You ve been diagnosed with AFib. Now what?

Transcription

1 afib makes your heart beat out of rhythm

2 you need an afib treatment that keeps it in rhythm

3 You ve been diagnosed with AFib. Now what?

4 2 Your doctor has diagnosed you with atrial fibrillation (AFib). Even if you ve been diagnosed for some time, you may still have several serious questions and concerns about AFib. What exactly is it? How will it affect you? What does it mean for your future? And what can you do about it? This brochure has been designed to help answer your questions, and refresh what you already know about AFib.

5 3 Take this to heart: Whether Normal sinus you feel rhythm symptoms is a or heartbeat not, AFib means with a your steady, heart constant goes out rhythm. of normal rhythm.

6 4 What is atrial fibrillation? AFib is a disease in which your heart beats out of normal rhythm sometimes called an abnormal heartbeat, or arrhythmia. In fact, AFib is the most common type of arrhythmia. What is heart rhythm? A normal heart beats in a regular, steady rhythm. Doctors sometimes refer to it as a repeated lub-dub, lub-dub, lub-dub. The speed or rate of the beat may change. But the rhythm the constant lub-dub should always be the same. When the heart beats like this, it is said to be in normal sinus rhythm.

7 5 Take this to heart: Whether Your heart you feel has symptoms its own or electrical not, AFib means system. your heart goes out of normal rhythm. How your heart is supposed to work Your heart s constant rhythm is created by its own natural electrical system. This sends signals that cause the heart s 4 chambers 2 atria and 2 ventricles to work together to send oxygen-rich blood throughout your body. Right atrium Right ventricle Normal Heart Normal electrical signal Left atrium Left ventricle

8 6 Heart with AFib Faulty electrical impulses cause the heart to beat out of normal rhythm. What happens when you have AFib? Your heart can go out of normal rhythm. The electrical impulses that tell your heart to expand and contract misfire. This can cause the upper chambers of your heart (called the atria) to contract rapidly and irregularly. This is known as fibrillation. The atria lose coordination and the heart can no longer pump blood efficiently to the rest of your body. Disorganized electrical signal

9 7 Take this to heart: Whether Over you last 20 feel years, symptoms hospitalizations or not, AFib means due to AFib your heart have increased goes out 2-3 of times. normal rhythm.

10 8 Why is AFib a serious disease? If you have AFib, you are 5 times more likely to have a stroke.* In fact, 15% of all strokes are caused by AFib. Plus, over the last 20 years, hospitalizations due to AFib have increased by 2-3 times. Compared to those who don t have AFib: You are 4 times more likely to go into the hospital 3 or more times You are more likely to have 3 or more visits to the emergency room AFib has no cure once you have it, you ll always have it. Even if you have been feeling better for a while, the disease is still there and it is possible that an AFib episode may occur. *MULTAQ (dronedarone) is not indicated to reduce the risk of stroke.

11 9 Take this to heart: AFib Whether episodes you can feel be symptoms a source of or anxiety.* not, AFib means your heart goes out of normal rhythm. How can AFib affect the way you live? AFib episodes can be a source of anxiety Fear of having an AFib episode without nearby help may cause people to: Avoid activities they fear may trigger an episode Be unwilling to travel, or even go for a long walk If you share these feelings or concerns, talk with your doctor about them and use the space on the next page to write down his or her recommendations. *MULTAQ (dronedarone) does not treat stress or anxiety.

12 10 Use this page to write down any feelings or concerns you may have about living with AFib. Then, talk with your doctor and write down his or her recommendations for how to deal with these issues. My concerns and feelings My Doctor s recommendations

13 11 Take this to heart: Whether you feel symptoms or not, AFib means your heart goes out of normal rhythm. What does AFib feel like? AFib can be different for everyone. Sometimes you may feel definite symptoms. Other times, you may feel none at all. But whether you feel the symptoms or not, AFib means your heart is out of normal rhythm.

14 12 Here are some of the ways different people describe the feeling of an AFib episode: A flopping feeling in the chest A fluttering experience in the chest A fast pounding in the chest No unusual feeling at all

15 13 Take this to heart: Whether People you experience feel symptoms episodes or not, AFib means more often your heart with some goes out types of of normal AFib rhythm. than others. Are there different types of AFib*? There are 3 different types of AFib, which are determined by how often episodes occur. 1 Paroxysmal AFib The heart is in and out of normal sinus rhythm. Episodes come and go on their own and last no longer than 1 week. * Do not take MULTAQ (dronedarone) if you have permanent AFib.

