What now, 300mg of Flecainide?

[Bee-Honest]

Less than a month since my last AF attack. Now intermittently going in and out of rhythm. Have had PAF for 17 years until now with a year or two between attacks. GP thinks I may be going into AF Persistant. Flecainide has been very good for me for about 13 years and laterly taking 200mg/daily, now having to take 300mg daily, which I believe is the maximum dose, so where do I go from herer, anyone have experience of other drugs being more suitable. Additional Flecainide upsetting my stomach.

[djbgatekeeper]

Have you thought of seeing a electrophysiologist and discussing your options? One might be to have a catheter ablation which tends to be the next step when meds are not doing their job.... Sorry to hear you are having a tough time..

[Bee-Honest in reply to djbgatekeeper]

Thanks for your kind reply

[pottypete1]

As djbgatekeeper suggests you should be seeing an EP, however I would be surprised if you haven’t already seen one.

For many ablation can improve your quality of life so this is a serious option that again I am surprised has not been suggesting to date. If this hasn’t happened then a good idea to investigate this option.

Pete

Pete

[Bee-Honest in reply to pottypete1]

Thanks for your kind reply

[KMRobbo]

I had an ablation in January and not had Afib since. I am 58. If i returned to afib i would have another one to keep of the drugs as i did not get on with them.

However if you had had only one AF attack a year and you were happy on the drugs with no side effects then i can see why you have not considered an ablation until now.

[ILowe]

Unfortunately, the range of drugs available is quite limited. I presume you are taking a betablocker with the flecainide? There is more scope to change that, both the drug and the dose. You could also ask about sotolol -- it works for some. The other thing you can ask for, at least in a hospital, is to have your flecainide levels checked. Google it.

I presume you are having at least yearly checks of the usual blood problems: urea, creatinine, Potassium etc. My notes say to check Potassium and avoid antihistamines (grr).

[Bee-Honest in reply to ILowe]

Yes I had a Cardiology clinic visit in March and was re-assured that everything was okay, at that time I was on 200mg of Flecainide, everything fine until again I had my flu jab a month ago and twice since then I have gone into AF. Hoping it settles again but rather concerning that a maximum dose needs to be taken to control it.

[Hidden]

I took 300mgs of flecainide per day for about 8 months and the things is, you can't take extra if it does not control your AF. Following ablations, I gave up flecainide and no longer take it daily at all now, and yes, I have intermittent episodes but they do self terminate and I can resort to pill-in-the-pocket flecainide if I wish. I use it very rarely as I feel, for me, the less I take of it the better. I realise the AF I get may be detrimental but it does not affect me too adversely and I just carry on at a slow pace and wait for NSR to return.

[pilgarlick]

I don't know if it's any reassurance for you, but I've had paroxysmal AF now for more than 25 years - I'm 76 - and manage more or less with a daily dose of 200mg Flecainide. ( I had an ablation which failed for technical reasons). Although I still have bursts of AF, they don't generally last more than a few hours and I can go for as long as a month at a time without an episode. When I do have more frequent attacks, I worry that the problem is getting worse ( or permanent) but it always seems to settle down again. AF doesn't particularly affect my life and rarely prevents me doing anything, so I am reconciled to this regime for life.

[Bee-Honest in reply to pilgarlick]

Totally agree with you. I have had PAF for 17 years, I am 67 and overall I have lived a normal life, everything in moderation. However with the two recent attacks I became very aware that AF could have a real impact on my daily life. I like to be out and about most days, I do a lot of charity work and generally enjoy meeting up with friends and family.

Today my heart has been mostly in rhythm, have taken it easy, so hopefully it will settle again. Thanks for taking the time to reply.

[dmack4646]

Is the 300mg keeping af at bay

[Bee-Honest in reply to dmack4646]

Yes it is but upsetting my stomach!

[dmac4646]

You should be able to get something to help that - I have had periods when I have had to go up to 300mg and was then able to come back down have been pretty regular on 2X50mg for ages since - may be something driving the af.. get tummy issue sorted and see how it goes.