Flecainide and PAF

[President2012]

Hi

Last December I was switched from Metoprolol to Bisoprolol. I also take coversyl for BP. My cardiologist also prescribed Flecainide as a PIP when I get an A.Fib episode. I am to take one 100 mg tablet at onset and if the A.Fib still there after four hours I am to take another one. Last night was the first time I have had A.Fib since late November last year. I took one Flec but after four hours it was still there so took another. About three hours later I converted to SR. Currently my heat rate is very slow sometimes hitting 43, does anyone know if this is unusual? Thanks

[BobD Volunteer]

Probably not. Did your doctor also explain that your MUST NOT take more than 300mg in any 24 hour period?

[President2012 in reply to BobD]

Yes. Thanks. He also told me that if after the 2x100 did not stop the A. Fib I should go on one x100 mg morning and evening. To be honest I am a bit afraid of Flec but having said that I had little problem with it last night. Thanks for the reply

[jennydog in reply to President2012]

Your flecainide pip instructions are the same as mine. EP said to take 100 as soon as AF is evident.

Flecainide is my best friend. I ALWAYS have a tablet with me in my purse.

[President2012 in reply to jennydog]

Thank you all for your replies and comments. I went to our out-of-hours clinic last night. I was advised to drop my Bisoprolol from 7.5 mg to 5mg for two days to allow flex to leave the system and then go back to 7.5. Feel better today. No ectopics as yet. Thanks to all.

[Paulbounce]

I`m not sure P2012. However 43 is pretty low. I`m sure it will be OK though so don`t panic.

Would it be a good idea to call your GP - he / she might suggest reducing your Bisoprolol slightly for a dose or two until it resolves itself. I would give them a call and see what they suggest.

It`s great the Flec worked for you and you went back to SR. Some people are fans and others not (I`m a fanboy of Flec at the moment as it`s working for me). Be careful though not to exceed 300 mg in 24 hours unless you doctor instructs you otherwise.

Best,

Paul

[President2012 in reply to Paulbounce]

Many thanks. My cardiologist does not want me to go over 200 mg in a day.

N

[Rubymurray25]

My Sotalol would often get my HR down in the early 40's with a regular rate of 48/50 , I have recently changed to Flecainide following an ablation , but prior to that Flecainide worked well as my PIP; funny how we differ as I was told to take 100mg after 30 mins of onset of AFib and then a further 100mg after one hour, I guess we are each monitored individually which is reassuring. My current average HR is now 50/55.

[Flyer2820]

Hi President2012

I was on 100mg of Flec. Twice a day but after a bad episode of af a few weeks ago and being taken to hospital, the hospital cardiologist suggested I take 100mg three times a day. My heart rate often goes down to below 50bpm and has gone down to the early 40s. Touch wood this treatment seems to be working better at the moment but I am to see a cardiologist on 28th August. My doctor has put it down as an emergency. The hospital I was taken to recommend I have an ablation but if I continue as I am I'm not sure that will happen.

Good luck for the future. Hope all goes well for you.

Regards Flyer.

[Juliesk]

No it’s not unusual for the heart rate to drop when you take an significant dose of Flecainide.

I take a combination of Bisoprolol (2.5mg daily) and Flecainide (300mg daily). I had an ICD implant last year which doesn’t allow my heart rate to drop below 70bpm and this meant that they could increase the Flecainide and control my episodes.

If you’re only taking higher doses of Flecainide on a PIP basis then you’ll be aware of the side effect in future.

However - as with all responses - it’s based on personal experience. Everyone is different and you should speak to your consultant.

Good luck!

[President2012 in reply to Juliesk]

Many thanks. Am feeling somewhat better today. This was my first time taking Flec so,as you say, it’s a learning curve.

[Juliesk]

👍

[CHRISAF18]

Never taken it just as a pip after two trips ending up in resus I needed the reassurance that it wouldnt keep happening...so stressful so my cardiologist put me on 50 mg x 2 works well 3 years later. However now have ectopics top and bottom of my heart so on propranolol really helped, helps with anxiety too. However it can affect your memory as works on the brain hence helps with anxiety. My resting heart is 54 but can ve 49 so tiredness prevails. Best wishes

[President2012 in reply to CHRISAF18]

👍