I was on Sotolol for a couple of years but had quite long episodes of Paroxysmal Afib a couple of times a month. The cardiologist changed me to 200mg slow release Flec and 3.75 Bisoprolol. All the annoying ectopics disappeared but I started having very brief episodes of Afib. This week I have had quite a few and this morning at 7am I went into Afib and am still in it. I have read on some sites that Flecainide shouldn't be taken with Bisoprolol and then a lot of EP's and Cardiologists do prescribe the 2 together. I am worried that I will go into persistant Afib if I continue to take this combination. Unable to get an apptmnt for 2 months. I have read that Flecaininde can cause Afib so I wonder while I am waiting if I should return to Sotalol.
Thanks for reading and any advice would be very welcome as it is very confusing with some dr's against combining these drugs and some insisting that it is a good combination.
xxxx
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Lilypocket
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You should talk to your doctor, but I am on both as are many many people.
I understand (but may be wrong) that Flecainide can also cause a flutter and that Bisoprolol is given at the same time to help counteract that.
When I started taking 100mg Flecainide am and pm I had a few episodes of flutter. They subsided after getting used to the dosage however. Per my Cardiologist - on the odd occasion now that I get AF or flutter I may take another dose of Bisoprolol if the previous dose was more than 8 hours ago.
Other members on here may know much better than me, but don't change your medications without first confirming with your doctor.
Thanks for your reply! It's not flutter it's definitely irregular heartbeat. Maybe I should stop the Flec and just take Bisoprolol to keep the speed under control.
Flecainide has the possisbility of causing other arrhythmias which is why it is important to take it with a beta blocker such as a bissoprolol. I Can't imagine why anybody would say this is wrong.
If your AF is getting more frequent and more prolonged this is not the fault of any dugs. AF is progressive and probably has done. Maybe time to think of ablation?
Please do not do anything without discussing with your treating doctor.
Thanks Bob! Well in fact it was on a UK site for Flec and in the list of warnings " do not take this drug with...." Bisoprolol was cited. Yes I have made an appmnt to see an EP in January as my cardiologist is very much " take drugs for life and live with it - many people do". This I know is true but I believe that Paroxysmal Afib which is not persistant/permanent has a good success rate with ablation. X
Successful ablation rates vary enormously - lots of factors - but generally the younger you are, the fitter you are, the more experienced the EP - then yes - a possibility.
Just bear in mind ablations don’t always work forever - it’s still a treatment rather than a cure and as one EP at patient’s day put it “We burn, patients heal - which is why we often have to repeat the procedure”.
My understanding is Bisoprolol is usually prescribed alongside Flecainide for reasons Bob stated.
Thanks for reply! Health-wise quite fit and a bit of arthritis in my hip. But walk an hour a day get up on a horse from Time to time and sing in a blues/pop/ rock band. I live in France and have a clinic a couple of miles away that specialises in arrythmias. I'm seeing an EP with 15 years experience of just doing that so I'm hopeful! X
Most EP’s recommend that a beta blocker such as Bisoprolol is taken with Flecainide to keep heart rate down in the event of Atrial Flutter. Propafenone anti-arrhythmic drug already has a beta blocker incorporated. Anti-arrhythmics can start Aflutter but I hadn’t heard of them starting AF.
Can you ring your cardiologist’s secretary, explain the problem and ask for advice ahead of your appointment? These are powerful drugs which may or may not suit you or you might need time to adjust to them. It isn’t a good idea to second guess and experiment without medical advice. Most consultants will respond fairly quickly to a phone call for help. Best wishes.
PS. By the way, I have taken Flec + beta blocker for over five years without problems.
None at all since starting Flecainide Lily. I combined it with all the recommended lifestyle changes and continue to hope it stays away. Fingers crossed.
Fantastic! I am otherwise pleased with my combined treatment. I suffered badly from ectopics -1000 a day that I could really feel on top of the Afib. Since I changed drugs the ectopics have gone ( the ones I can feel) and my QoL is better. But as Bob said above drugs only work for so long before Afib creeps back. Oh well can't complain when I see what some of the other members are struggling with.
