Flecainide and blackouts

[President2012]

Hi. I am on flexainide as a PIP. Twice now having used it I converted to sinus but blacked out for seconds as I felt a rush to my head. My heart rate is 40. Anyone experience this. Love reading the experiences of other fibbers.

[Hidden]

Interesting. Ive taken flec as pip for a few years with no issue, take it twice daily now. Are you sure it is the drug and not the a fib? Have you asked your heart doc about it? That is scary. Hope it settles down for you.

[President2012 in reply to Hidden]

Thanks

For reply. It happens at the moment the AF stops. There is a feeling of blood rushing to my head and then comes the faint. I take 100 mg at onset and another 100 mg after four hours of not stopped. I have informed my cardiologist and have an appointment with him in early March. Glad it works for you.

[Hidden in reply to President2012]

Let us know what your doc says about it.

[President2012 in reply to Hidden]

Will do

[jesse-james]

hi I was on flecainide as a pip found it worked but made me feel light headed sick and just awful don't know what dose you take but I was on 300mg so what I did was take 100mg to start with then about 20 mins later take another and if still in a/f take the last one 20 mins after that

Hope this might help you x

[President2012 in reply to jesse-james]

Thanks for that. I take 100mg at onset and another 100 mph after four hours if it has not stopped. The second one stops it but I blackout for a few seconds for a few hours afterwards I have lots of skipped beats before I go fully back into sinus. The faints are worrying. Glad all good with you.

[doodle68]

Hi President what is your normal resting heart rate it isn't usually 40 is it.

I am being offered Flecainide so have been reading up on it and note that one of the requirements before prescribing it is that '' the resting heart rate should be greater than 70 bpm',' (mine isn't)

In your position I wouldn't take it again until you have consulted the prescribing doctor.

[President2012 in reply to doodle68]

Thank you that is interesting. My resting heart rate is around 48 which I consider low but my cardiologist does not seem to think so as it does not affect me. I am

Not taking it again until I see him.

[doodle68 in reply to President2012]

Hi President my RHR is in the high 40's low 50's as a result of taking beta blockers I guess but the Dr isn't concerned as long as I don't get dizzy spells.

On the plus side I am starting from a low threshold RHR when I have episodes of P-AF so it doesn't get quite as high as it used to .

[President2012 in reply to doodle68]

Many thanks

[doodle68]

...are you in the UK President, I am quoting from the NICE guidelines at 8.3 I will post a link if it works....

....Sorry link won't work .

[President2012 in reply to doodle68]

Thanks. No I am in Ireland though right now I am in Lanzarote for a week.

[Sabrina70 in reply to President2012]

Hi, not been on here for a while but I’ve been put on Flecanide as pill in the pocket. Not had to take it yet but this worries me as I’ve been prescribed 150mg and I’m off to the U.S soon

I have a fear of passing out on it.

[Buffafly]

Hi, I used to take propafenone (same class as flecainide) until I had a spell of flutter/atrial tachycardia so I had Diltiazem added, then I had a couple of spells of pauses which apparently can happen as an episode stops though mine seemed random, so I was offered pacemaker or ablation as I had to come off the meds. It sounds as though you have the pause that happens as your rhythm reverts to sinus.

[President2012 in reply to Buffafly]

Thanks

[Gowers in reply to Buffafly]

Interesting info re pause & sinus. Thanks for the info

[Tux18 in reply to Gowers]

I have had several pauses over the last couple of years usually when I’ve been in afib and converting back to sinus rhythm.

[Camelia23]

Thank you for the information. I have only just been prescribed this and shall be very careful when and where I take it.

[DueNorth]

Hi. I've posted before about pauses in my heartbeat while on flecainide. One thing I discovered in reading up around this was that it isn't unusual to have a pause of a few beats at the point of reverting to nsr. It sounds like you might be one of these people and that you have a pause long enough to cause a drop in blood pressure enough to experience a blackout.

I'd speak to my cardiologist as it's a known feature of af for some people, but my own experience is that the flecainide, if not causing this, certainly didn't help.

