Reta washout timeout

My prescriptions are Metoprolol 50mg and Lisinipril 10mg, taken twice daily. A severe case of pneumonia landed me in the hospital for 3 weeks — 2 of them in ICU — and brought on AF. I came very close to dying, yet I pulled through. That happened roughly 4 years back. No problems since then, but my cardiologist keeps me on both medications anyway, which is no inconvenience to me. Once a year I go see that slave driver, and he still gives me grief over drinking 2 beers a day. Still, he's a good doctor.
 
Hi all,

I want to give you an update on how my health is going, and I'm hoping you'll share your thoughts on the next steps I plan to take.

At this point I have gone 4 weeks without any GLP1 or weight loss peptide. My diarrhea has fully resolved (for at least 3 weeks now), and 2 days ago an electric cardioversion brought back my sinus heart rhythm.

Since I'm still only midway through my weight loss journey, my plan is to resume GLP1 injections once the washout period is over (possibly starting again this coming Sunday).

What I have in mind is to restart Tirze at 2,5mg/week, the same way I began 1 year ago, and to titrate up more slowly than I did over the past year.

Down the road I may add Cagri or Reta; I'm considering combining Reta with Tirze at a 2:1 ratio.

Thanks ahead of time to anyone who posts suggestions or comments.
 
Good to hear that your Afib has stopped, at least for the time being. For a whole year I dealt with Afib (cardioversion 2 times, each time it worked for about a week before I went back into Afib).

If the Afib keeps happening, my advice is to bring up ablation with your doctor. For me it was the single best decision I ever made. 1 year with no symptoms. I realize it can always return, but my life is genuinely different because of it.

Wishing you the best going forward, and I appreciate you sharing the update!
 
Nate2plate said:

Good to hear that your Afib has stopped, at least for the time being. For a whole year I dealt with Afib (cardioversion 2 times, each time it worked for about a week before I went back into Afib).

If the Afib keeps happening, my advice is to bring up ablation with your doctor. For me it was the single best decision I ever made. 1 year with no symptoms. I realize it can always return, but my life is genuinely different because of it.

Wishing you the best going forward, and I appreciate you sharing the update!
Click to expand...
Ablation is something I'm looking into for down the road. To help me make that call, I've already scheduled an appointment with a cardiology specialist.

When your AFIB was active, were you on any GLP1 medication?
 
BLASIUS said:

Nate2plate said:

Good to hear that your Afib has stopped, at least for the time being. For a whole year I dealt with Afib (cardioversion 2 times, each time it worked for about a week before I went back into Afib).

If the Afib keeps happening, my advice is to bring up ablation with your doctor. For me it was the single best decision I ever made. 1 year with no symptoms. I realize it can always return, but my life is genuinely different because of it.

Wishing you the best going forward, and I appreciate you sharing the update!
Click to expand...
Ablation is something I'm looking into for down the road. To help me make that call, I've already scheduled an appointment with a cardiology specialist.

When your AFIB was active, were you on any GLP1 medication?
Click to expand...
No, I never did. That said, I kept a close eye on my heart rate the whole time I was using them. Early on there was a bit of tachycardia, but that has since gone away.
 
Worth keeping this in mind.

In Eli Lilly's Phase 2 and continuing Phase 3 Retatrutide trials, the following groups were strictly barred from enrolling:

  • Resting heart rate above 100 bpm
  • Any prior atrial fibrillation or clinically significant tachyarrhythmias
  • Recent heart attacks or decompensated heart failure
Between those on tirzepatide (0.79%) and those on placebo (0.83%), AFib rates were virtually identical. Based on this Study
 
BLASIUS said:

BNLFL said:

Which medications are you on to manage the AFIB?
Click to expand...
Apixaban 5mg x 2 daily
Click to expand...
Apixaban is a blood thinner—it does not address AFib itself.

Ask your cardiologist whether a beta blocker such as metoprolol and/or an antiarrhythmic such as flecainide could be appropriate for you.

AFib tends to worsen over time. As you get older, episodes usually become more frequent. Still, my advice would be to definitely discuss with your cardiologist the possibility of adding medications that might help settle the arrhythmias.
 
QueenMuntha said:

BLASIUS said:

BNLFL said:

Which medications are you on to manage the AFIB?
Click to expand...
Apixaban 5mg x 2 daily
Click to expand...
Apixaban is a blood thinner—it does not address AFib itself.

Ask your cardiologist whether a beta blocker such as metoprolol and/or an antiarrhythmic such as flecainide could be appropriate for you.

AFib tends to worsen over time. As you get older, episodes usually become more frequent. Still, my advice would be to definitely discuss with your cardiologist the possibility of adding medications that might help settle the arrhythmias.
Click to expand...
Beta blockers and most antiarrhythmic drugs are off the table for me, since my resting heart rate is already on the low side (50–55 bpm). Taking them could push it down even more, which is why they aren't regarded as appropriate in my situation. Right now, my plan is to have catheter ablation done, with the hope that it will eliminate the AFib for good.

Edit:

I'm attaching a screenshot showing tonight's heart rate reading from my smartwatch





62df230354478c769e6db91448b3da21a3337d67289fb0b225c05bf2e64c4a3c.webp
 
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