Hi yes I know Flec can provoke flutter ( fast regular heart). But it can also provoke irregular heartbeats ( arrythmias) which is an unwanted side effect. Either way beta- blockers are necessary with Flec to slow the heart if either happens. But Flec is supposed to stop irregular heartbeats so it not successful in my case. But on a Flecainide site drug combinations to avoid mentioned Bisoprolol. Just wondered why. What a jungle! What is your story ( if of course you want to share it) XX
It all depends on what is wrong, normally bisoprolol and flecainide will benefit most arrhythmia, but not all and it could be a bit of trial and error to get it right. In my case they were not a good combination. Only the Doc can give the best advice based on their risk assessment of your condition. I can say that the flecainide morphed my arrhythmia into a dangerous flutter, then doc changed my meds by reducing my bisoprolol and staring on digoxin. this seemed to work. Following my ablation Doc thought I should continue with the meds but after a few months of trial and error (and ablation recovery) concluded that I should only take 1.25 of bisoprolol. Been good ever since. Do not change meds without Docs advice.
Hi thanks for your reply! Well in fact the Flec is putting me into more episodes ( albeit most of them brief) of irregular heartbeat than Sotalol. Which probably means I'm heading towards persistent. Don't worry I'm a stickler for obeying dr's orders 😛. The whole appmnt thing is so slow. I have made a rdv to see an EP but need a letter from my cardiologist which I'm not seeing 'til March. Were you taking these meds for Afib ? Has your first ablation worked? So many people on here have had several it seems ablations don't really work. Xx
Over many years my meds changed from 2.5 bisoprolol to 7.5 bisoprolol and at this does my arrhythmia often changed (I know now it went into Aflutter), when I was put on Flecainide I thought it was a wonder drug for 3 months, then went into a bad Aflutter. Doc recognised that it was there Flecainide and after Cardioversion changed it to digoxin which was good. Thankfully the EP put my top of the list for an ablation now 9 months later only on low dose of Bisoprolol. You will find many hospitals carrying out ablations many times a day all over the world, very few ablations do not work either completely or to significantly relieve symptoms and their getting better at it with more precise tools at their disposal. At the time of the ablation they carry out an EP study and only then will they know the detail they need to provide the right treatment, before this they work on the best information they have. The biggest problem is the wait, during which time you may not be getting the right treatment (as in my case). Please read the posts on my ablation and recovery, they may provide some information that may help or some indicators worth knowing to speak to the Doc about.
I live in US ... it’s simple to see your cardiologist ... same day appointments ... so much for socialized medicine ... can you not pay to see a cardiologist? I wouldn’t change anything without seeing a one, two months is too long ... ... my advice would be to go to a private clinic ... if you don’t have $$$, beg borrow or steal it! You must see a professional. We have one heart, one life and it’s precious ... I take sotalol with no problems and rare bouts of afib. I wish you the best.
Hi. I have been taking 75 mg Flecainide and 2.5mg Bisoprolol daily for PAF without a problem. I hope that you are able to get your meds sorted
Chemicals can cause all sorts of problems inside your body, and not even doctors know all what goes on inside your body. If you can, try this (works for me):
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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 (this is why all doctors agree that afib gets worse as you get older). 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?? I also found that strenuous exercise does no good – perhaps you make yourself dehydrated??
I'm pretty sure that Afib is caused by a gland(s) - like the Pancreas - or an organ that, in our old age, is not working well anymore and excess sugar or dehydration is causing them to send mixed signals to the heart - for example telling the heart to beat fast and slow at the same time - which causes it to skip beats, etc. I can't prove that (and neither can my doctors), but I have a very strong suspicion that that is the root cause of our Afib problems. I am working on this with a Nutritionist and hope to get some definitive proof in a few months.
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
PS – there is a study backing up this data you can view at:
Yes I have already seen this post a few times. I have pretty much stopped sugar and don't drink - just water or tea with no caffeine and haven't eaten meat for 30 years. Sometimes you just have to accept that Paroxysmal means just that 😊
Poor you. Really sympathise. Once took pill in pocket Flecainide while I was on bisoporol and was really ill for about three hours. Cardio nurses advised that these should not be taken together. Flecainide, in any case, does not help me for the AF. I have found best for me is slow breathing, alternating with glass of ice cold water and lots of burps. A consultant once told me that this probably works because the oesophagus is near one of the Nerves (forgotten name) that partly causes AF. Good Luck. It doesn't take much to send me in to AF. Recently it was a chest infection. As soon as I had sufficient antibiotic in my system, plus the former regime, I was back to normal. Good luck.
Hi thanks for your reply! I'm afraid there are no triggers and nothing converts it to NSR.( It stops on it's own) It can start at any time. So sugar, alcohol, tiredness etc are not factors. But that is what makes it Paroxysmal! Is yours irregular or is it ectopics? Xx
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