[President2012 in reply to DueNorth]

Thanks

[tunybgur]

Hi,

I am on Flecainide for Afib, 150mg/day and it works fine for me, I also have a low pulse rate, 45bpm.

I was talking to a retired doctor friend of mine who suffers permanent Afib and asked if he had tried Flecainide, he said he couldn't use it because he had a long QT interval, and it could potentially cause serious heart rhythm complications.

If you have an ECG the QT interval is normally noted on the printout, I always ask for copies of mine and have a big bundle at home....sad I know.

I'm not suggesting you have a similar problem but it demonstrates how subtle the effects of these drugs are on different people.

Perhaps you should discuss this with a cardiologist....understanding the details of an ECG is a very specialised skill.

Good luck.

[President2012 in reply to tunybgur]

Will do. Thanks

[Hidden]

It’s possible this is a syncope (the result of too little blood flow to the brain). It might be the product of the medication or the AF itself. 40 is quite slow. I would say that you should contact your doctor promptly for an evaluation.

[President2012 in reply to Hidden]

Thsnks

[Bob56]

I have had a couple of fainting episodes ( pre my ablation) at the point when I went back into NSR after a period of AF. I was told that it was quite likely it was a sudden drop in blood pressure as the heart quickly gets used to beating normally again. To put it in non technical terms, the heart is saying slow down while I adjust to the new regular beat, and does this by lowering BP. I’m often sitting down when I revert to NSR, and might not even notice a BP fluctuation, but it last happened when I was standing in a coffee shop, and I blacked out for a few seconds at the exact moment I came back into NSR. Fortunately, there was a para medic on hand very quickly, and he immediately picked up the low blood pressure. It lasted just a few minutes, and I was perfectly ok again.

Obviously, I can’t comment on other people’s experience, but I’m less inclined to think it’s the Flecainde. I was given the same explanation about dramatic BP variation by the consultant who saw me shortly afterwards so if I’m in the same position again, I know to sit or lie down and wait for it to pass.

[President2012 in reply to Bob56]

Thanks. That scenario makes sense.

I have PAF for 19 years now and never had this experience until I was put on Flec as a pip last year.

[Bob56 in reply to President2012]

I have had AF for a similar period but like you only started to get the dizziness more recently. However, I’ve been on regular Flecainide for most of that time so haven’t associated that with the fainting. Perhaps it’s an age thing!!

[DueNorth in reply to Bob56]

You hadn't just got the bill when you felt faint had you? It's known as Starbucks Syncope Syndrome

[President2012 in reply to DueNorth]

😂👍

[Bob56 in reply to President2012]

Yes, a £3 skinny latte is definitely pro arrhythmic!

[Bee-Honest in reply to Bob56]

Shouldn't be having coffee if you have PAF😊

[Bob56 in reply to Bee-Honest]

Strictly decaf for the last few years.

[Bee-Honest in reply to Bob56]

👍

[quanglewangle]

My AF was getting more obvious and I was switched from metoprolol to sotalol plus flecanide - and promptly started syncope faints and collapsing 3 times in 5 days. GP said (I was collapsed on the floor) stop the Flecanide and incidents stopped. After a loop recorder and a few more random collapses I got a pacemaker - hooray! All is now well and troublefree on sotalol alone. GP said he was aware of other patients having problems with Flec. But we are all different.....

[sfh3l]

Be careful with Flec, and take when you are somewhere with others around you would be my suggestion. For what it's worth I have Flec as a p.i.p. but was told to take it 'under supervision' when it was needed, owing to precisely the symptoms you refer to.

I did take Flec for a while as a supposed preventative measure. However, I suffered really embarrassing sweats and also nausea while I was on it. In addition, 'depression' doesn't describe the feelings I had - it was more an uncontrollable desolation that overcame me, without warning. Seeing as it did nothing to correct by background AF, I took the executive decision to cease taking it. Now it is just there to stop a prolonged episode, at which it seems OK.

Not a nice drug though, so be careful.

