PIP

Never used PIP before. HR 105-115 for a couple of hours & feeling very dizzy.. Just waiting to see if it increases / rhythm changes, felt irregular at first, now seems more regular. At what point do others use PIP? I take 50mg Flecainide regularly twice a day and PIP is an extra 50mg. Don’t want to over- react

[jeanjeannie50]

Hi Archie

What is your normal heart rate?

Jean

[Hidden in reply to jeanjeannie50]

Hi Jean. Heart seems to be calming, currently around 90. HR usually around 55 - 60 resting.

[jeanjeannie50 in reply to Hidden]

That's good if it's calming down. Strange that you were feeling dizzy at that rate which is not overly high, but then your normal rate is fairly lowish. If the rate keeps changing from high to low, that can make you feel a bit odd. Such a nuisance this AF!

Did you try doing any deep breathing to bring the rate down and do you know what your BP was when your heart was going fast? I think as you've been prescribed an extra dose of Flecainide as a PIP I would have taken a tablet shortly after the episode started. Do you take a beta blocker with your Flec?

Has it left you feeling drained now, or are you o.k.?

Jean

[Hidden in reply to jeanjeannie50]

Hi Jeanjeanie, dizziness is one of my major problems since the AF began in July. I get ‘spells’ most days but was much worse during today’s short episode. They are considering a 7 day event monitor and/ or a tilt table test.

I did have a couple of episodes last year and again back in May where I had palpitations and nearly fainted - guess that was when the AF really began, though I put it down to stress / dehydration etc etc as they only lasted for less than 30minutes. Hadn’t even heard of AF then!

Have just started keeping a symptom diary. I don’t take a beta blocker as Bisoprolol took my HR down to 44 - Cardiologist says I mustn’t take it again. I don’t have any monitors at home, my BP is usually low side of normal. Have been doing deep breathing - very tired this afternoon - feet up, just relaxing.

[jennydog]

I discussed this with my EP last year. I said I waited to see if the AF abated. He said that was wrong. When I was aware of AF I was to take 100 flecainide within 20 mins with another 100 if it hadn't stopped 3 hrs later.

Max dose is 300 per day.

QUESTION for you to ponder: does a fibrillating heart get into the habit of fibrillating? Certainly my EP was anxious for it to be stopped asap.

[Hidden in reply to jennydog]

Thanks Jennydog, It’s a shame there’s a lot of conflicting advice eh? I’ve been told by Cardiologist ( not an EP) to wait an hour, take 50mg Flec, wait another 4 hours, then go to A&E if no improvement. As I’ve already posted, my heart calmed on it’s own after a couple of hours & seems to be NSR now. Didn’t take the PIP as rate not overly quick.

[jennydog in reply to Hidden]

I don't have a rate problem either. In AF I clock in at about 100 but the rhythm is horribly ragged.

Incidentally my EP was rated 2nd best in the UK in a recent Daily Mail feature about doctors who other doctors would consult so I reckon that his recommendations have value.

[Hidden in reply to jennydog]

Yes, when I was first diagnosed I hadn’t heard of EP as a specialism so consulted a Cardiologist, so I think all I can do now is wait and see if & how this develops. I have discovered I have acquaintances who have been stable on Flecanide, Bisoprolol or Sotalol or a combination for years, but can see that there are many others who have had to run the whole gamut of drugs/procedures

[KMRobbo in reply to jennydog]

A F begets AF! (I think that was Dr Gupta but happy to be corrected). The more you have it , the more you will have it.

This It appeared to be what happened to me.

I believe this is owing to atrial remodelling.

Regards

[jeanjeannie50 in reply to KMRobbo]

That doesn't sound like a saying of Dr Gupta's, more like BobD , but I may be wrong.

Jean

[BobD Volunteer in reply to jeanjeannie50]

Not a BobD original but been using it for many years.

[KMRobbo]

ncbi.nlm.nih.gov/m/pubmed/7...

I still think I heard Dr Gupta say it, but a search on Google brings up several entries for the phrase "AF begets af" the first is 1995 which is the link above.

Cheers

Mark