Many people take different drugs for AF. I am curious to know how effective the drugs are. When on drugs, does AF stop, decrease, increase, etc.? Are some drugs more effective than others? When on drugs, do triggers still cause AF? And any other impacts would be helpful.

I realize everyone reacts differently, so responses will not be something anyone can take to the bank to definitively help them but the responses may give some semblance of comfort to some people.

16 Replies

  • It's a good question, EngMac to which there are dozens of answers and no two people may have the same answer for the same drug. But my experience, for what it's worth is:

    Bisoprolol 2.5mg did nothing for my AF or tachycardias which raged on as before

    Sotalol made tachycardias worse and was stopped after 4 days

    Flecainide 100mg twice daily has, for the last 3 wonderful months stopped all arrhythmias. My known triggers are alcohol and caffeine - both of which I avoid, although adrenaline in a topical anaesthetic recently did make my heart race for 5 to 10 minutes but I had no AF as a result.

    Other people may have the opposite reaction to these 3 drugs, so it's not a case of one size fitting all.

  • hi There,

    Here we go this is my own experience and interpretation.....Following my first episode of AF nearly three years ago the Cardiologist prescribed Bisoprolol , Flecainide and Aspirin....These calmed the heart and I was AF free for about !8 months, Although I felt tired and lethargic most of the time.

    Because of the stroke risk I wasn't happy being on Aspirin so consequently my Cardiologist changed this to an anti coagulant and Warfarin was introduced ....

    At times i wondered whether I really did have AF and maybe that one off attack had aborted itself...So I persuaded my Cardiologist to reduced my dosage -after a couple of days the AF was back with a vengeance so the original dose was reinstated...

    All was fine again for a short time until about this time last year the PAF got alarmingly worse- I was passing out -dizzy and I mean dizzy likened to being twirled around on a fair ground round about...I really didn't know what had hit me...

    For the first 12 months or so after being diagnosed I carried on drinking Alcohol- one large glass most nights and Coffee- although I had realized by then that these substances would trigger and attack of AF but at that stage all I had to do was take the meds and the heart would settle quickly -but gradually they stopped working ...

    I gave up Alcohol and Coffee totally at the beginning of this year nine months prior Ablation...Also in preparation for the procedure I exercised daily= lost the extra few Kilos I was carrying -ate clean healthy unadulterated food the purpose being to be at maximum fitness to help myself=and my EP's to hopefully ensure a successful outcome....I will continue with this healthy lifestyle for the rest of my life....

    I had PAF and as you are probably are aware "AF begets AF" there is no doubt about this in my mind- sometimes it just takes a little longer as the drugs get stronger....

    This is my own personal experience - I am certain others will give you there own interpretations...

    All the best.


  • I had 100mgs of flecainide twice a day reduced to 50mgs x 2 when it had been 100% effective for three months and, just as Carol said, within a couple of days my heart was off again being silly. Back to the original dose and all went quiet for almost a year.

    A couple of years later when it didn't seem to be controlling AF enough and I was prescribed 150mgs x 2 that seemed to have no effect whatsoever, except the side effects (numb feet) seemed to escalate.

    I have found flecainide very effective as a pill in the pocket, although when you are on 300mgs a day you can't take much extra if you need it.

    I stopped taking flecainide in July after an ablation in March. I have had just the odd bit of AF every few weeks since March. November is the first month when I've been completely AF free - have had five clear weeks now.

  • At first 100mg x2 flecanide and 1.25 bisoprolol more or less stopped my A.F. which had been present around 70% of the time. After 6months I needed flecanide increasing to 150g x2 but had visual side effect as so decreased to 250mg a day. This is keeping it at bay for about80% of the time while I await an ablation. X

  • Hi EngMac

    Out of interest, the cardio who put me on my first pills, whilst I was in hospital, said it is like cooking, they keep on trying different ones till they get the right one. His words not mine. Back then they tried 3 or 4 ones on me and the last one took away 99% of the AF, but I eventually developed side-effects (bad memory). 10 years later I have a different arrhythmia and again I have been tried on 4 drugs, and the last one works a treat and has taken away about 99% of my wobbles.

    Both times we could have stopped at the third drug which did quite well, but not perfect, and I'd now be saying the drugs only worked 75%.

    Re "do the triggers still cause a problem". My current drugs suppress my arrhythmia very effectively, but I still feel uncomfortable after eating even though I don't actually get an arrhythmia. I can feel my heart trying to go irregular, but the drugs won't let it !!!


