When to take a PIP

[ShimmeringLillyMae]

Hello everyone! I had my first heart ablation almost 3 months ago, I've been taken off all medications and I only take an aspirin a day, my Dr. said if by chance I go into afib again to take a couple flecainide, I feel my heart flip flopping or fluttering again but my Hr is staying around 80 most the time, I felt really anxious yesterday and checked my HR and it was 96 while I was just sitting.. My question, how high should the hr be before popping 2 flecainide and should I just pop 1 instead of two? How long should I wait before taking a pip? I'm nervous that it's coming back 😢

[Tikaneko]

About 10 days following my Ablation in July I ended up in hospital with a HR of 160, they did the usual monitored and gave me a bisoprolol to calm it. They gave me some to take away as a PIP and said don’t take it unless your HR goes over 100 for longer than 30 minutes. Don’t know whether that helps?

[ShimmeringLillyMae in reply to Tikaneko]

Yes, thank you!

[ShimmeringLillyMae in reply to Tikaneko]

What did they give you as a pip and how much should you take? I'm so bummed, I was so hopeful this would be cured but seeing all these posts seems it's never really cured 😢

[Tikaneko in reply to ShimmeringLillyMae]

They gave me 5mg Bisoprolol as a PIP, I take Adizem as my usual one. But Bob is right your rate doesn’t seem too high. It is frightening when this happens but stay calm and try not fret! I had my first ablation 1st July to be told that a I have to have it done again which apparently is not common.

[ShimmeringLillyMae in reply to Tikaneko]

I also had mine on July 12th , I wonder how long you have to wait to have it again? I actually feel like the ablation left me with a heavy feeling chest I'm hoping it will pass

[Tikaneko in reply to ShimmeringLillyMae]

Well I am on the list and is all she said was 4 to 6 months, I honestly thought it should be given a longer time to heal properly.

[kaiserloveoo in reply to ShimmeringLillyMae]

Hi I was told by the specialist that it take 3 to 4 months to establish if an ablasion was successful I also had one and have to wait 4 month for my hospital appointment

[wilsond in reply to ShimmeringLillyMae]

But it can be much reversed...I have been able to come off ablation list,and reduced meds from daily to PIP...don't give up... Reducing stress, triggers,massive diet changes...try it..? Xxx

[BobD Volunteer]

I think I would be more worried about the aspirin and no anticoagulant. Your rates are not high anyway as 60 to 100 is considered normal range. Stay well hydrated and try to relax rather than pill popping at this stage would be my advice.

[ShimmeringLillyMae in reply to BobD]

I am a bit worried about stopping the blood thinner but he said I didnt need it as long as in NSR and taking an aspirin every day, I was really sick on the blood thinners so maybe that's why 🤷‍♀️

[ShimmeringLillyMae in reply to ShimmeringLillyMae]

The flecainide I have is 50 mg, if I do go back into afib would you take two or just one? My EP made it sound as if I was cured and wouldnt need any of it again but I see that's not always true for most of us 😰

[BobD Volunteer in reply to ShimmeringLillyMae]

Oh if life were that simple! Different EPs have different ideas,. Here in UK aspirin is only used after stroke or with other caradiac disease, not for stroke prevention in AF.

[pottypete1]

Like Bob it never ceases to amaze me how different the advice is from one EP to another.

I would not be comfortable with only aspirin and expect to continue taking anticoagulants (not blood thinners!!!!) for the rest of my life.

It is now over 2 years since my last ablation and it was only really 6 months ago when things completely settled down.

I urge you to give it some more time.

Regarding PIP you should ask your EP what he/she thinks is an appropriate dose for you - we are all different.

For me it had to be 200mg. I do take 100mg x 2 each day anyway.

Pete

[hartbeast in reply to pottypete1]

I so appreciate your reply, pottypete1. I am 15 months post ablation and still have occasional AFib, maybe every month or two, although never as bad as before the ablation, and it always reverts either on its own (within 30 minutes) or with a Metoprolol Flecainide combo. I am only on blood thinner, and feel that I am getting better, however slowly. I may decide to have another ablation, but I wanted to give my body a good long while to heal, first. We are all so different, and just going by the statistical numbers isn’t the only way to make a decision (“3 months later and you had an episode? Have another one!”). The longer I wrestle with this thing, the more I realize how big the gaps are in what the docs actually know, vs what studies they’ve decided to trust and what studies they don’t.

[wilsond]

What is the aspirin for, more to the point? Not an anti.coagulant..aspirin is pointless for AFib and Flutter.

[Snowball66]

Hi hunny my son Louie is about to go in for his 3rd ablation has his first at 14 number 2 at 16, and now seventeen and waiting for his 3 rd any time now .Each time we thought it worked but around 12 weeks later got more attacks his gutted as wants to go to uni and just wants it gone his been put on flecianade now seems to have calmed things down x hope you get it sorted

Regards

Alison

[Snowball66 in reply to Snowball66]

He has svt with hr that goes at 220 bpm

[ShimmeringLillyMae in reply to Snowball66]

I am so sorry your son has to go through all this being that young, I pray this 3rd one will work for him and he can get off the flecainide, its definitely not any fun. (Btw I have a son named Louie also )💗

[brit1 in reply to Snowball66]

praying for Louie to be healed

[Mikededent]

Excuse my ignorance but what is a PIP?

