Onto Flecanaide...off bisoprolol...issues

[wilsond]

Had a suspected TIA recently,hospitalized,lots of tests,all ok.heart structure good,so candidate for flecanaide.Also put on apixaban,pleased to be on it.On statin and Spartan too.was on bisoprololfor 3years,taken off when given flecanaide.

My question is,I seem to behaving more AF events than before.Spoke to largely useless GP today..suggested taking flecanaide 1 hour before food to get best effect.is anyone else taking both bisoprolol and flecanaide?

Same GP didn't think it was worrying today that my home blood pressure machine was reading 170_80 over 130_40......I was about to go to A and E when it started to drop,now 140/90

Is it me or are we knowing more about our condition that GPs sometimes?

Sorry for rambling rant

[BobD Volunteer]

No it isn't you. Sadly too common but GPs have to know a bit about a lot of things. Who prescribed the flecainide? If the hospital then fine but often combined with a beta blocker. Rhythm control drugs are not usually prescribed by lower than consultant level and ideally should be started in hospital under control.

Re your BP machine. These are seldom accurate when you are in AF so best to be careful about worrying too much over readings. My doctors wanted my BP much lower than that ie below 130/75 when I was very happy at 145/85. Took me a while not to feel dizzy that low.

[wilsond in reply to BobD]

Hi Bob,flecanaide was prescribed in my hospital stay2 weeks ago,after suspected TIA.General cardiologist took me straight off bisoprolol altogether,as HR was 30_ 40

Since which had what I thought were extended AF sessions,hence post.However yesterday early am,was blue lighted into resus as son found me on floor ,HR high at 180...positive outcome,now under care of an EP at last,will attend his clinic while waiting for double ablation...they found AF and also Aflutter which may/may not have kicked in from Oceanside.

I take your point on home BP machines too.I didn't know they should be 'calibrated' every year...was told by pharmacist but didn't have more details .

Thank you Bob stay well!

[CDreamer]

Your GP is correct in advising to take Flec on an empty stomach, I only took it once after eating within an hour and it made me feel absolutely dreadful, very nauseous and dizzy,

I was lucky enough to have a very well informed GP when first diagnosed but sadly he retired a few. Years ago and I was recently in a meeting when the representative GP stated that there was no-one currently in the practice who could read an ECG so always referred to the hospital.

GPs tend to have special interests and if you are lucky enough to have one with a special interest in a subject it is an advantage, otherwise totally agree we can tend to be better informed and experienced!

Remember that any drug can have side effects and Flec can cause Arrythmia as well as help so if things don’t settle I would be heading back to see your EP.

[wilsond in reply to CDreamer]

Hi Cdreamer,had a hairy ride yesterday involving blue light trip to resus.HR of 180 knocked me out... Going home later.Anyway positive outcome,now at last seeing an EP after 4 years,back on bisoprolol,which I tolerate well apart from some dizziness to keep things even.I have AF and now also AFlutter.

Feel better for taking flecanaide before food,thank you for your reply,stay well!

[Hidden]

Hi I take Bisoprolol and Flecainide the latter twice a day. I take Bisoprolol at night now and think I feel less lethargic. Both prescribed by my EP

[wilsond in reply to Hidden]

Thank you Frills!after a hairy ride yesterday involving blue light ride,the outcome was that I am at last under the care of an EP so am happy about that.Thank you for your reply,stay well!

[Finvola]

I have been taking 2x100mg Flecainide and 1.25mg Bisoprolol daily for over three years and have been AF free in that time.

My EP says Bisoprolol is essential in my case as I get short runs of AFlutter caused by the Flecainide and Bisoprolol keeps the heart rate down.

Home BP monitors may give false readings if you are in AF - my Omron displays a wobbling heart icon. Taking your BP can also raise it - especially if the reading is surprising.

The best person to advise you would be a heart rhythm specialist - an EP (electrophysiologist). Best wishes.

[wilsond in reply to Finvola]

Thank you Finvola,after I posted this was blue lighted into resus ....mad heartbeat and unconscious!however,positive outcome.Indeed flecanaide put me into atrial flutter as well as AFbut I am now on bisoprolol as well as the other meds,am now seeing an EP in very near future and will be offered double ablation in due course.Close monitoring meanwhile.Thank you for your reply,stay well!

[Finvola in reply to wilsond]

Not a pleasant experience for you and hopefully the Bisoprolol will keep your HR down. Excellent news about the EP and ablation - as well as ongoing monitoring.

[wilsond in reply to Finvola]

Thank you

[drdang_20 in reply to wilsond]

I am a doctor by profession and also a patient of Paroxysmal Afib . Bisoprolol and flecainide can be prescribed together.

But it is important to check you QT interval every week of fortnightly. Flecainide is a proarrhythmic drug and known to prolong QT interval and cause arrhythmia itself.

[Hidden in reply to drdang_20]

I've been on both for at least three yrs only have yearly ecg at consultant checkup ??

[icklebud99]

Yes, I have been on Bisoprolol and Flecainide together. Bisoprolol caused me to many side effects so am now on Atenolol with Flecainide and feel so much better with no palpitations, fluttering or AF so far. Am waiting on my first Ablation.

[wilsond in reply to icklebud99]

Me too after a hairy ride yesterday,now waiting like you,full details in the thread above!thank you for your reply,stay well and good luck!

[Clarrie]

I was put on Bisoprolol and Flecainide and was getting episodes of AF every couple of days and heart rate dropped to low 30s so changed to Sotalol which suits me better.

[wilsond in reply to Clarrie]

Thank you Clarrie,that's something ill bear in mind,as I did drop right low at one point with bisoprololthank you for your reply,stay well.

[Hidden in reply to wilsond]

Hello there

I think you mentioned having a 24 hour ECG some time back. Was there any suggestion of heart block? I only ask because my mother had sick sinus syndrome (SSS) which caused her to have fainting episodes due to very low heart rate. She also had atrial fibrillation. At age 60 she was given a permanent pacemaker, digoxin and Warfarin. She was very active and bright as a button until a few months before she died aged 92 because of aortic valve problems.

You said your heart rate had dropped to 30. A beta blocker would not usually do that unless the dose was very high or you had an underlying predisposition to heart block. I expect SSS has been ruled out but it might be worth asking.