Reduction in Flecainide and PVC's - any advice please?

Morning all

I'm now in my third week of a reduced dose of Flecainide - down from 2 x 100mg gradually to 2 x 50mg. In that time I've had no AF or tachycardia but in the last week (on 2 x 50mg) have had several half-hour runs of PVC's, coming every 2nd, 3rd, 6th beat, singly and randomly. I could better understand if I had PAC's which are more related to AF but why the PVC's have gone from an occasional jump in the past to semi-organised runs is very strange.

Before I mention any of this to a physician, I would be interested in other people's experiences. Any comments from members who cope with these things, or have had similar experiences after reducing an anti-arrhythmic drug or post-ablation - would be most welcome. I do so want to stay on the lower dose of Flecainide and would rather put up with PVC's if they really are harmless and that is the price I have to pay!

For other members about to take the step of Flecainide reduction - I feel so well (apart from the half-hours!) and every day that passes means 100mg fewer of Flecainide through my system. Fingers are still crossed for all of us.

Any comments are very welcome,

Finvola

15 Replies

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  • I think that these are a natural result of reducing rhythm control drugs. I had similar problems when trying to come off propafanone. Stay with it as mine did reduce eventually although I do still get them from time to time.

    Bob

  • Thank you Bob - that is reassuring. I intend to give it my best shot.

  • I can't remember any problems with reducing flecainide, but I agree with you wholeheartedly (sorry) that the less you take, the better. Though it can do a wonderful things too!

  • My EP felt that the 2 x 100mg dose was showing signs of 'organising the signals', even though I was happy to be almost arrhythmia free. With the thought in mind that drugs may not be for me eventually, I'm keen to use them for as long as I safely can.

    I agree that Flecainide is a wonderful invention - it gave me back my quality of life.

  • Yes, I still use it if I really need to, but fortunately very rarely.

  • Thanks for posting this and I hope things work out succesfully. I am taking flecainide - 2 x 100mg daily - and I am hoping to reduce this.

    Are you also taking bisoprolol?

    The reason I ask is that when I started my flecainide my PAF episodes got a lot worse and things only improved when I was prescibed 1.25mg of bisoprolol daily as well. The two drugs appear to be working in partnership so it will be interesting to see what happens when I reduce or stop one of them. My instinct is to stop the bisoprolol before reducing the flecainide. Needless to say this will be done under guidance.

  • Thanks Craggy - I wish you well too with your drug reduction. I also take 1.25mg Bisoprolol daily as it was felt that a beta blocker helps to keep the rate down if needed, which might be why it helped Flecainide with your PAF.

    Certainly I have an unhappy heart at the moment - having a quiet read earlier this evening when a big PVC nearly kicked me out of the chair, then half an hour of heart two-step and waltzing, then back to normal rhythm.

  • Thanks Finvola, please let us know what your physician says. I hope to do the same next month and am not on anything else.

  • orchardworker - My EP today advised me to go back up to 100/50mg doses daily. Although I'm disappointed, the symptoms were becoming unpleasant - the ectopics were bearable but I had started to feel very wobbly-legged and breathless, tight chested and generally well below par.

    The good news is that in almost 3 weeks on lowered doses, I had no AF - so let's see what a prolonged time on 100/50mg will do . . .

    Best wishes for a successful lowering of your Flecainide.

  • Hope that works better for you Finvola.

    Two points: firstly having suggested to my cardio, to reduce my Flec, I should go to 50mg am and 100mg pm (as my AF was pm/night usually), he didn't agree & said I should have a constant dose as longterm irregular doses was not good.

    Secondly, as you can't get 25mg tabs I have got a pill cutter and intend on starting with 75mg am and 75mg pm.

    Hope to get to this soon but it's a slow process getting to an optimum position health wise first - incidentally good news today, my MRI result on the brain was all normal! I had been referred because I developed tinnitus in just one ear. Just got a bit more to do on the gastro side and I will be ready.

    It's a crazy balancing act, I don't want to be on Flec a minute longer but I am enjoying feeling normal and not keen on rocking the boat plus also I read here that one cardio had said the longer the period of no AF the less likely it will reoccur.

  • Excellent news about your MRI. I remember your post about unequal doses and will bear that in mind. Did your cardio give a reason other than not good?

  • He just didn't favour unequal doses and unfortunately I didn't push him on what his advice was based. If your EP has good reason to think it OK, I can raise it again as I am due for my 6 monthly appointment soon.

  • Thanks, I'll make some enquiries too.

  • I had a CV last week. I lasted 2 days in NSR, flipped back into PAF, last Tuesday. Now, pre CV I was on 15mg Bisoprolol a day. After the CV, they reduced the Bisoprolol to 10mg, but introduced Flecainide, 2x150. For those two days last week, my HR was at 60. However, I did not feel spectacularly better. Tuesday, dreadful and I stopped the Flecainide, of my own accord, Wednesday morning, and I upped my Bisoprolol to 15mg. I did tell the cardio this is what I had done. I have felt great this week, although in full AF, HR at 105, and people are telling me how much better I look.......make of all that what you will.

  • Short update: The PVC's mostly occur just before my Flecainide dose is due but have reduced somewhat in the last couple of days, lasting only a few minutes. Strangely, I can calm them down so that they stop by lolling on a recliner until the Flecainide kicks in but also a brisk walk across the mountain seems to get rid of them too. Can't figure that out at all! Still waiting for medical appointment . . .

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