  • I started on a tiny dose of bisoprolol, and was put on aspirin (before I knew anything about warfarin). Two years later when I had another episode, the dose of bisop was upped to 5mg and I was put on warfarin, and have been on those ever since (boring, eh?). The biggest side effects for me are tiredness and weak nails (believe that's the warfarin). I'm lucky, I think, everyone reacts differently to the drugs! As Koll said, it's a bit like cooking and all our bodies like different recipes :)


  • Hi Koll,

    You must have cooperative doctors who listen to you as a patient.

    I saw the following on a website and found it interesting so I took the liberty of extracting it. I hope the author, a chiropractor named Doctor Lowe, won't mind. I guess we patients may need to be persistent if the recommended health remedies produce less than optimal results.

    Dr. Lowe's statements:

    "I only rarely hear that someone has unfairly castigated me for my unconventional views. Whenever I do, I take solace in a statement by J. Paul Getty, whose unconventional views in business during the depression helped make him once the richest man in the world. Based on his personal experience, he wrote: 'In business, as in politics, it is never easy to go against the beliefs and attitudes held by the majority. The businessman who moves counter to the tide of prevailing opinion must expect to be obstructed, derided, and damned.' "

    "The same is true in medicine and research. The consistent pressure is to conform to conventional beliefs. When one declines to do so, the reactions of some physicians and researchers are far less than cordial. Some of us, however, are stubbornly committed to unearthing and spreading the truth. This makes it impossible for us to conform when doing so will violate what we believe to be the truth. Fortunately, over time, I’ve become inured to derision; today, it’s more amusing to me than punitive."

  • That is so true and J. Paul Getty was spot on. There is a tremendous pressure to conform all the time and that's what most people do, but luckily, not all.


  • See my post below!

  • Very true Koll....

    We have to have to stand by our beliefs no matter how trying or difficult that situation may be...


  • We are all unique so it is hard to say which is best for all. I was given a new drug many years ago that was supposed to be one of the least side effects they have ever made, but it felt like my head was going to explode and I felt so ill until the took it off me with a lot of form filling on what it did to me.

  • I have Paroxysmal AF since 1999,since 2012 I've been taking Flecainide,as

    "The Pill in the Picket" prescribed by my Cardiologist is 300mg ONLY when an episode of AF comes on,this works very well for me,and usually cardiovert

    Within a couple of hours,I really feel more secure,and never think of my AF between episodes,I also take another beta blocker,Rivaroxaban to help prevent stroke and other heart related medication,I must say all this keeps me well.

    Hope you find best information from your Cardiologist,I've been told by mine

    "To pick up the telephone and get a message to her,anytime I'm worried " so

    This helps a lot,very reassuring.

    Good luck.


  • Engmac.

    I forgot to say,I attend an AF clinic at my local hospital,where I see my Consultant,I live in Scotland,maybe care is different here,you could ask your doctor about this.


  • I was given a small dose of propafenone, 150mg twice a day, once I had had all the tests. That worked very well until this year when I had a bad attack of AF and 240mg of diltiazem was added.. The doctors in hospital were amazed I had had propafenone straight away but I am very grateful to the doc who decided on it! I think the attack this year was triggered by having two very nasty viruses at once which left me with ongoing problems.

    The consultant I saw in hospital said he was prescribing flecainide but when I queried it he promptly changed it back! And said he would like to prescribe bisoprolol but he couldn't (yay!).

  • 100mgs of Flecainide twice a day (no other drugs) stopped my Lone PAF straightaway - no episodes in 8 months.

    During this time though I have reduced stress level all-round, completed overdue dental work and maintained regular daily 2 mile walks but nothing strenuous not even tennis, no alcohol and more attention to the stomach. I have also started taking a Magnesium(with other good stuff in) supplement and CoEQ10.

    My cardio suggested in October I can try reducing my Flec to 150mgs (50mgs x3 per day) but won't be doing that until mid Jan after the supplements have had chance to work.

    I strongly believe certain people can use non-drug solutions, particularly if your condition appears to be governed by the Vagal nerve or perhaps more relevant to me the risks of an ablation are higher.

  • As others have said, everyone is different. I am 88 and on Pradaxa and digozin and have been for nearly 2 years. There has been no change in my irregular heatbeat but I am fortunate in not suffering from any problems with this Check ups every 6 months and my doctor says he is quite happy with this situation

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