Flecainide & ECGs

[secondtry]

Would like to know if any of you who are on Flecainide and your cardiologist or GP recommends an annual ECG.

I am on 200mgs/day Flec and neither my GP or Cardio seem to be bothered about an annual ECG to check the drug is not re-modelling my heart or for any other reason.

Thanks a lot

[Finvola]

Yes - I take the same dose of Flecainide as you and I get a cardiologist’s review every six months, including an ECG. He compares the trace back to previous ones and told me last visit that there has been no change in over four years. I assume he was looking at QTc intervals for change.

Incidentally, he told my GP that he wanted to monitor my ‘advanced anti-arrhythmic therapy’. For that I am very grateful. You are within your rights to ask for an ECG to keep an eye on things.

[secondtry in reply to Finvola]

Thanks Finvola, I will quiz my cardiologist next month on this.

[Funkygirli]

I also take 200 mg/day Flecainide, and my GP does an ECG every couple of months... or anytime I request it. I’ve never heard of Flec remodeling the heart, I thought that when it controls the AF, it also slows down the remodeling caused by AF... or am I wrong???

[Finvola in reply to Funkygirli]

My layman’s understanding is that Flecainide can prolong the QT interval in the heart’s cycle and that this can allow other arrhythmias to occur. I don’t know about physical remodelling - haven’t come across that except in articles about AF itself affecting the atria adversely.

Sorry, pressed post too soon. I too read somewhere that Flecainide can slow or reverse remodelling caused by AF, especially if it is able to control and eliminate it. Hope so anyway.

[secondtry in reply to Funkygirli]

No you are probably right, I can't point to a specific reference on any 'remodelling' risk, I just recall reading here, I think, that a regular ECG is a good way of checking all is OK

[secondtry]

Thank you ectopic1, my oxygen supply/circulation is below par so will discuss on my annual review with the cardiologist.

[Patient007]

I have an annual ECG at my GP Surgery. My Cardiologist said I could have it done there instead of going to the Hospital every year to have it done.

[Hidden]

The PIL for Flecainide states

‘your doctor will monitor your progress on a regular basis with ECG and blood tests, and may alter the dose if necessary’.

Annoyingly, it doesn’t give a suggested frequency or state which blood tests, though looking again at the possible side effects I would imagine at least an annual full blood count, potassium levels and liver function tests would be advisable in addition to at least annual ECG. Mine is currently monitored 6 monthly.

You should also visit an optician at least every couple of years to check any possible optical problems, which are rare, apart from initial visual disturbances many of us on here had during the first few weeks taking Flecainide.

Hope this is helpful

Pat x

[secondtry in reply to Hidden]

Thanks Pat, I imagine my GP will dismiss the PIL statement with ' oh they just say that to cover themselves'. I had my bloods done yesterday as much as the GP allowed incl your suggestions. Also good point on the eyes, my optician said you can get something (forgot what she said) on them when taking flecainide but she also said when you stop taking it (I wish!) it will go. Fortunately I don't have that issue.

[Kellyjelly]

Hi secondtry,

I was on flecainide 50mg twice a day for 12 years and I was never monitored by my doctor or a cardiologist. I did have ecgs during that time in a&e and a few times in the early days with the cardiologist but then he signed me off and I was just left with a repeat prescription. I used to always see on the back of the prescription the date of my patient medication review but no one ever called me or mentioned it, they just kept repeating it.

[secondtry in reply to Kellyjelly]

Thanks Kelly, good to know.