Pauses with Flecainide

[DueNorth]

I've been on flecainide for a couple of years. I must say that it had limited benefit but I was ok with it. I had a bit of flutter that I think it triggered but it was fine.

More recently I've had a series of scary feelings of suddenly being about to collapse. These lasted 3 to 10 seconds (?) and I spontaneously returned to normal each time - thankfully. On one of these occasions I happened to be checking my pulse, which seemed to pause altogether for a few beats (4 or 5?). This wasn't an ectopic beat but a pause.

I eventually connected these pauses with the flecainide intake. I stopped taking it and the pauses stopped. I tried 50mg again during an af episode and it happened again. It only seems to happen with the flecainide.

My cardiologist says that flecainide shouldn't cause pauses but I'm not sure this is the case from things I have read.

Any comments / similar experiences would be welcome. Thanks.

[CDreamer]

Any substance you take that has the capacity to stop a symptom will also have a capacity to cause a symptom.

As far as I am aware the most common side affect of Flecainide is long QRS Syndrone which is why it’s not considered a good option for very long term use but I’m not sure you would experience that as a pause.

bnf.nice.org.uk/drug/flecai...

I would have thought that your cardiologist would be able to identify any changes to the QRS because of Flecainide use from an ECG - I know mine did and action was promptly taken.

What sort of pauses, how long? If you experience other symptoms you might be wise to go back and drill down further into what is causing these pauses.

What you describe could be something called SSS = sick sinus syndrome which is what my husband suffered from - his pauses lasted up to 9 seconds but he was hardly aware of them. It was quickly identified and he had a pacemaker inserted which immediately compensated - it only kicks in when the heart pauses.

However, if the pauses ceased when you ceased taking Flec then problem may be solved?

mayoclinic.org/diseases-con...

Hope that helps, obvious caution that I am passing on information learned from experience, not medically trained.

[DueNorth in reply to CDreamer]

Thanks for the reply. The cardiologist talked about sinus node efficiency and potential for a pacemaker if that was the cause, but, as you say, the link to flecainide would prove that unnecessary. It's one of the reasons I want to establish that a link is a possibility.

He never takes any tests as part of a consultation, which I find frustrating and don't really understand. So he hasn't seen a recent ecg. However, he's booked me a 48hr holter monitor for early January and hopefully this will help. However, I'm pretty sure he won't see any pauses unless I take flecainide during the test period.

Thanks again.

[Eirecara]

The same thing happened to me. I stopped taking fleicanide and the scary pauses stopped happening. ☘️

[DueNorth in reply to Eirecara]

Thanks so much. I was beginning to doubt myself. Just needed somebody else to confirm it as a possibility.