[President2012 in reply to sfh3l]

Thanks

[Gowers]

I felt unwell on Flec - feeling faint & sick. They told me to take 100mg in x 2 doses which helped but, in the end put me on the lowest dose of Digoxin & feel much better. Let us know how you get on at next appointment

[President2012 in reply to Gowers]

Thanks

[Flyer2820]

Hi President2012

40 bpm is quite low and is classed as bradycardia. I was rushed in to hospital last year with a heart beat at around 40bpm. It is possible that some people can stand a low heart rate at 40bpm but may be not you. My normal heart rate at the moment is about 52 to 54bpm and it does not worry me. So long as there are no side effects low heart rates are not considered life threatening by the medical profession but of course if you are blacking out then something must be done about it.

Good luck with your appointment with the cardiologist. Hope all goes well.

Regards Flyer.

[President2012 in reply to Flyer2820]

Thanks. I have no problem with a heart rate down to 48 but lower than that and problems start.

[CloudRunner]

I used to get this when I was on Flec. I actually recorded it a couple of times on my Kardia. It showed that, when going from AF to NSR, my heart would pause for up to 2 or 3 seconds. I showed the Kardia traces to the EP and he said that this was quite common with Flec and would only be of concern if I actually blacked out, which I never did. I did get symptoms as you describe though.

Needless to say I didn’t ride my motorbike whilst on Flec because of this😳

[kvmj]

My husband was put on flecainide by his cardiologist and converted to NSR. His EP decided that he should wear a monitor for 10 days. The cardiologist increased the dosage. While being monitored, my husband's heart stopped 3 times for a few seconds. They took him off the drug. He went back in AFIB then had an ablation and has stayed in NSR for the past 4 years.

[President2012 in reply to kvmj]

Thanks. Glad it worked out for him

[Rubyray]

A year ago, I was not on Flecainide but I was wearing a heart monitor for a month because of AF. At end of month I went into AF and blacked out for 8 seconds because my heart rate dropped to 38 bpm when I tried to go to normal sinus. I fell broke my ankle. I received a pacemaker on March 4, 2019. On flecainide and metoprolol now. No more AF or blackouts.

Heart rate stays in 50s and 60s.

[President2012 in reply to Rubyray]

Many thanks. Glad it worked out well for you.

[cpalmermn]

I also get close to blacking out when my Afib converts, and was not taking Flecainide. I think it’s related to the conversion, maybe takes the body a few mins to get blood pressure equalized after finding sinus rhythm?

Since starting regular Flecainide, my Afib Borden was reduced greatly and the conversion to NSR became less dramatic.

[President2012 in reply to cpalmermn]

Thanks. Let’s see what happens when I see my cardiologist. Glad you are

oK

[angeliks]

The first time I took flec as a pip I felt dreadul. Head between the knees stuff. Later the cadio nurses told me that was because I was also on a betablocker - which according to her you shouldn't do and, in any event, suggested I took it in future when I could sit down for a while. Since then I haven't taken it immediately when I have slipped into AF but at night before going to bed and this seems to suit me. I have been prescribed 300mg but once only. Otherwise I take only Losartan for the blood presssure

[President2012 in reply to angeliks]

Thanks. I was told you need a beta blocker

When taking flecainide. !!!

[OurCoach]

We have something in common as the same has happened to me. The last time I was standing when the blackout hit. I fell, hit the corner of a counter and fell to the tile floor. Woke up in a pool of blood. At the hospital a CT Scan showed a brain bleed. And the AF was on a wild ride. I was monitored by a dedicated nurse. I returned to NSR. Stayed overnight. Had a second ctscan and the bleed was gone. Thankfully. Had a third scan by a cautious doc and it was still gone. Three months later and I no longer take Propfapone as the pauses were too dangerous. The experience scared us all including all the docs who work with me. Now I just take half a metoprolol when an AF arrives and I return to NSR without the pauses or the drama or feeling dizzy. Note sure if this story is helpful or not. Good luck.

[President2012 in reply to OurCoach]

Many thanks. You had a tough time. I don’t remember this ever happening to me when I converted to NSR before I started Flec. In fact many times I did not realise I was back in NSR for a while until I checked my pulse. Glad you got sorted.

[Tux18]

Due to extreme weakness and overall horrible feeling I could not take flec , felt like I could pass out. Maybe having low resting heart rate contributed to this.

Wish it would have worked for me.