16 14 2 Persistent AFib Episodes last longer than 1 week and do not go away on their own. Medical treatment is necessary to restore normal sinus rhythm. 3 Permanent AFib* A person s heartbeat is irregular and does not return to normal sinus rhythm, even with medical treatment, or the patient and doctor decide not to pursue AFib treatment.* * Do not take MULTAQ (dronedarone) if you have permanent AFib.

17 15 Take this to heart: Whether The longer you you re feel symptoms out of or rhythm, not, AFib the means harder your it is heart to get goes back to out normal of normal rhythm. rhythm.

18 16 Does AFib get worse over time? Over time, AFib episodes may: Become more frequent Last longer Require a doctor s help to get you back to your normal rhythm Each episode may keep your heart out of normal rhythm longer. The longer your heart is out of rhythm, the harder it becomes for your doctor to get your heart back to normal rhythm again. Why is early treatment of rhythm problems important? If rhythm problems are left untreated, AFib may become permanent, and your heart may never beat in normal rhythm again.

19 17 Take this to heart: Maintaining normal rhythm is one of the main objectives of treating AFib. What can you do about AFib? According to guidelines set by the American Heart Association and the American College of Cardiology, there are 3 objectives to managing AFib. 1. Maintaining normal heart rhythm To help prevent AFib episodes, doctors use medications that stabilize the electrical impulses in the atria. 2. Controlling heart rate* To help slow down the fast heart rate that occurs during an AFib episode, doctors use medications such as beta-blockers, calcium channel blockers, angiotensin-converting enzyme (ACE) inhibitors, and digitalis. *MULTAQ (dronedarone) is not indicated to control heart rate or reduce the risk of stroke.

20 18 3. Preventing stroke* AFib can cause blood clots that can obstruct a brain artery and cause a stroke. Doctors use anticoagulation or blood thinning drugs like warfarin to thin the blood and help prevent clots. Each of these treatment objectives is important, and your doctor may recommend all 3. Because AFib is a rhythm disorder, however, finding a treatment that helps keep your heart beating in normal sinus rhythm may be an important part of your AFib treatment plan. *MULTAQ (dronedarone) is not indicated to control heart rate or reduce the risk of stroke.

21 19 Take this to heart: MULTAQ has been proven to help keep your heart beating in normal rhythm. MULTAQ (dronedarone) is a prescription medicine used to lower the chance you would need to go into the hospital for an irregular heart rhythm called atrial fibrillation (AFib). It is meant for people who have had AFib in the past but are now in normal rhythm. Important safety Information for MULTAQ Do not take MULTAQ if you have symptoms of heart failure that recently worsened and you were hospitalized, or if you have severe heart failure. multaq doubles your risk of dying if you have these conditions. Do not take MULTAQ if you have a type of atrial fibrillation (AFib) called permanent AFib. You should not take MULTAQ if you are in AFib and your doctor is not planning to change you back into normal rhythm. People with permanent AFib who take MULTAQ have a higher risk of death, stroke, and needing to be treated in a hospital for heart failure.

22 20 multaq (dronedarone) because your heart needs help TO STAY in rhythm

23 21 why your doctor has prescribed multaq (dronedarone)

24 22 Your doctor has prescribed MULTAQ (dronedarone) because it can be a critical part of your overall treatment plan. You may not know that many AFib medications treat things other than rhythm. Some treat rate (the speed at which the heart beats) while others help prevent the risk of a stroke caused by AFib. MULTAQ, on the other hand, helps maintain rhythm. If you have AFib, you are at greater risk of going into the hospital than someone without AFib. MULTAQ is the only medicine of its kind that can help lower your chance of going into the hospital for AFib. MULTAQ may cause liver problems, including life-threatening liver failure. Call your doctor right away if you are taking MULTAQ and develop any of these signs and symptoms of liver problems: loss of appetite; nausea; vomiting; fever; feeling unwell; unusual tiredness; itching; yellowing of the skin or the whites of the eyes; unusual darkening of the urine; right upper stomach area pain or discomfort.

25 23 23 some things you should know about MULTAQ (dronedarone)

26 24 multaq (dronedarone) has other benefits Reduce episodes: MULTAQ can help you have more days without AFib episodes Reduce hospitalization risk: MULTAQ reduces your chance of hospitalization for AFib multaq also has risks Drug interactions Certain medications, including some antibiotics, antifungals, antidepressants, or medications used to treat HIV can have dangerous interactions when taken with MULTAQ. Other medications in combination with MULTAQ can lead to a dangerous, abnormal heart rhythm. (See pages for a list of those medications.) Talk to your doctor about all the medications you are taking.

