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Tapanac profile image
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Hello everyone. I was on Bisoprolol and Flecainide from when I had a cardioversion about 14 months ago, then was told I needed an ablation although I felt great on the meds. Since the ablation last March I was told to cut down and come off both the bisoprolol and flecainide. I had a tricky time when the flecainide stopped, but since trying to cut down on the bisoprolol the palpitations, AF and ectopic beat have come back with a vengeance. So much so I ended up in hospital once more on Boxing day until day before new years eve. I have to see the EP tomorrow and I dread he says another ablation.

The reason for this message is that I have read in a couple of places that ablations weaken the heart. Does anyone know if this is true please?

Also when I was doing so well on flecainide did he say to stop it? One nurse said she thought that flecainide if had an ablation for Afib could cause Aflutter???????

I think I know why he said to stop the bisoprolol as my BP was something like 130/46 and pulse 39-44.

Try to keep well everyone

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Tapanac
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13 Replies
wilsond profile image
wilsond

Hi sorry to hear this. I have to say when i was taken iff bisoprolol ,I was given Flecanide by itseld,something I have read on here is not advisable.This is because it can cause other arrthymias,and indeed sent me into Atrial Flutter! Was put straight back onto bisoprolol AND flecanide...

I have recently weaned off both under Gps guidance as a)didnt like side effects of bisoprolol and b)had gradually felt worse on flecanide.One day I missed the daily dose and didnt have my usual 3pm run of heart shennigans,so thats when my gP and I went down tbe route of using both drugs as a pIP if needed.

I am on the list for ablation,but am not sure why,as I now have a great quality of life in tbe whole,and cant see how ablatio can improve that.

I do hope you find some amswers and hope this may have helped. Xx

BobD profile image
BobDVolunteer

Your main question if I understand correctly is does ablation weaken the heart?

Well in terms of what it can do to the heart muscle not much but it does create scar tissue on the surface (to block the rogue impulses) which can I suppose make it less resilient. Since AF itself left untreated and uncontrolled can damage the heart it is a question of priorities. For example, many people with AF when first diagnosed discover on echocardiogram that they have some enargment of the left atrium caused by the AF. Succesfully treating the AF in most cases allows this to return to a more normal size.

I know of people who have had four, five six or more ablations still in reasonable heart health so as they old saying goes "you pays your money and you takes your pick."

I would also add that nurses often though well meaning do not understand the condition and even many GPs fail to grasp many of the nuances of the condition so best to get your information from a reliable source such as your EP or the AF Association who's fact sheets are approved by NHS England and various medical bodies.

Tapanac profile image
Tapanac in reply to BobD

Thank you Bob. Trouble is I perhaps think too much and believe everything I hear or read.

pottypete1 profile image
pottypete1

Interesting regarding advice for stopping Flecainide.

I have had 7 ablations, my heart us pumping away and I have been told to keep taking Flecainide.

After 25 years of PAF I have been virtually AF free for 18 months.

The advice seems to differ significantly from one EP to another.

Pete

Tapanac profile image
Tapanac in reply to pottypete1

Do you take a beta blocker in conjunction with your flecainide as dr Gupta on his website advocates?

pottypete1 profile image
pottypete1 in reply to Tapanac

I used to take Bisoprolol. However I have bad conductivity as a result of which Bisoprolol caused me to have Bradycardia with me heart rate as low is 37bpm on occasions. I was therefore taken off it.

I seem to be OK without Bisoprolol. My only issues are nausea, breathlessness and ectopics from time to time. These symptoms are probably nothing to do with me either taking Bisoprolol or not.

Pete

Tapanac profile image
Tapanac in reply to pottypete1

Thank you. Stay as well as you can

KMRobbo profile image
KMRobbo

I had AF and was on flecainide for rhythm and diltiazem as the rate control.

I had a pvi cryo ablation which sorted the afib, but 7 days later developed re entrant atrial flutter, that my EPs registrar advised was not present previously and was very possibly promoted by the flecainide. I ended up having a second ablation, which is right atria, simpler ,less risky and more succesful on average 90+% rather than 65-70% for afib.

I have had neither afib nor a flutter since the ablations which were 12 months ago.

I am not a doctor but from my experience I have understood that flecainide alone can promote a high heart rate hence why often rate control meds are prescribed at the same time, however I got the impression that some people are more prone to this high heart rate, my self for example. When in afib I was 165 bpm resting varying from130 to 190bpm, and up to 240+ when moving. This was why they prescribed a high dose of diltiazem.

It sounds like you may be similar.

As to the heart damage, what type of ablation did you have? A pvi cryo is not really in the heart, it is in the "mouth" of the veins (there is a medical word for this but I forget it).

My flutter ablation was RF in the heart itself, but I do not think it has caused a problem, i am back running 6 miles twice a week. I am slower than I was but I am limiting my hr to under 155 so I would expect to be, plus I am 3.5 years older!

As Bobd advised, A Fib can damage your heart too.

I am sorry to hear you are still having issues, but if you just need a touch up in the work that has already been done, I would have it if I was in your position.

Best wishes

Tapanac profile image
Tapanac in reply to KMRobbo

Thank you. Would you believe I haven't the faintest idea what sort of ablation I had. The registrar talked to me first before I went in (ages afterwards) and he said that because there were so many places I needed (how they knew as I had never had anything other than an ecg, not even an echo) they would zap all round the heart???!!! The EP when he did it hardly said a word and then I saw no-one except a nurse whilst I waited lying flat. That was it.

I do hope you stay well. Did you have your's here in England? I suppose I just felt so well on flecainide that I want to feel like that again, but of course I was only on it from the Christmas until about July.

KMRobbo profile image
KMRobbo

Yes I am in Knutsford but had the ablation at Royal Stoke. I have recently been getting some "different" ectopics but these seem to have stopped again. Possibly just had a bug, which in normal pre afib times would not have been noticed, but we are all hypersensitive having had the afib.

I have been off all drugs since May 15 and it was brill getting off them he rate control drugs really screw me up.

How long have you had afib?

Tapanac profile image
Tapanac

I think I've had Afib for years, but it was only diagnosed last December 2017. I found Flecainide brilliant, but had an appointment at St Georges Tooting London today and EP said the last heart halter monitor showed up lots of ectopic beats and other stuff so he is trying to change meds otherwise it will be a pacemaker which he's not keen on, but he's not wanting to do another ablation as he said the one I would need was very abrasive and could be risky. No...I don't want that either!

I'm glad you're off your drugs and long may your health problems stay away. I would like to come off everything as well as I'm sure one tablet means having to take another tablet to counteract it and so on.

Best wishes

mj146yk profile image
mj146yk

my self have been on bisoprolol 10mg for 8 year as well as digoxin 250mcg daily having been diagnosed with atrial fibrillation in 2010 .this has helped my fibrillation attacks. getting more tired recently this may because of present age. Would not change these medication unless my

consultant recommends the change.

Maisie1953 profile image
Maisie1953 in reply to mj146yk

Thank you for answering Tapanac. You have also put my mind at rest. I am taking Bisprolol 10mg with Digozin. Feeling more at ease now after reading your reply

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