Multaq, Pradaxa, and Exforge...

These were the three drugs that I was prescribed before we went to England. Pradaxa is a blood thinner: Multaq is for the arrhythmia or fibrillation: Exforge for the blood pressure. Pradaxa and Multaq have to be taken twice a day, which is a nuisance because it is very easy to forget to take the evening doses.
    We went to England on June 1, and as time passed I did begin to forget that I had the pacemaker. In London we walked for miles and miles, but never very strenuously. In Wales, with Dan and Karen, we did some strenuous hikes along the coast. And in Devon we hiked the coastal path, which had a lot of steep uphills that had us both pausing for breath. I would check my heart rate, and usually it was in the range of 90 to 100 bpm.

    Here is Joan on a stretch of the South Devon coast, and you can see the up-and-down nature of the terrain. All this hiking was very encouraging, as it seemed that--heart problem or no heart problem--I was able to engage in vigourous physical activity. We returned to England on August 23--a significant date as Washington had an earth tremor, or earthquake, which lasted about 30 seconds and had everyone running out of buildings.
    Shortly after getting home I was trolling around on the Internet and did a search on Multaq. This is what came up:

    "FDA notified healthcare professionals that it is reviewing data from a clinical trial that evaluated the effects of the antiarrhythmic drug dronedarone (Multaq) in patients with permanent atrial fibrillation. The study was stopped early after the data monitoring committee found a two-fold increase in death, as well as two-fold increases in stroke and hospitalization for heart failure in patients receiving dronedarone compared to patients taking a placebo. FDA is evaluating whether and how the preliminary results of the PALLAS study apply to patients taking dronedarone for paroxysmal or persistent atrial fibrillation or atrial flutter. The PALLAS study results are considered preliminary at this time because the data have not undergone quality assurance procedures and have not been completely adjudicated. FDA will update the public when more information is available."

    I had an appointment with the pacemaker technician on Monday August 29, when he checked the operation of the pacemaker--which was working perfectly. I asked if I could see the cardiologist, and I showed him the FDA warning. I did not get the impression he had seen it before. He assured me that my fibrillation was paroxysmal and not permanent, and that the warning only applied to permanent fibrillation. The technician, who was monitoring my heart, cut in to say that I was, at that time, actually 'in fibrillation.'

    So I am left with a question mark--something like this: if X doubles the chances of death of someone whose fibrillation is 'permanent,' might there not also be a detrimental effect on patients with fibrillation that is less than permanent? And obviously the FDA think that could be the case, as they are going to evaluate what Multaq's effects are on patients with paroxysmal fibrillation.

    It was agreed I would remain on Multaq until my next appointment on September 29.

    I renewed my prescriptions: my share of the total cost was about $270. Aetna covers the rest. These drugs are expensive.