Flecainide side effect control

[jwsonoma]

Is anyone taking bisoprolol,, digoxin or any other rate control drug just because flecainide could cause a rapid heart rate?

My BP and HR are already low due to exercise and Bisoprlol and other rate reducers drops my resting HR into the low 40s and I find the associated fatigue crippling so I won't take it.

He now wants to add Digoxin to take with Flecainide(150mg/day).

I haven't read anything about taking a rate control drug just incase Flecainide puts you into VF.

My Kaiser cardiologist wants me to take one even though I have had no AF in the last 3 years? Kaiser tends to be Rx heavy.

Any comments will be greatly appreciated.

[CDreamer]

I am assuming that you are unhappy with his advice? Has he explained to you his reasoning?

It would be unwise for us to comment on his advice however if I am unhappy with a suggested treatment I try to drill down into the reasoning of the suggested treatment and if it seems to me to be a logical and reasoned suggestion to help my quality of life - then I am prepared to give it a go. If not I refuse.

I have been know to upset some cardiologists because I have asked for explanations and refused their suggested treatments because I wasn’t swayed by their reasoning and sought second and third opinions - and both of us have been much happier with the result. I have also found that many very skilled and knowledgeable consultant are very happy to be questioned and for me to seek a second opinion and we get along very well - but I still decide what I put into my body.

[CDreamer]

PS - I took Flecainide as a lone treatment for a few years and was fine BUT I took the first dose under medical supervision and monitoring.

[dmac4646]

Have heard of Bisoporol being used with Flec but not Digoxin - if you are unsure I would ask a bit more.

[jwsonoma in reply to dmac4646]

Thanks CD Dreamer. I had to go into the ER for 4 hrs to start Flecainide as well.

I have read the associated arrhythmia mostly occurs with IV flea. and in the first few months.

I have been reading up and this board seems the best place to look for Leeds.

Regards

JW

[Finvola]

That’s an uncomfortable-sounding heartrate, jwsonoma and must make you feel bad. In your position, I would read up as much as possible and prepare a series of questions to put to your cardiologist.

I take 200mg of Flecainide daily and was told by my EP that Bisoprolol was essential in my case as I get occasional runs of AFlutter, brought on by the Flecainide. He explained that the Bisoprolol helps to keep the heartrate down during these runs. I asked if I could take it as and when AFlutter started but he said it was too risky to let the AFlutter get started.

You may find this article of interest -

medsafe.govt.nz/profs/PUArt...

Best wishes with your quest

[jwsonoma in reply to Finvola]

Thanks Finvola.

Having not had an incidence in over 2 years I don't see why he would want me on.

This board defiantly helps my research.

Regards

JW

[Redders]

I am taking 50mg twice daily flecainide and have been put on digoxin 1.25mg one daily. My heart rate went up to 150 so that is why they put me on digoxin. I’m in af all the time and a very upset stomach. Don’t feel well at all so will need to ask my doctor if it’s the meds.

[wilsond]

Yes I take bisprolol,because Flecanaide 100mg twice a day put me into Atrial flutter as well as AF.

I would suggest be guided by your specialist but ask as many questions as you need to. I had to adjust the time of day i take the bisprolol,now take at night and its not as fatiguing.

This is a personal perspective of course,and you may find it different.

Best wishes

[jwsonoma in reply to wilsond]

Thanks Wilsond

I have been + 2year with out a problem and have had a 7 day HR monitor on each year.

I will prepare my questions

Regards

W

[rosyG]

I think calcium blockers can be alternatives to beta blockers when you are guarding against flecanide’s ability to allow 1 to 1 conduction to ventricles. Worth asking your doctor about but don’t change without medical advice

[jwsonoma in reply to rosyG]

Thanks rosyG

I appreciate the comments.

I need all the advice I can get so I can ask enough questions.

My concern is taking another heavy duty med when I have had no events in 2 years and I have had a 7 day HR monitors each year showing all clear.

I will prepare my questions

Regards JW

[rosyG in reply to jwsonoma]

I can understand that. Do you think you haven’t had episodes because of the meds you’ve been on?

[jwsonoma in reply to rosyG]

A few things have done it. I cut alcohol consummation from a beer and large wine daily to a couple of drinks a week. I now drink wine like you would drink whisky and I always pour out 1/2 the bottle of beer. I dropped my BMI from 24 to 18 (for me 25lbs). The doctor said both were huge factors and I may never have another event.

