They have a strong statement there that is quite worrying.
In a study of people who had experienced heart attacks within the past 2 years, people who took flecainide were more likely to have another heart attack or to die than people who did not take flecainide. There is not enough information to tell whether taking flecainide also increases the risk of heart attack or death in people who have not had heart attacks within the past 2 years. Because of this serious risk and because flecainide has not been shown to help people with irregular heartbeats to live longer, flecainide should be used only to treat people with life-threatening irregular heartbeats.
Tell you doctor if you have atrial fibrillation or atrial flutter (conditions in which the upper chambers of the heart do not beat effectively). People with atrial fibrillation or atrial flutter who take flecainide may have a higher risk of developing certain types of irregular heartbeats.
Talk to your doctor about the risks of taking flecainide.
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Andyt36
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I just know I didn't have ectopic beats until I was prescribed Flecanide. Was on it only 3 months have had ectopics ever since, 18 months continuously.
Just wanted to say I have never had a heart attack so the first part doesn’t apply to me but I have been on flecainide for 12 years and I haven’t had any heart attacks during that time. I was started on flecainide in hospital after a very sustained episode of AFib that wasn’t life threatening. My heart was checked for structural abnormalities and I was given it through an IV and closely monitored. I reverted to NSR within 3 minutes. I think this could be really scary to read if you have just been started on this drug.
Flecainide should not be prescribed for anybody who has any kind of cardiac artery disease. (MI is usually a result of blocked arteries to part or all of the heart) This is well known in medical circles so I feel the article is closing the door long after the horse went awol. When I started my AF journey such drugs were usually started only in a controlled hospital environment to check that it did not introduce unwanted other arrhythmias. Many people have angiograms to check for such issues as I know that I did.
So much stuff out there one must be careful what you read and why.
I think the statement reflects current practice and the NICE guidelines.
Flecainide is contraindicated if you have symptomatic coronary artery disease, that is angina or previous heart attack. It is also known to be pro-arrhythmic which means it can precipitate other cardiac rhythm problems, very occasionally serious in certain circumstances, and that could be said of any rhythm control medication.
It is not unusual for Flecainide to cause atrial flutter, and a rate control med, usually a beta blocker, is often prescribed alongside it to reduce the rate if atrial flutter does develop.
Flecainide can only be prescribed by a consultant, so it would be unusual for there to be any problem. I developed atrial flutter 150 bpm after my first dose but it settled without treatment after 8 hours and I wasn’t unwell. I had not been given a rate control med to go with the Flecainide.
I have to say that I went into flutter a week after being started on flecanaide,a new arrhythmia for me. I was then put back on bisoprolol alongside flecanaide as daily dose until recently.
I have come off both meds except as PIP,and feel better than for years. I think flecanaide is very useful for many people though.
I think its always been recognised as a powerful drug that may not be suitable for all.
IS THERE ANY ROOM FOR FLECAINIDE IN CORONARY ARTERY DISEASE PATIENTS?
The main precaution for flecainide administration is to rule out the presence of “structural” heart disease and/or ischemic cardiomyopathy in order to avoid the associated increased risk of proarrhythmia. This caveat was mainly formulated on the basis of the CAST results which demonstrated that flecainide is associated with increased mortality when administered in patients with prior myocardial infarction.
< Because of this serious risk and because flecainide has not been shown to help people with irregular heartbeats to live longer, flecainide should be used only to treat people with life-threatening irregular heartbeats. >
As you can see they have taken a statement from the coronary heart disease and tried to imply that it is encompassing atrial fibrillation.
I would follow BobD advice and just be aware of paucity of information.
I guess " I never promised you a rose garden". Some ailment will polish us all off. The literature does say only use for " life threatening arrhythmias" but I assumed my cardiologist had his reasons and it keeps me relatively symptom free apart from occasional short runs of regular tachycardia and ectopics which I have learnt to mainly ignore as I'm still here to tell the tale.9 years on flecainide and counting!
After a few fainting episodes while taking Sotalol for AF my cardiologist switched me to Bisoprolol and Flecanide - result three major Cardiac Syncope episodes in five days with complete blackouts. My GP, when attending the last one, told me to stop the Flecanide and things got better until further episodes a year later prompted hospital admission and a PMaker installed - result two years without faints or as many 'slow' mornings.
Have you had an heart attack or are known to be at higher risk of one for an existing condition?
If so I would not take Flecainide but i would be surprised if a doctor prescribed it in that case anyway. I have not had a heart attack but was on Flecainide for 10 months with no problem, until I had an ablation for my afib, and then 10 days after developed flutter which may have been caused by the flecainide.
That said if I ever get afib again I would take flecainide if I had to, as there are drugs with a lot worse side effects.
Also put things in perspective regarding heart attacks for people who have not already had one - lots of things are known to increase your heart attack risk: drinking alcohol , smoking, lack of execise, over exertion, being overweight, eating too much, high blood pressure or cholesterol /etc
-why worry about the flecainide in particular if this is an unknown risk?
Hi - drugs always involve trade offs between benefits and risks and hear earnings are always generic and worst case ( to cover various people’s backs) and not personalised but you are right to ask questions and you should ask them of the doctors who are treating you - and ensure you get to talk to a specialist not just a Gp. In case it helps - I was on flecanaide for some 15 years to treat paroxysmal Af - or possibly Persistent AF - that needed drugs to revert - never quite sure of the definition
Anyway I sometimes found the pills to work but often had to have IV in hospital under careful Supervision precisely because it is a strong and dangerous drug if misused or overdosed.
My EP explained all the risks and benefits of different drugs and we tried a lot - and this was the only one that did the job so it was a no brainer really. Betablockers sent my BP through the floor and didn’t revert me to sinus anyway and others had worse side effects
So in summary ask questions including re whether there are alternatives and ensure you get full and respectful answers
Sorry for typos I meant - these warnings are always generic not personalised. Btw I do have an enlarged atrium now probably as a result of the drug so I was monitored with an echo every year whilst on flecainade and in the end they recommended an ablation which I accepted. I have been AF free for 2 years though I gather from
Posts it might not be permanent but I was v unlucky and the operation caused me major problems in other areas because of a freak accident. So if drugs do the trick my view is stick to these!!
From what I understand that study was from the 1980’s and early 90’s. If you have heart damage or an attack flecainide is not for you. It’s safe for those with a fib, atfib, multifocal atrial tachycardia. That do not have any damage to their heart.
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