 years ago.

Dr. Cameron :

hello

Dr. Cameron :

are you still there?

Dr. Cameron :

Well, I do not see that you are on right now, but I think that you have encountered some of the difficulties of medicine- i.e. more of an art form :-)

Dr. Cameron :

We try to make decisions based on science, and for the most part it does help our decision making

Dr. Cameron :

but in some patients, who have responded quite well to a previous therapy- changing it does not make it for the better

Dr. Cameron :

THe concern with your thyroid is that amiodarone can cause hypothyroidism in some patients (and in others, hyperthyroidism)

Dr. Cameron :

Both of these are treatable conditions.

Dr. Cameron :

You can read about it here: here is an elegant excerpt:

Dr. Cameron :

http://www.ncbi.nlm.nih.gov/pubmed/15989900

Dr. Cameron :

At any rate, if your thyroid issues are NOT causing you problems (only the hyperthyroidism one is tricky to treat and is more common in iodine lacking areas- which is not the UK) then you don't need to change the medication if it is working for you

Dr. Cameron :

Which it is

Dr. Cameron :

So, I would not change your medication and would consult with your old cardiologist

Dr. Cameron :

I hope that this helped.

Dr. Cameron :

Please leave positive feedback if it did :-)

Expert:  Dr. Natasha replied 3 years ago.
Murray
I did not see you online so I answered your question above.
Please let me know if you need anything else.

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