[Fazerboy in reply to Mikededent]

Pill in Pocket.

[Mikededent in reply to Fazerboy]

👍

[Goldfish7]

Hi I'm not medically trained but have been on and off various PAFib meds for years. What I have experienced is that Flecainide is for heart rhythm problems rather than heart rate issues so is probably not going to directly affect how fast your heart is beating. However, if you are having a significant AFib attack where your atria are badly out of synch that will obviously affect your heart rate so I guess in putting your heart back into a normal rhythm (hopefully) Flecainide probably will lower your heart rate back to normal.

Dr's usually seem prescribe give beta blockers such as bisoprolol if it is primarily to lower your heart rate either as Pill in Pocket or as daily medication in my experience.

[dani777]

I am new here but I thought ablation was a cure. It must be so frustrating to think that after you go through this, you still have palpitations. What was the ablation like? Is it outpatient or do you have to stay overnight?

I finally had enough of heart flutters that lasted all day, and went to my GP and almost broke down, this was last week, and I told him I couldn't take it anymore, it was like torture, they wouldn't stop. So he gave me beta blockers, supposed to take 80mg a day but I was scared so I halved the dosage.

After just one half a tablet, my blood pressure plummeted after about an hour and a half. Normally, it's like 143 over 93. It went down to 105 over 69. Crikey. However, now that I've been on betas almost a week, it's not dropping as much although my heart rate sometimes drops a lot. So the flutters came back, so I think I need to increase the dosage a bit now. My guess is that my body got used to the medication and is now saying "i want more now".

But I am only prescribed these until they find out what's going on - the results from my echo and holter I'm still waiting for.

Do you know? we are designed very badly as human beings. I feel like a bad car these days that keeps breaking down and has one thing wrong with it after another. x

[Hidden]

Your Doctor is a moron. Try this to stop future Afib episodes:

--------------------------------------------

After 9 years of trying different foods and logging EVERYTHING I ate, I found sugar (and to a lesser degree, salt – i.e. dehydration) was triggering my Afib. Doctors don't want to hear this - there is no money in telling patients to eat less sugar. Each person has a different sugar threshold - and it changes as you get older, so you need to count every gram of sugar you eat every day (including natural sugars in fruits, etc.). My tolerance level was 190 grams of sugar per day 8 years ago, 85 grams a year and a half ago, and 60 grams today, so AFIB episodes are more frequent and last longer. If you keep your intake of sugar below your threshold level your AFIB will not happen again (easier said than done of course). It's not the food - it's the sugar (or salt - see below) IN the food that's causing your problems. Try it and you will see - should only take you 1 or 2 months of trial-and-error to find your threshold level. And for the record - ALL sugars are treated the same (honey, refined, agave, natural sugars in fruits, etc.). I successfully triggered AFIB by eating a bunch of plums and peaches one day just to test it out. In addition, I have noticed that moderate exercise (7-mile bike ride or 5-mile hike in the park) often puts my Afib heart back in to normal rhythm a couple hours later. Don’t know why – perhaps you burn off the excess sugars in your blood/muscles or sweat out excess salt??

Also, in addition to sugar, if you are dehydrated - this will trigger AFIB as well. It seems (but I have no proof of this) that a little uptick of salt in your blood is being treated the same as an uptick of sugar - both cause AFIB episodes. (I’m not a doctor – it may be the sugar in your muscles/organs and not in your blood, don’t know). In any case you have to keep hydrated, and not eat too much salt. The root problem is that our bodies are not processing sugar/salt properly and no doctor knows why, but the AFIB seems to be a symptom of this and not the primary problem, but medicine is not advanced enough to know the core reason that causes AFIB at this time. You can have a healthy heart and still have Afib – something inside us is triggering it when we eat too much sugar or get (even a little) dehydrated. Find out the core reason for this and you will be a millionaire and make the cover of Time Magazine! Good luck! - Rick Hyer

[ShimmeringLillyMae in reply to Hidden]

Thank you for all that information, I believe you are right abt the sugar and salt, I am going to try cutting out the sugar, I'm not eating much salt but I will try this because the medications make me so sick and not functional so I really dont want to be on them 😓

[Palpman]

Beta Blockers merely decreases the pulse rate and the strength of the beat.

A rogue pulse does not care about your pulse rate and will still fire regardless when in SVT.

If your normal rate is 60 or below then taking a PIP in the form of a Beta Blocker would put you in Bradicardia when the rogue pulse ceases to fire. This can cause you to faint.

[Palpman]

I have to take a 75mg Aspirin tablet daily as my blood is too thick and when I have tachycardia the blood can curdle in the Atrium and cause cardiac arrest or blood clots.

The cardio doc said it was like whisking milk to make cream.