I was diagnosed with AF at the beginning of March, and have been taking Bisoprolol (at first 10mg, now 7,5mg) ever since... it does help keep my rate down, although I still have regular episodes (sometimes every day short a episode, sometimes 2-3 days without, bearable in intensity), my HR seldom goes above 110. Now I am planning a trip to visit family at the end of June, and recently found out that no travel insurance will cover any problems I may have with my heart while I am overseas, because it is a pre-existing condition... I was given a prescription for Flecainide (supposed to take 2x 50mg a day), but I haven’t tried it yet, as my symptoms are not so bad lately... My GP said I can also use it as PIP, but doesn’t it require monitoring the first time it is taken at a high dose? So my dilemma is the following: should I start taking Flecainide on a daily basis in the hope that it will keep my heart stable until I get back, or should I try it as PIP the next time I have a bad episode (but what if I don’t have a bad one before I leave? I really should try it at least once while I’m still at home and covered by my insurance)? I am quite worried about the side effects, and about reducing my Bisoprolol when I take the Flecainide...
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Funkygirli
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I believe there are companies that will cover people with AF and I was told stay sure was one of them. I assume the cover will be slightly more but can you put a price on peace of mind. I'm sure I've seen a post on here from a lady that has just returned from somewhere like Mexico
Unfortunately, this does not seem to be the case here in Germany... seeing as I was only diagnosed 2 1/2 months ago, no insurance company will cover me (I looked quite hard, there was one that covered if I had been without treatment and medication for 3 months, others cover if without treatment for 6 months).... I would certainly be willing to pay the price if I found insurance that covers AF, but it looks like I’m out of luck!!! I did not require hospitalization yet, so I’m hoping all will go well for the 3 weeks I’m gone, but having Flecainide would offer me some reassurance (if it works for me)....
You should really discuss this with your EP and get firm guidance on what you should take, how much and how often.
You are on a relatively high dose of Bisoprolol (a rate control Beta blocker). Flecainide is a rhythm control medication which can taken regularly and also as PIP. Some are not on a regular dose but find it works for them as a PIP alone. I am in the former category.
It is complex and every patient is different. Therefore despite the wide range of opinions based on experience on this forum, in my opinion you should seek the advice of your EP.
Pete
Hi Funkygirli, some good suggestions about travel insurance and it might also be worth typing "travel insurance" in the search box, top right of this page because it's a subject that regularly crops up. Regarding the medical issues, as you may know we are not medically trained so we cannot interfere with what has been prescribed by your doctor. However, we can share our personal experiences but you have to understand that we are all different and you must always follow your doctors advice.
Have you seen a cardiologist who has suggested Flecainide or was it prescribed directly by your GP. Because you say you have frequent episodes, to take it daily as a maintenance dose as suggested is normal. It was what I was asked to do and it worked for me. As far as side effects are concerned, Flecainide was not a problem for me, but I know others have had issues so it's really a case of take it as prescribed and see what happens. As far as I know, the reduction in your Bisoprolol dose should not cause any issues but you must seek proper medical advice. Hope this helps and that you resolve your travel insurance issues......
I think you should start a regular daily dose of Flecainide; as said already it is a rhythm not rate drug but I have also found it reduces HR a bit as well. I know nothing about Bisoprolol but you need a cardiologist's advice here as I suspect that will be reduced if you go onto Flec.
I did 10 months on flecainide 2× 50mg as rhythm control
I also had to take a rate control which was diltiazem 200mg. ( I DON'T tolerate bisprolol).
I don't like the effects of these drugs as they make me feel bad so I have had an ablation and am now off all drugs. However I came off the flecainide first (EP instructions) and only 3.5 weeks later came off the diltiazem. The improvement coming off the flecainide was minor. The improvement after coming off diltiazem was more.( So i assume now that most of my drug issues were not flecainide).
I was told not to use a PIP as I had very high rate Af(180 to 190 bpm) and the hospital cardiologist said it was better (easier?) in my case to keep me out of AF rather than to get me out of AF when I am in it.
You may be different but the only time I went in to AF when taking flecainide was the morning after I missed my evening dose!
I now have flec as a PIP but so far have not needed it . However I am advised my PIP dose is 200mg initially and another 100mg few hours later if it does not work. 300mg per 24 hours is max dose
If your GP has prescribed 2x 50 daily (and I assume this is taken morning& evening), I would think ( i am not a doctor) this is a maintenance dose You have been given not a PIP.
Thank you all for sharing your experiences! The EP pretty much gave me three options: remain on rate control only (Bisoprolol), switch to rhythm control (Biso + Flec), or ablation... she also left it up to me whether to take Flecainide on a daily basis or as PIP, as did my GP, they basically said I should decide for myself depending on how badly I’m suffering...
The thing is, if I were not going on this trip, I think I would opt to remain on rate control only, as my episodes are becoming shorter and further apart since I quit smoking and am taking Magnesium....
Would it be no problem to just stop taking Flecainide once i get back without rebound effects (unlike Bisoprolol)?
Hi I have recently started flecainde (since march) and it has totally got rid of my PAF before that on a low dose bisoprolol which was largely useless. Previously having episodes every other day for several hours at a time. I would give it a go.
Seeing as I am having an AF episode for the last 2 hours, I think I am going to go for a daily dose of Flecainide... I am supposed to start with 50mg twice a day, and reduce my Bisoprolol from 7,5 to 2,5 mg daily, so I guess 2x 1,25 mg... do the two pills have to be taken at the same time? I have been taking Biso after meals as I wasn’t tolerating it well on an empty stomach, but Flecainide should be taken on an empty stomach... would it be ok if I take Flec an hour before the Biso? As I mentioned before, I am also worried about a rebound effect if I reduce the Biso from 7,5 mg to 2,5mg from one day to the next, or does the Flecainide take care of that?
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