27 25 getting off to a good start with multaq (dronedarone)

28 26 a few tips important things to do Before taking MULTAQ (dronedarone), tell your doctor or healthcare team about all the medications (including vitamins and herbal remedies) you are currently taking. This can help you avoid serious drug interactions Remember, any time there is a change in the medications you are taking, be sure to alert your doctor about it immediately Taking MULTAQ without food may not provide an effective dose always take MULTAQ with a meal ideally with breakfast (eg, a banana and oatmeal and eggs) and dinner (eg, meat and vegetables) Tell your doctor or healthcare team about any side effects or unusual symptoms you experience

29 27 a few more tips important things to do Give MULTAQ (dronedarone) time to work. It can take up to a week to build up in your system Be sure to keep an open and ongoing dialogue with your doctor and healthcare team Here are a few simple things you can do to help you remember to take MULTAQ: Because MULTAQ must be taken with food, keep your pills in an easy-to-see spot in the room where you eat most of your meals Set an alarm clock or the alarm on your watch or cell phone to remind you to take MULTAQ at the same time each day Buy a pillbox labeled with the 7 days of the week, and place the prescribed amount of MULTAQ into each day s compartment

30 28 a few more tips things you should NOT do Do not stop taking MULTAQ (dronedarone) if you begin to feel better. It s important to take MULTAQ exactly as prescribed by your doctor. And be sure to talk to your doctor immediately if you have any questions. Do not take 2 doses at the same time if you miss a dose. Wait and take your next dose at your regular time Do not drink grapefruit juice while taking multaq. It can increase the amount of MULTAQ in your blood and increase the likelihood that you will have side effects

31 29 What is MULTAQ ( dronedarone)? MULTAQ is a prescription medicine used to lower the chance you would need to go into the hospital for an irregular heart rhythm called atrial fibrillation (AFib). It is meant for people who have had AFib in the past but are now in normal rhythm. Important Safety Information for MULTAQ What is the most important safety information I should know about MULTAQ? Do not take MULTAQ if you have symptoms of heart failure that recently worsened and you were hospitalized, or if you have severe heart failure. MULTAQ doubles your risk of dying if you have these conditions. Do not take MULTAQ if you have a type of atrial fibrillation (AFib) called permanent AFib. You should not take MULTAQ if you are in AFib and your doctor is not planning to change you back into normal rhythm. People with permanent AFib who take MULTAQ have a higher risk of death, stroke, and needing to be treated in a hospital for heart failure. MULTAQ may cause liver problems, including life-threatening liver failure. Call your doctor right away if you are taking MULTAQ and develop any of these signs and symptoms of liver problems: loss of appetite; nausea; vomiting; fever; feeling unwell; unusual tiredness; itching; yellowing of the skin or the whites of the eyes; unusual darkening of the urine; right upper stomach area pain or discomfort.

32 30 When should I call the doctor? Call your doctor right away if you re taking MULTAQ (dronedarone) and have any signs and symptoms of heart failure. These may include shortness of breath or wheezing at rest; wheezing, chest tightness, or coughing up frothy sputum at rest, nighttime, or after minor exercise; trouble sleeping or waking up at night or using more pillows to prop yourself at night because of breathing problems; weight gain; or foot or leg swelling. Call your doctor right away if you notice that your heartbeat or pulse is irregular. This is a sign that you are in AFib. Call your doctor if you develop shortness of breath or a dry cough during treatment with MULTAQ. Call your doctor if you experience an allergic reaction, such as itchy rash, low blood pressure, or rapid swelling of the throat or skin, especially around the lips or eyes. Who else shouldn t take MULTAQ? You should not take MULTAQ if you are allergic to dronedarone or any of the other ingredients in MULTAQ. You should not take MULTAQ if you have severe liver problems or if you had liver or lung problems after using amiodarone. You should not take MULTAQ if you have a certain type of heart problem called heart block, and you do not have an implanted pacemaker.

33 31 Important Safety Information for MULTAQ ( dronedarone) (continued) You should not take MULTAQ if you are breastfeeding, pregnant, or plan to become pregnant. It is not known if MULTAQ may pass to or harm your baby. Women who may become pregnant should use effective birth control while taking MULTAQ. Talk to your doctor about the best birth control methods for you. Are there any medications I should avoid while taking MULTAQ? MULTAQ can interact with certain medications. Do not use the following medications with MULTAQ: Nefazodone Ritonavir Ketoconazole Itraconazole Voriconazole Telithromycin Clarithromycin Cyclosporine Are there other medicines that would be harmful when taken with MULTAQ? The following medicines can lead to a dangerous abnormal heart rhythm if taken with MULTAQ: Phenothiazines Tricyclic antidepressants Certain antibiotics Certain medicines used to treat an abnormal heart rhythm or fast heartbeat What are possible serious side effects from taking MULTAQ? MULTAQ may cause serious side effects including slowed heartbeat, inflammation of the lungs (including scarring and thickening), low potassium and magnesium levels in your blood, and changes in kidney function blood tests.

