I had a successful ablation in March 2014, with trouble free recovery and lived a "normal" life until Jan 2015 - in A/E and admitted. They tried various drugs etc then flecainide 200mg which took 13hrs to work. was given flecainide as PIP but didn't need to use it. Scheduled 2nd ablation, which I had in May, but unable to cardiovert at end of procedure and tried to revert me with flecainide to no avail. I was brought in as a day case after a week and cardioverted then.
Taking Bisoprolol 5mg daily plus warfarin (for 3 month post procedure - & due an op on 28 Aug so coming off it 1 week prior)
Current situation
Checked and was given go ahead to book holiday so a 14 night cruise around the Med starting Tuesday. Got good cruise insurance so all set up to go.
But recently, had more ectopics (which everyone has) but impending fear AF will kick in as some fast runs. Decided to check it out with my chest strap past couple days. Monitor shows almost every 90 mins yesterday from lunchtime to bed time I had fast runs up 235bp (my cardiologist once check my monitor against there monitor and was impressed it was so accurate. The thing is, my heart rate was 49bpm, my norm, then the heart symbol started flickering and I watched the beats rise to 133-235. Episodes last 2-4mins then dropped but I was asymptomatic. Taking pulse at wrist or neck, it felt strong & regular about 60bpm. When I felt flickering in my chest most times nothing showed on monitor, when I had fast runs didn't feel them. On the positive side, I seem to keep dropping back into NSR.
Dilemma
So there is some activity still going on - 2 weeks until 3 month mark but most times I would really know. I am just starting to get worried I may have a big A Fib attack on holiday and can't remember what they told me about flecainide. I have 2 separate 200mg doses which I will take with me but from past history it may take a while to work or not work.
How long would you sit it out in an afib attack? Will take me chest strap if any severe episodes, when there is never any doubt it is AF, I will know rate and how long it is lasting.
Don't want to be put ashore and lose much needed holiday (work full time, both parents bedridden and dementia - Dad cared for at home by me & carers, plus operation in late August). I have no trips booked, just looking forward to wandering around ports & some sunshine.
Am attending pre op assessment tomorrow so am sure an ECG will be done anyway.
Am hoping I don't need to use any advice/info given but would love some pearls of wisdom fro those who understand
Thank you for taking time to read & hopefully respond
Gill
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yoyo_again
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I was only ever on flecainide for a few months as PIP. I had to take 300mg at the start of an event and no more for 24 hours. When I saw my EP he changed me to propafanone twice daily which eventually went up to three times and higher doses before my ablation started.
Hi, have no advice to offer im afraid but wanted to send you all my best
and hope you have a wonderful, restful, holiday you deserve it. Looked after
my dad with dementia and know how hard that is.
Hi Gill... just saw your message.
Firstly I would find out from your cardio/Ep or GP whether, in view of your recent heart activity, it is still OK to continue with your holiday plans. I am of course thinking of your insurance here. If you hadn't been monitoring would you have been aware of the unusual activity? On the other hand it is not long since your ablation so your heart will still be settling. Perhaps you will get some reassurance tomorrow at your pre op.
If you are given the OK then I would certainly go ahead & enjoy yourself. I have done a 14 day med cruise & it is fabulous. Keep well hydrated, don't get over tired & keep away from the alcohol ... well maybe just one!
On my last cruise ( June ) I intended to get all the info from the ship's medics on how they treat AF patients but missed a great opportunity with the Doc in my cabin ( ? ) ....administering an anti nausea injection as I was so ill with Norovirus. I was in no state to put him through the 3rd degree!! However I did speak to one of the nurses earlier in the cruise as I had seen ' cardioversion ' in the list of charges ( £ 250 I think ) I asked how they did this ... sedation ? ... she didn't know as she said they had never had to do one ! I noticed that airlifting off the ship was 5K .
When I went into fast AF on an earlier cruise I just relaxed in my cabin until we docked ... 40 hours I think. On reflection maybe I should have notified ship's medics.
Let us know how you get on. Sounds like you are really in need of a good holiday.
There's not a lot of agreement on flecainide as a PIP. My most recent instructions were to wait an hour and, if needed, take 50mgs and if no joy, take another 50mgs an hour later. I haven't tried this out as I have usually reverted to NSR or just taken 50mgs once and reverted. I'm not on flecainide as a daily dose.
Other people take a bigger PIP dose, and when I was taking 100mgs twice a day, I always took 200mgs if I woke with AF - i.e. my usual dose plus 100mgs.
The max dose in 24 hours is, I think, 400mgs.
I think if I was away for 2 weeks I'd want to have more than 400 mgs with me. A private appointment with your EP might give you instructions and a sensible forward plan.
My GP encouraged me to go travelling and I'm glad I took his advice. You came through unscathed last time. AF just has to fit in with what's planned and slapped on the wrist if needed with an appropriate slug of flecainde. Yes, do be properly insured. If AF crops up, just take it easy, take flecainide and don't bother the medics unless you really need to. Good luck!
In the past, used flec daily and PIP. Would wait and hope episode would pass. But then when I thought about risk of blood clot and unnecessary suffering, I started using PIP as soon as I was sure in an episode. In my country, insurance will only pay for a certain amount of medication. So my MD wrote a small prescription for extra PIP flec for trips or other unusual circumstances and I just bypassed insurance and paid personally.
Had a pre op appointment today for an operation in late august. ECG was normal & sinus rhythm and they have no concerns, to stop warfarin 20th Aug (3month post ablation) so full steam ahead. Haven't monitored by heart past 2 days, felt really well, Chest strap useful tool & will take on cruise but more important I listen to my body... I know when AF is severe or out of control. May pack BP machine to take on holiday, in case I need to take Flecainide, ut might need ditching pair of shoes - lol. Feel happier after speaking to consultant EP ( who I got through to as a fluke when I rang his secs) - he remembers me and was very confident re my stopping warfarin and holiday. So all is good at the moment. Had INR (venous) doen today & seeing GP tomorrow to set levels for next 2 weeks (would cost £56 to get it check on ship IF they have coag strips left!!)
Must be so easy for other peeps to just pack and go...aka my husband who needs little so I can poach some of his luggage allowance
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76 years old with A F
My recovery from my pulse field ablation April 15.
apixaban and hematuria 
3% Afib burden and proposed medication
breathlessness 