[rosyG in reply to jwsonoma]

That’s excellent well done

[KMRobbo]

Yes I take diliazem (calcium channel blocker) as a rate control in case the flecainide causes me to be in rhythm but at a very high rate. I cannot tolerate bisoprol or Attenonol another beta blocker although the latter is far less of an issue for me than bisoprol. Diltiazem 200 mg daily is not great either as it gives me brain fog and limits my HR to 137 bpm max which for me is 9 min miles or slower, the main problem being to even do that takes so much effort. Still better than bisoprolol though. 120mg diltiazem is quite a bit better for both side effects but owing to some issues I had the doctors dont want me on the lower dose.

I have had an ablation and due to be off both drugs shortly anyway.

[jwsonoma in reply to KMRobbo]

Thanks KMRoobo,

I will be talking the the pharmacist about side effects then the Doc.

Regards

JW

[Spiritji]

If you are in Kaiser by Sonoma Dr Turk great cardiologist is in San Rafael and Petaluma. He helped me a lot. Now taking Diltiazen for rate-and Pradaxa blood thinner. When I met him I was on digoxin so took both for some months and then he recommended I go off the digoxin which Inhad been on for a few years. When I stopped taking it I became extremely exhausted like chronic fatigue level and I never really knew for certain what that was but thought had something to do with going off the digoxin or taking at same time as Diltiazen..... now seems fine other than my primary says my heart rate too high and Maybe have to up the Diltiazen which I don’t want to do so will get into Dr Turk eventually.

Good luck

[jwsonoma in reply to Spiritji]

Thanks Spirtjl,

How did Dr Turk respond to your side effects which sound pretty bad?

[Spiritji in reply to jwsonoma]

Good question I was so on “one cylinder” not even remembering But I do feel he takes care not to over prescribe and told me some compelling story in a subtle way no pressure way that coaxed me on to the blood thinner.....I asked the nurses who was the best cardiologist and they recommended him..... curious if we are meeting on the English group but you are local

I need to go in myself

[CDreamer in reply to Spiritji]

We have people from all over the world and I know many just read the posts as post themselves - various reasons.

Isn’t it so fantastic that we can all share experiences and knowledge, even though we live so far away!

Quite a few here meet up occasionally - Ian’ Nosh & Natter, Bob’s lunches, Rosy’s support group. Support here is SO helpful and every post and comment helps someone else who can’t or won’t post.

[Spiritji]

My Diltiazen is 120

[Dottilind]

Hi hope you are feeling well at this moment. I was on Biso for ages but only small dosage as it lowered my heart rate and it went down to 38 resting. I now have a pacemaker as there was nothing else they could try me on. My biso is now higher dosage but feel fatigued at times but fingers crossed not had an episode of AF since December when pace maker was fitted. Not a lot more I can tell you really but beware if offered Amiodarone, shocking med that is.

[CDreamer in reply to Dottilind]

How are you finding the pacemaker Dottilind? I am on waiting list.

[Dottilind in reply to CDreamer]

Hello C Dreamer. I find it ok but a bit uncomfortable to lay on left side but no pain or discomfort otherwise. It was a last resort for cardiologist as everything else had been tried but I was not a candidate for the other wired procedures. I must warn you that you are awake all the time but obviously the site is anitheatised ( sorry for spelling) it is painful I will not lie to you but I had two wires attached to heart so more pulling and pushing. But it is worth it in the end, takes about hour and half. Good luck and hope it is sooner rather than later then enjoy the rest of your life. Why are you having it done?

[CDreamer in reply to Dottilind]

QOL - no emergency I’ve had 2 ablations & 3 rd too risky as I am very high risk for sedation. I can’t take any rate or rhythm drugs period. My HR generally in & out of AF varies too much -between 40-130 & I get very fatigued & it causes my Mg to flare. My EP wants an aethetist present in case I need to be intubated even with a local as I can react. Ablation of the It will be 3 leads 2 ventricular & 1 atria so ventricular will be isolated. Then ablation of the AV node 6 weeks later.

I’ve been warned about the pain but told it will only be for short time & if I can’t cope I can have morphine.

[Dottilind in reply to CDreamer]

Hi C Dreamer, it seems we are in the same boat. I went on to Flecanide but I was so tired I could hardly put one foot in front of other some days. So another med hits the dust. Anyway I hope all goes well as I said and wish you luck. I had morphine but alas it did not help me at all , but its soon over. Take care.