34 32 What are the most common side effects? The most common side effects when taking MULTAQ include stomach problems such as diarrhea, nausea, vomiting, stomach area pain, and indigestion; feeling tired and weak; skin problems such as redness, rash, and itching. Tell your doctor about any side effect that bothers you or that does not go away. Are there other things I should avoid while taking MULTAQ? Do not drink grapefruit juice while taking MULTAQ, as this can increase the likelihood that you will have a side effect of MULTAQ. What else should I tell my doctor? Tell your doctor about all medications, vitamins, and herbal supplements (including St. John s Wort) you take to help avoid serious drug interactions. Is it OK to take a diuretic ( water pill ) while on MULTAQ? Your potassium levels should be within the normal range prior to and while taking MULTAQ. Tell your doctor about any diuretic medications ( water pills ) you are taking as some can lower the level of potassium or magnesium in your blood. Will I need any tests while I m on MULTAQ? Your doctor will monitor your heart rhythm regularly to make sure your heartbeat keeps a normal rhythm. Your doctor may perform certain tests, such as heart exams and blood tests, while you re taking MULTAQ.

35 33 take advantage of multaq matters join today

36 34 Our website can be a great source of information and support Specially designed learning modules that can help you better understand AFib A doctor s appointment reminder tool that can help you stay organized A refill reminder to help you keep taking MULTAQ (dronedarone) as you and your doctor have agreed Answers to your questions about MULTAQ Tips on eating right, exercise, and activities; ongoing updates; support; and more Be sure to join MULTAQ Matters TM today. Visit MULTAQ.com or call to learn more.

37 35 questions to ask your doctor about multaq (dronedarone)

38 36 your doctor will be able to help with answers to your questions How is MULTAQ (dronedarone) different from the other medications I m taking? Could MULTAQ help keep my heart beating in a steady, regular way? Could MULTAQ reduce my risk of hospitalization from heart problems? How does my disease affect other health conditions? Will MULTAQ interfere with any of the other medications I m taking? What are the serious risks and side effects associated with MULTAQ that I should know about?

39 37 Terms your doctor may use when discussing AFib Anticoagulant A medicine that thins the blood and helps prevent blood from clotting. Arrhythmia Any change in the normal rhythm of the heart. Atrial fibrillation (AFib) The most common type of arrhythmia. When you have AFib, the right atrium of the heart quivers rapidly and unevenly changing the constant rhythm of the heart. Atrial flutter (AFlutter) A temporary or long-term disturbance in the rhythm of the heart that often occurs with AFib. Atria (singular atrium) The 2 smaller, upper chambers of the heart. The right atrium receives blood from the body. The left atrium receives blood from the lungs. Cardiovascular Involving the heart and blood vessels. Cardioversion A method to restore a heart to normal sinus rhythm. This can be done using electric shock (electric cardioversion) or medications (pharmacologic cardioversion).

40 38 Clot A mass of blood that can form when the flow of blood is slowed down. Electrocardiogram (EKG) A test your doctor uses to show how the heart beats. Heart failure A condition in which the heart can t pump enough blood to the body s other organs. The heart keeps working, but not as efficiently as it should. People with heart failure have difficulty exerting themselves because they become short of breath and tired. Hypertension High arterial blood pressure, generally defined as being above 140 mm Hg systolic and 90 mm Hg diastolic (140/90). Normal blood pressure is considered to be below 120/80. Left ventricular ejection fraction (LVEF) A measure of how much blood is being pumped out of the left ventricle. This shows a doctor how strong the heart muscle is and whether it s pumping as much blood to the body as it should. Normal sinus rhythm The normal, constant rhythm of the heart.

41 39 More Terms your doctor may use when discussing AFib Rate The speed of the heartbeats. Remodeling The changing of the shape of the heart, which can be caused by AFib. Rhythm The pattern of recurring heartbeats. Stroke What happens when a blood vessel carrying oxygen to the brain is blocked by a clot or bursts, leaving part of the brain without the blood (and oxygen) it needs to stay alive. Ventricles The 2 lower chambers of the heart. The left ventricle pumps blood to the body. The right ventricle pumps blood to the lungs.

42 40 NOTES

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