PIP users

[sarniacherie]

I have an appointment with my cardiologist soon and I hope some of the forum might be able to give me some feedback on PIP (pill in pocket). I have had PAF for 29 years and in that time I have been on many different tablets. At the moment I take a beta-blocker, Bisoprolol (1.25mg daily). This is the lowest dosage but my heart rate is always around 44 bpm. This leaves me feeling tired and generally under the weather. I had a check-up with my new GP recently and he was unhappy with my heart rate being so low and asked me to mention this to the cardiologist when I see him. My question is for those of you with PIP, does it work and do you have more AF episodes than when you took daily medication. Thanks everyone.

[Hidden]

Hello sarniacherie, I’m not really sure how best to answer your questions, but would not like you to think that you are being ignored!

Please bear in mind I’m not medically trained, so anything I say must be checked out with your Doctor. I had an ablation almost 2 years ago, but if I have an AF episode I take Flecainide as PiP and so far, it has worked well for me. With your heart rate at 44, I wonder if you should be taking Bisoprolol but you need to clarify that with your consultant. That said, many say you should only take Flecainide in conjunction with either a betablocker or a calcium channel blocker so again, you need to ask you consultant. I have heard Cardiologist’s say it is not necessary if using Flecainide as a PiP. It will be interesting to hear what others might say later in the day. Not sure that my reply is over helpful, but wish you well for when you see your cardiologist.

[sarniacherie in reply to Hidden]

Thanks for your reply. I used to be on Flecainide until the cardiologist changed it to Bisoprolol 8 months ago. He said he was taking me off it due to my age. I was 70 in February. I shall mention this to him when I see him in June. I appreciate you taking the time to reply to me.

[pottypete1 in reply to sarniacherie]

I have been on Flecainide for many years but also took extra as PIP which invariably worked but not always. I had to have many a DCCV.

For most of the time I was also taking 1.25mg of Bisoprolol but my EP stopped that as my heart rate was too low (Bradycardia).

Regarding the oft said statement that a patient should not take Flecainide without a beta blocker, in my case my EP is happy for me to just take Flecainide alone.

Pete

[Chris1945]

Your post has resonated with me in so far as the low heart rate is concerned. I was diagnosed with PAF 4 years ago and although cardiologist refutes it, I still think it's associated with digestion, but that's another topic! I was given 2mg of bisoprolol at the beginning and felt so light-headed on it my GP reduced it to 1.25 which I've been taking every since but my heart rate now is very low. Last afib episode I was aware of was 7 months ago and my Kardia gadget, has regularly been showing 'normal' ECGs...but recently, my heart rate has gone down into the 40s which means the Kardia unit can't provide a reading. Lately, I've been feeling a tad spaced out and not much energy so I guess a visit to the GP won't go amiss, but just wondered if anybody on here has had anything similar happen and how it was resolved.

[sarniacherie in reply to Chris1945]

Your mention of digestion is interesting. I have learnt a lot on this forum and many a post has dealt with digestion and the vagus nerve being a trigger to AF/PAF episodes. Dr. Sanjay Gupta, a cardiologist at a York hospital does some very informative videos on You Tube on all aspects of heart conditions. Having a low heart rate does result in light-headedness, tiredness and feeling almost zombie like. It is not a pleasant feeling and I will be mentioning it at my next hospital visit in a few weeks time. Seeing different doctors and consultants is not always the answer as they all seem to have their favourite medication. I have tried quite a few in 29 years!. Many thanks for your reply and good luck with your health. X.

[mjames1]

Hi, Your Kardia will produce a reading, it just won't analyze the reading if your HR is too low or too high. The ekg is still good and you can email it to your doctor and/or Kardia's analysis service if you want.

Jim

[Maureens46]

Hi Sarniacherie,

I too have PAF and take Bisoprolol 1.25mg daily I also use Flecanide as PIP.

So far the PIP has worked and returned me to normal rhythm. Like you I have a low resting heart rate of 45/50 beats and sometimes wonder if I need to take Bisoprolol at all. When I enquired with my EP he told me to carry on taking the Betta- Blocker, and I have to say my most recent episode of AF (two days ago) my racing heart rate didn't go above 80bpm. I can confirm that taking a PIP hasn't in any way increased my attacks. I regularly get two or three per week and am heading for my first Ablation on Thursday 24th.

I am 74yrs old and have had PAF for about five years and I get a little fatigued after walking daily but I attribute this to my age.

Hope you find this helpful

Mo

[sarniacherie in reply to Maureens46]

Thank you for your reply. I have had PAF for 29 years and no 2 doctors prescribe the same medication it seems to me. I get tired too and although I still have episodes of racing heart beat they don't get to the rapid rate they used to before I was put on Bisoprolol, so perhaps they do a job. Good luck with your ablation.

[KathFrances]

My resting heart rate is 50-54 and I only have occasional PAF so my cardio is happy for me to have PIPs instead of daily meds, other than anticoagulation. I've only had to use my PIPs - 2.5mg Bisprolol plus 100mg Flecainide - once and it worked within 10 mins.

[sarniacherie in reply to KathFrances]

Thank you for reply. We sound very similar regarding heart rate and occasional PAF. I am undecided whether I am safer taking 1.25mg Bisoprolol daily and putting up with a low heart rate and the tiredness etc it brings or taking a chance on a PIP. I will talk to the cardiologist when I see him next month. Look after yourself.

[KathFrances in reply to sarniacherie]

Just to add to this . . . my PAF is lone - no known co-morbidities. My cardio originally prescribed Bisoprolol daily. But when I questioned this and told him my usual resting heart rate, he said 'Oh yes, you're right, PIP would be better, you don't need a daily dose'. He's a very highly recommended cardio who deals with a lot of AF, so this shows me that medics can have a default setting for prescriptions which doesn't always take into account all of the individual's particular variations or preferences. Well worth researching and querying medical pronouncements, as medicine is an art as well as a science.

[sarniacherie in reply to KathFrances]

Good advice, thank you. I shall be asking the cardio a few questions when I see him next month!

[Flyer2820]

Hi sarniachererie

I have been on flecainide for about a year now for paf. I take 50mg twice a day every day, so not as a pip. I don't take Bisoprolol with it and never have, so it can be taken without a beta blocker. Bisoprolol did not work for me so the cardiologist put me on flecainide and some people take flecainide as a pip. If Bisoprolol is not working for you then let your cardiologist know. We can only give you our experiences, they are the experts.

Good luck for the future.

Regards Flyer.

[sarniacherie in reply to Flyer2820]

Thanks for your reply. I have an appointment coming up so I will certainly mention this. Keep well.