Flecainide of beta blockers?

[Bahrain22]

I've got PVCs, 24% of all beats at the last halter. Was prescribed 50mg Flecainide twice a day. It s not working now, started feeling the fast/extra hard beats again. I have an appetite my EP next week. Should I agree to increase the dose of flecainide (which is what I think he'll suggest) or ask to try beta blockers?

[Bahrain22]

I meant 'or' beta blockers! Sorry.

[Palpman]

Beta blockers would not help my PVC's or tachycardia at all. It slows the heart down by about 10% and drops BP somewhat. It is not an antiarrhythmic drug.

[lettingoffsteam in reply to Palpman]

I take propanolol and it certainly helps me.My consultant,who is also an EP, said it was a good one to start with.It has abolished my tachycardia but I still get some ectopics and short runs of arrhythmia...just a few beats.

[ILowe in reply to lettingoffsteam]

The dosage of flecainide is quite individual, and for me it has been changed, sometimes up, sometimes down, many times. Important to note that increasing the dose can sometimes increase the palpitations.

It is not either or, either flecainide or bisoprolol. Most people on flecainide also take a small dose of bisoprolol. The bisoprolol puts a lid on some of the nastier side effects of flecainide. Also, bisoprolol is a great calmer in its own right.

Please do not be worried if your EP increases the dose of flecainide, since this medicine has been known for decades and, especially in the hands of experts like an EP, has an excellent safety record.