Hi David. Wow! That's quite a story. I had to look up DRESS as I'd never heard of it before. Even the description of DRESS never mentioned the eyes so I imagine you have a bunch of doctors scratching their heads. My best wishes to you for a good outcome not only with your afib but with some kind of help with the adverse reactions you're getting from drugs. Welcome to the group.

There are a few things you could look into that might help with your afib and flutter. First is sleep apnea. When you snore, you're not getting enough oxygen. When you're not getting enough oxygen, it does bad things to the heart, including arrhythmias. Sleep apnea can be treated without drugs of any kind.

Second is thyroid hormone levels. If yours are out of whack, it can cause arrhythmia as well. This unfortunately is usually treated with drugs.

It seems like you are hypersensitive to drugs, so if you're considering a Maze procedure, just keep in mind that you WILL be given drugs before, during, and after the procedure, as well as radioactive contrast dye. Sorry you had to join our little group.

Are you Working...or are you able to devote time to relaxing?

If you are in afib/flutter 34% of time, are you symptomatic...can you tell when you are in it? If so, perhaps that Metoprolol just to bring your rate down only when you are in afib

Did you go back to drinking caffeine and alcohol? I stopped both 4 yrs. ago. I still have episodes....but, I am Certain they would be so much worse and more often if I still indulged.

Do you have access to any stress control programs, if what you are doing isn't helping....perhaps seek out something else.

Just thoughts....and I'm hoping you had a successful 2nd opinion!

You are never alone~

Many thanks to all for responding.

@Ultratodd: the DRESS Syndrome ... did my eyes no favors (it nearly fried my liver, so ... biliary salts were oozing from every pore in my body ... and circulating in my eyes), but it didn't *cause* the eye problems.

Those were caused by use of prescribed eye drops ... preserved by a chemical known to damage eyes ... for >six years.

I'm guessing the "ultra" is for ultra-marathons. I'm a former runner. A buddy started running to join me, and is now a competitive ultra guy. It's a blast watching his accomplishments. I have zero desire to do what he does, but do miss running. Not in the cards, today, though.

It's also possible that I'm one of those people who utterly exercised too much. I'm way over the cumulative "2000 hour" mark that they talk about, and ... pushed pretty hard ... for decades.

@duder: thank you. My (nurse practitioner) wife swears there's no indication of Sleep Apnea, but ... I'll have to mention it at the next Primary Care app't. I know it's fairly easily elicited in a sleep study.

I'll be seeing the city's best 'functional medicine' group in about five weeks. I'll ask them about thyroid, and ... anything else they can come up with.

I don't think I'm dangerously close to 'persistent' yet, so I feel like I have a bit of time to try alternative options that they might offer.

Yeah. I definitely know that surgery would involve drugs, on the front end, during, and -- almost certainly -- after. The hope would be not to be on them for months and months (or indefinitely) -- "front-end load" the risk.

@yogacat: definitely symptomatic when it hits -- shortness of breath, lightheadedness, dizziness/vertigo episodes, and .... lots of near-syncope (it all goes gray, and ... I either hit the floor or risk passing out; I choose the former).

Declared disabled in 2004, so ... at this point ... all I do is walk/hike with the dog and veg out on the couch.

I've had such a long and complicated medical history that I'm not particularly anxious about the afib.

I've been working on managing the stress level for years. 10d Vipassana retreat, 2wks at a Buddhist monastery, yoga courses, the walking, music, etc.

I don't actually feel that stressed, though ... the Neighbors From Hell years ... it was truly a runaway train. All my learned techniques utterly failed me. It was life under siege.

I have had to use the Metoprolol only prn (as-needed), since it prevents me from getting out of the house otherwise. I'll come back from a walk ... heart banging ... and take a pill.

Even when I push the dosage, it's only mildly effective, at best. What I'm left with -- says yesterday's cardiologist -- is almost surely the a-flutter -- HR 120-150. Can't titrate the dosage upward more, or ... the next day is a total write-off.

2nd opinion cardiologist -- very good doc and decent man (who has had three episodes of DRESS Syndrome, himself !) -- had lots to say, but ... in short .....

- Gadolinium MRI and CT could be useful. He thinks the die used in the MRI might be too risky in my case;

- Mini-Maze probably represents the sweet spot, for me, of risk:reward. In his experience, and his understanding of the data, catheter ablations fail (1st time) in (at least) 40-50% of the patients;

- Since walks/hikes trigger it ... he'd stop those, but he's pretty sure I won't (he's right ... grin). He suggests I slow it down even further, walk for 10min, then rest for 5min;

Sigh.

- Though he "wouldn't ordinarily recommend this for any other patient," he'd recommend that I have the procedure done at a Mayo, a Cleveland Clinic, or one of the top spots, as much for the capacity to deal with a possible drug complication as for their surgical expertise;

- He says most EPs are Rx'ing months and months of antiarrhythmics, postoperatively, in the belief that it improves long-term outcomes;

OhByTheWay: on my last Mayo journey, their conclusion about my history of Adverse Drug Reactions was .... that I'm "just not lucky."

As you can all imagine ... that was amazingly comforting and helpful news ;-)

Seriously: they have no idea why my body is so sensitive to meds. Based on Mayo's findings ... I've long wondered whether it's something like Chronic Fatigue Syndrome or ... as Mayo diagnosed ... "borderline autonomic dysfunction," and that was well before the afib.

Which always makes me wonder: is the arrhythmia the problem, or is it a symptom ?

Which ... leaves me chasing my tail ;-) I suspect you all understand.

Many thanks, again. It's surely an interesting journey, but ... I'm growing pretty weary of interesting journeys ;-)

Well David, it sounds like you could write a pretty interesting book!.

I am an ultramarathoner. I've run about 70 or so in the last 20 years. I'm very competitive in my age group but it's getting a lot harder. On flat ground, very few can beat me (age group wise) unless I have some physical problem. Current physical problems are under control but afib just flared last week on a short training run. My cardiologist suggested that I keep my heart rate down a bit so I'll follow that advice. I also have a prescription for a very low dose of metoprolol. I'll carry it on my runs. It's low enough that it didn't seem to affect my energy but did help me get back to NSR.

When I can't run, I walk or hike. I prefer the company of people so I try to find people who regularly want to do the same. It keeps my spirits up.

Quite frankly, I like your attitude about walking/hiking. I have a friend with ventricular tachycardia that led to ventricular fibrillation. He almost died. So what does he do now? He still does ultramarathons, just very, very slowly. He's content just to be out there even if he has to stop or drop out. His run is as fast as my walk. His walk is about as fast as his run. But he's living life and getting as much enjoyment out of it as he can. He has no idea if his heart is going to suddenly kill him while sitting on the couch or while he's out doing something he loves. So, he gets out there and does what he loves. Please don't take this as a suggestion to take up ultrarunning. :-) I'm just trying to say that I admire you for doing what you think you can.

Todd