Ablation then Cardioversion and conflicting Flecanide prescription

[Max501]

Hi, I joined the forum late last year and have to say it’s really great to read the posts and get peace of mind from other people’s experiences.Quick question if possible ? I had an ablation for A fib and Flutter in October, had some mild irregular beats over the past while and understand it’s normal to experience these for a period to allow the heart to heal etc...however late January had a mix of a fib and flutter lasting for three hours and then on Tuesday of this week I ended up going into AFib and not coming out of it, so much so that I ended up having a cardioversion on Wednesday, heart was all over the place..... finally the question )))). I’ve been put on flecanide 100mg twice a day but when reading the leaflet it states not to take if you have many conditions and I believe one of them looks like cardio version ...I am taking it but wondered if anyone has a view on this ..? My Ep directed me to take it along with my other meds, he couldn’t do the cardioversion so had a colleague do it instead and his colleague said not to take flecanide under any circumstances and for me to not take one of my BP tablets either ... I addressed this yesterday with my EP and was told to do what he had recommended ...

The saying doctors differ...... comes to mind ..

Sorry bit of back drop , I’m a 48 year old male and first experienced AFib a couple of a years back

Thanks in advance

[jeanjeannie50]

Welcome to the forum Max.

I must say I've never heard of anyone having to stop taking Flec after a cardioversion. I've had lots and never been told to stop. In fact it's always stressed how important it is to keep taking this drug. However my EP, who discharged me from his care a few years ago, recommended that I try to keep the dose at 2 x 50mg daily and not 2 x 100mg, even if it meant increasing my dose of betablocker. It was as though he really didn't like that drug and thought it harmful.

Yes, medical opinions certainly do differ.

Just looked at my Flec instruction leaflet and some of the things it says amongst others are:

Do not take if you:

suffer from conduction problems of the heart such as a slow or fast heart beat or heart block

have rapid and irregular heart beat (long standing atrial fibrillation)

Have highlighted where they have It's all a little worrying isn't it?

Jean

[jeanjeannie50]

I guess someone will come on here and pooh-pooh reading the instruction leaflet, but I think it's important to read about and understand what your taking.

[Max501 in reply to jeanjeannie50]

Hi Jean

Thanks for your response, it is a little worrying alright, I normally don’t bother reading the leaflets but my pharmacist recommended I do with this one... just to keep us paranoid I’m sure ..😅I’m going with my EP and taking it as prescribed ...

cheers

Brian

[jeanjeannie50 in reply to Max501]

It's all you can do really. Good luck.

[Hidden in reply to Max501]

My EP kept me on a daily maintenance dose of 2 x 50mg for six months after my ablation. Very often they prescribe rhythm drugs for a few weeks either side of a cardioversion to help the heart maintain sinus rhythm. I think you are right to follow your EP’s recommendations, but regular doses of Flecainide should be taken in conjunction with either a betablocker or calcium channel blocker, good luck.

[Max501 in reply to Hidden]

Thanks yes I am on verap also so makes sense

Cheers

[BobD Volunteer]

I think it is important to understand that flecainide is a powerful drug which is outside the prescription ablility of GPs. This drug is normally prescribed by consultant level (EP) after consideration of general heart condition and used to be started in a hosptial inviron. It should not be given to anybody with cardiac artery disease. We are not medically trained but recommend that you follow your EP's instructions.

[Max501 in reply to BobD]

Thank you for the info.. will definitely be following my EP’s advice 👍

[Chris1945 in reply to BobD]

Hi Bob, that's interesting what you say about who can prescribe Flecainide, since the onset of PAF 6 years ago when A and E put me on the drug, my GP has always prescribed Flecainide for me to take if my (always nocturnal) bouts of AF kick in.....a dose comprises of 3 tabs of 100mg and it does the trick for me, I'd hate not to have a dose on hand!

[BobD Volunteer in reply to Chris1945]

GPs can continue to prescribe if orginated in secondary care (hospital). 300mg is max dose in any 24 hour period.

[Caradomben]

Hi I have had 3 cardioversion in the last 6 months for episodes of Afib:flutter. Each times the cardiologist (different ones) recommended I take 100 mg flecainide twice a day . I find the flecainide makes me breathless on exertion. My GP said to try to reduce the dose to 50mg at night .. hence the episode of flutter just a few days ago resulting in another Cardioversion . So now been told to keep the dose at 100 mg twice a day until I see my own cardiologist to discuss another solution . I also take 1.25 mg bisoprolol in the morning.

[Max501 in reply to Caradomben]

Thanks for sharing .. great to see so many replies .. makes you feel normal somewhat..

Cheers

[absolutepatsy in reply to Caradomben]

Are you sure its not the Bisoprolol causing breathlessness as I had this side effect plus extrelme fatigue on Bisop. Never had a problem on Flecainide.

[Caradomben in reply to absolutepatsy]

Yeah I’m not sure . Could be .. because I do have a low resting pulse .. normally 45/50

[Slim2018]

Well I am on 100 mg twice a day of Flecainide since Fibrillation started again after 10 months clear and my consultant wants me to continue for the next six months. He says for people with healthy hearts ie good plumbing it is an excellent and safe drug and does the job. I have all but given up alcohol (not that I was ever much of a drinker) and I do get cold feet and slight breathless feelings though strangely not when exercising as in cycling, rowing or cross country running. Notice slight very minor vision disturbances a bit like tiny flashes which again is apparently normal. Don’t like taking it but far better than the alternative...and my cardiologist says lots of new things coming down the pipeline...

[Max501 in reply to Slim2018]

Thanks and great to hear it’s working for you. I have no issue taking the meds, my confusion really stemmed from the cardiologist completing the cardioversion insisting and going against my EPs direction

All good now as we say