Flecainide

When I take Flecainide as a PIP should I take a betablocker at the same time?

[Hidden]

As I know you know Hylda, we are not medically trained but I was told it’s not necessary when taken as a PiP but very necessary when taken as a regular daily maintenance dose. Calcium channel blocker’s are OK too....

[wilsond]

I was told not needed when using flec as pip..but definitely as daily dose. Might be best to double check?

[Tako2009]

Hi Hilda. I take extra Flecainide as pip but not with a beta blocker. There is an exception (for me!) to this rule. Normally my heart rate doesn’t get above 100 during an episode - on the rare occasions when I do experience very rapid heart beat then I do sometimes add a low dose of bisoprolol. GP and EP both aware and ok with this for me.

I’m all for a Hampshire get together although I am planning to attend Mr Beancounters nosh&natter in September if it goes ahead! Liz

[Hidden]

Many thanks for your advice. I’m like Liz and my heart rate is usually in the 70s-80s when in Afib. Di

[pottypete1]

We are not medically trained and we are all different.

However I have done both and was told not to recently by my EP.

Over many years I have been taking Flecainide and also taking it as PIP. Because of this the dose related to the time of day can be critical as there is a maximum dose you should take in any 24 hours.

For all these reasons I recommend you talk to your EP and get specific individual medical advice from someone who knows your case.

Sorry it wasn’t a short straightforward response.

Pete

[Hidden in reply to pottypete1]

If only Pete if only! EP sent me back to Dr as I didn’t want an ablation, Dr says he doesn’t know a lot about AF, sent me back to hospital. Urgent appointment November!!! Di

[pottypete1 in reply to Hidden]

I note you live in Hampshire get yourself referred to Southampton General they know what they’re talking about there.

Pete

[Hidden]

Thank you, will certainly try. Di

[Hidden]

It probably matters what kind of a fib one has. I have PAF with RVR( rapid ventricular response) so in a fib , I might count my heart rate at 200, but my ventricles are really going 400. So in my case, I take Metoprolol with my flecainide.

[secondtry]

Hi Hylda, I am in East Hampshire and have always gone to RSC Hospital Guildford. My Cardio gave me Flec 100x2 per day without a beta blocker as my pulse is low (around 52) and my blood pressure 115/60. When in AF (over 5 years ago now) my rate goes to around 90 occasionally higher but only very briefly. He said I would be unwell with anything else and I have checked this with him twice! The result is that I have good QOL. So although I am in the minority, there are two approaches to this regular question.

I appreciate this does not answer your question. My limited understanding is that you need to have shown a stable history with regular Flecainide to follow my case and incidentally my cardio favours regular rather than PIP (which was my past preference).

Parting shot: If you can I would pay to have an earlier appointment than Nov

[pottypete1 in reply to secondtry]

Your symptoms sound much like mine.

Also I live in Hampshire. Prior to that 25 years ago I lived in Guildford and had a very good consultant but was referred from there to St Georges Tooting.

Since living near Southampton I have been looked after by Southampton General whose cardiac unit IMHO is second to none.

As another contributor said in this thread it is incredibly how our individual experiences differ and also the approach by different EPs is very different.

Pete

[secondtry in reply to pottypete1]

Yes Pete, I have read good reports about Soton.

[Hidden]

Flecainide is very much a hit and miss affair with me. Sometimes it works, sometimes it makes the beats stronger. I had put in four attempts at contacting arrhythmia nurse and finally heard from her Friday. She is going to talk to cardiologist re propafanone.

[LouBrig]

I am under an EP at one of the specialist cardiology units in Yorkshire. I take Flecanide as a PIP and have been advised to take half of 1.25mg of bisopropol furmate beta blocker at the same time to avoid the onset of atrial flutter.

[Sfhmgusa]

Hi there I have PAF and take 50mg of flecamide twice daily with no beta blocker. The reason for this it seems is, I am very sensitive to it and when not in afib my rate goes into the 40s even with half of a 1.25 Mg tab of Bisoprolol a day. This course of action for me was proposed by a consultant EP who I trust. I agree another doc visit seems a good course of action.

[tillymcgilly]

I take 2 x 100mg flecanide daily but no beta blocker as I have low blood pressure. I was told if I take an additional 100mg as a pip I should take some beta blocker but thankfully I haven’t needed to yet (history: 50mg flecanide twice daily still gave me AFib 3 times a week so v grateful this dose is working, 56 year old female with no other core morbididies)

[secondtry in reply to tillymcgilly]

Snap Tilly, all the same as me except male 66yo, can I ask 1) how long you have been free of AF on 2x100mgs Flec per day - I have been OK for 5+ years 2) Do you take any supplements or other lifestyle action that you think could have helped?

[1xrower in reply to secondtry]

Hi. Same here, and same age! No supps, just a lot of working out.

[secondtry in reply to 1xrower]

Mmmm a lot of exercise was no good for me skiing, tennis and running caused problems so now I limit myself to x2 daily Nordic walking and x1 per week walking basketball plus a lot of general exercise on my smallholding. Keep well.

[1xrower in reply to secondtry]

Hi there. I feel very fortunate. Performance has really recovered and doesn’t seem to affect AF. Just need to ensure I don’t overtrain. Using a Whoop to help with that. Be well!

[tillymcgilly in reply to secondtry]

Only been on 2 x 100mg since end of June, but fingers crossed not had full blown PAF since only a couple of flutters... don’t take anything else, tried magnesium but kept forgetting to take it and didn’t notice any improvement. Tried giving up alcohol, no improvement so drink plenty again!

[secondtry in reply to tillymcgilly]

My approach was to hit all bases on initial diagnosis - first was a Naturopath who said he treats all his AFers with a Magnesium compound (includes lots of other heart goodies like Taurine & Potassium) and CoQ10. I have been on this for 5 years along with no alcohol and no caffeine. I know this may sound a bit OTT but I feel absolutely fine and although I miss a pint and a coffee in the morning there is too much at stake! Hope all goes well.

[Nafi]

Hi , sorry new to all this . What is a pip?

[Hidden in reply to Nafi]

It stands for Pill in Pocket. Some people are very lucky and if they take a dose of Flecainide at the start of an AF episode they can stop it in its tracks. I took a dose yesterday morning but am still having an episode!!

[Nafi in reply to Hidden]

Thank you Hylda, not heard of that tablet one of the few I haven't been given...yet . Sorry to hear you are struggling this morning and hope you will feel better soon x

[Rubymurray25]

Reading all the above responses, it just reiterates in the main how different we all are and indeed how different the advice we get from the EP and Cardiologists. I was on Sotalol and had Flecainide as a PIP , 100mg after 30 mins of onset of PAF and another 100mg after an hour. I was never told either way about taking my Sotalol with the Flecainide, so I didn't take it as I knew it would still be in my system to a degree. Sometimes the episode would stop after one tablet of Flec, other after two and a couple occasions it didn't work so needed a DC Cardioversion.

[SMRM]

It's always interesting reading of others experiences. I'm a year post ablation and off all meds since May. But have now had 4 episodes since then - all resolved with Flec pip but it has taken longer each time for NSR to return (from a couple hours initially to over 12 hours). Not taking beta blocker with it but I have that as a question for my EP when I see him. Luckily I was able to schedule an appointment for two weeks from now.