Just looking for some advice, I have had daily ectopics for years now but have been free from AF for the last 18 months, I take Flecainide 50mg x 2 daily, the issue is that I am currently midway into a two week holiday and went into AF last night (no doubt holiday heart - I have not been overdoing it I’m my opinion)I took 100mg of Flec and reverted back to sinus rhythm after a couple of hours, I went to a local clinic just to double check that I was back in SR as I was finding in difficult to tell and they confirmed that I was, my question is, on the basis that my ectopics and this attack seem to happen when the flec is wearing off has anyone ever taken 50mg of Flecainide three times a day rather than 2, my cardiologist would not mind me increasing to 100mg twice a day if I needed to but think that the 50mg three times might be more effective - I will catch up with my cardiologist on my return but any advice would be appreciated - thanks - Karl
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karl1524
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In your position I would try it. You have already discussed going to 2x 100 daily with your Cardiologist. You are in a similar position to me and we both know not to exceed 300 daily.
I also have not had any Afib for 15 months of 100mg of Flecanide twice a day. I recently weaned myself down to 50mg twice a day. It has helped a great deal with the side effects. So far so good. I say the less you take the better.
Yes. I was on 100 mg twice a day and noted (after careful observation over a period of many weeks) that I would get many ectopic breakthroughs in the last 2-4 hours before I was due to take my next dose. When my EP raised my dosage to 150 mg twice a day, I tried taking 100 mg three times a day instead (I had 100 mg pills on hand anyhow and I was really curious as to whether this would work better for me). I experienced more pronounced side effects from the increased dosage, but the breakthroughs in that last few hours were almost entirely eliminated. If I had it to do over again, I probably would have tried changing the frequency to 3x without increasing my overall daily intake of flecainide.
When I needed the prescription refilled, I asked the doctor to write for 100 mg 3x a day rather than 150 mg 2x, and though I had to get past a disapproving nurse who screened the doctor’s emails, the doctor was happy to write the prescription that way.
I completely believe that my body just eliminates/metabolizes flecainide more quickly than some.
Thanks for reply, that makes sense to me, I have now changed to 50mg 3 times a day, although I still was woke by numerous ectopics at 3.45am, I just took it easy and they passed, Inseem to be ok through the day but wake up between 3.30 - 5am each morning and I cannot think what is causing this at this specific time - let’s hope today is better - cheers
Have you been tested for sleep apnea? If you have that, it could explain why the episodes occur during sleep hours. You may want to discuss with your specialist.
I had none of the normal sleep apnea warning signs, like a lot of snoring, but my wife noticed that I seemed not to breathe for long intervals of time while sleeping. When tested at sleep center, determined I was not breathing nearly 30 times per hour for an average of 30 seconds, and had one incident of going 51 seconds without breathing.
I am in US and both my cardiologist and EP are now saying that studies are showing a major connection between sleep apnea and flutter/fib. EP went as far as saying that for a person with sleep apnea the probabilities of an ablation being effective long term...with untreated sleep apnea...is about 10%. Cardiologist told me that he has observed that patients he has, which are confirmed not to have sleep apnea...or are treated with CPAP for that...seem to have long lasting results from ablations. He said that sleep apnea has become a major discussion item at cardiology MD meetings in the US...and assume other countries, as well.
And, of course the key question is whether treating sleep apneas early enough would avoid the arrhythmias entirely, and eliminate the need for ablations or Rx treatment.
Have been on a CPAP machine for about a month now, and have also noticed that both my systolic and diastolic blood pressures have dropped significantly, as well.
Interesting point, I don’t snore badly but often wake up as I can’t breathe and take huge recovery gasps of air - I will ask my GP to arrange a test - thanks
I take 100 mg 2x per day. No AFIB, no ectopics. I was hesitant to go up to this dose level, but I feel so much better after suffering ectopics for years and following two failed ablation.
If you go with 150 per day, you might want to consider 75 2x per day than 3x at 50 per day. The half life of Flec is long enough and you might get a better benefit taking a higher dose (ie 75) 2x per day (same total dose) It will also be more convinient than having to remember taking a mid day dose. Check with your doctor
Wow...gasping as you describe sure sounds like apnea...can't imagine your MD wouldn't want to send you for a test when you described that to him. The other thing the sleep study looks at is oxygen levels...think 90% or above is normal...mine were in low 80's at times due to erratic breathing...assume you may be similar. Assume the heart is then trying to compensate for lack of oxygen levels, etc and that may lead to arrhythmia issues.
Also, don't know if you have same issue, but my blood pressure has been creeping up over the last 10 to 15 years, for reasons that MD's couldn't really identify as I was watching diet, exercising, etc. I don't know if I can attribute it all to CPAP....but not sure what else would account for it...but my blood pressure readings, both systolic and diastolic have dropped about 15 to 20 points since starting CPAP about a month ago. I used to have higher blood pressure readings right after waking up than later in the day....and couldn't figure out why....assume it was caused by apnea which didn't exist later in the day. Now I have noticed that the AM readings are generally well within "green" zone and generally much lower than before.
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