AF Association
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Back Again!!

Hi Everyone, I am so disappointed, having an ablation December 2016 the dreaded AF has returned. I am giving Flecainide a go as "pip", just curious if anyone uses Flecainide as "pip" and if so is it successful? Do you have to take it for many days? I know we can,t compare but this is great to share our experiences, many thanks for reading...Caroline

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Hello Caroline, as you recognise we are all different but I am happy to relate my experience of using Flecainide as a PiP. I had my ablation back in July 2016 and apart from early blips all was well until last October 2017. Between October and January 2018 I had 5 episodes and each one was stopped using Flecainide PiP. On my doctors advice I took the maximum daily dose of 300 mgs within an hour of the episode starting and sinus rhythm returned. Fortunately no episodes for the past 4/5 months, but I am on the waiting list for a second ablation. The first was a cryoablation and it is not uncommon to need a second RF ablation to tidy up any loose ends!!.....hope this helps, but please be sure to follow your doctors advice.

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Hi Flapjack, many thanks for your reply, its great to hear "pip" works and indeed I will follow my Dr's advice! I have great respect for the medical profession, I have had great support along the way since experiencing AF. I hope you get a date for your ablation soon Flapjack....Caroline

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Hi Flapjack, I used to take Flecanide prior to having an ablation, and found it to be a most problematic drug. I never took more than 100mg at a time, then 100mg three hours later if it hadn't worked, and finally 100mg a further 3 hours later. Was very surprised you took 300mg all at once. I only once took the 300mg spaced out over 6 hours and the effect was so drastic I resolved on that day to have an ablation. Based on my experience I wouldn't recommend someone taking Flecanide for the first time as a PIP to take the maximum dose all at once based on my personal experience of the drug, as no two people will have the same reaction.

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I agree with the point you raise which is why almost every post of mine states (ad nauseum) that I’m not medically trained and my comments are based on personal experience. I was prescribed Flecainide as a PiP by a very eminent Cardiologist and he indicated that the high dose was necessary (for me) to jolt me back into rhythm - not unlike a CV. Taking the dose over time would dilute the effectiveness (again for me). The leaflet makes it clear that, for some people there can be a significant adverse effect and it recommends the first dose is taken in hospital under medical supervision. I was fortunate not to have any side effects, other than tingling around the mouth and short term constipation. At all times, medication must be taken as prescribed......

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Hi Caroline. I had an catherter ablation in Dec 2016. Had to use the PIP several times and never leave home without it. Luckily It has worked 100% of the time with being back in NSR in hours. My EP gave me an 80-85% risk of only having to have it done once. Time will tell if he was right.

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I was prescribed (albeit a low dose) of daily flecainide but with my GP's approval I stopped the daily dose and use it instead as a PIP. It has always worked within a couple of hours in the four episodes I have had in the last 12 months. I didn't have any side effects when taking 50mg daily but felt my episodes were so few and far between that I didn't need to take daily medication. My GP agreed.

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I used Flecanide both as PIP and as daily dose. I never had any issues with flecanide either way. Initially i only needed 100mg to convert. Later years it took 200mg and now Flecanide no longer works for me at all.

Anytime I used Flecanide I also took Metoprolol. I beleive it is not a good idea to use Flecanide alone.

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I had an ablation in January 29th and have just come off all meds. I have flecainide as a PIP but have never had to use it do far. My instruction from my EP is to take 200mg initially and if the AF does not stop in a few hours to take another 100mg but not to exceed 300mg daily.

I have previously been cardioverted by flecainide infusion, and also by 150mg flecainide in addition to the 50 mg twice daily I was already taking

Those 2 events were months before my ablation.

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I had cryoablation in 2016 but it caused a pseudo anyerism and I dread having another ablation so take flecainide as PIP and it works fine within couple of hours.

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I used Flec as a PIP successfully for several years - same as Flapjack - 300 Mg within one hour, on EMPTY stomach. First dose only after echocardiogram was clear & under medical supervision for 6 hours. My understanding is that 300 Mg is the normal dose when used as a PIP but you must NOT take anymore for at least 24 hours. Best wishes.

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Quick question: what do you do if AF starts after a meal? Wait a few hours till food is digested?

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Yes, I did.

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Thank you all for your comments, I am so pleased to say the Flecainide has worked, I took 2 tablets yesterday and now its gone!! What a relief I don't have to wait weeks for Cardioversion, not only am I very symptomatic with AF I find it very debilitating it also puts my life on hold! Having a quiet day today! Healthy Wishes to you all....Caroline

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I too 50 mg twice a day and it made my pulse drop to 44 so went to pip approach and it worked for a while but started having episodes everyday so am back on it 2x a day and so far so good

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My AFIB came back 20 months after my second ablation. It may be worth your while to get a touch up ablation after discussing with your EP, but in my case, the dreaded AFIB came back anyway. I tolerate Flec very well and now take 100 mg 2x per day. This allows me to proactively prevent any further AFIB events (for now) rather than doing a PIP after the fact. Seems to me that the goal should be to prevent AFIB so I (and my EP) are not big fans of PIP. If you tolerate Flec well, you may want to consider taking daily until you choose to have another ablation and have a successful outcome. .

In my case, my doctor has advised against a third ablation for now especially since Flec (and a concurrent tiny dose of Metropolol) keep my AFIB away (with the added benefit of no noticeable ectopics and a super smooth heart rhythm). You’ll need to discuss with your specialist as to what makes the most sense for you and your tolerance for FLec.

Best of luck

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I was told I could increase my 50mg twice a day to 100mg twice a day when "unstable" as a pip.... only had to do it once and it took three days.

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