Hi I have paroxyl afib. Comes on about once a month usually after alcohol, even one drink can start it, although I have had attacks without a drink. The attacks usually last 16 hours. I can feel my heart is out of beat but otherwise I can continue with my life normally even during an attack. I tried bisoprol but it was dropping my already very slow normal heart rate too much. So now I am trialling flecainide 50mg twice a day. My cardiologist says if I can tolerate this for 7 days and the ecg is normal I could take it as a pill in the pocket just when I have an attack. My question is that after only 7 days can I just stop taking it
Flecainide : Hi I have paroxyl afib... - Atrial Fibrillati...
Flecainide
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Janey1955
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That would b a question for your heart doc. I have taken Flec as a pill in pocket, worked great for me. Good luck💜
Janey1955• in reply to
I would rather take it that way but will follow their advice
Don't stop taking it until the doc says so. It is very common to either take flecanide as pip or regularly each day and it is very effective in both stopping an afib occurance as well as preventing one.
Hi Janey, obviously you need to follow your doctor’s advice, but if Flecainide is taken long term as a daily maintenance dose, it should be taken in conjunction with either a betablocker or calcium channel blocker. This prevents you from getting other forms of arrhythmias however, if Flecainide is used as a PiP then it can be taken on its own. As has been said, used as a PiP, it can be very effective. Again, follow your doctor’s advice, but many EP’s suggest taking the maximum daily dose of 300 mgs in one go, but this must not be exceeded within any 24 hour period.
Janey1955• in reply to
Ok thanks
My cardiologist's advice was better to take Flecainide on a regular basis than the roller coaster of PIP despite my request for the latter. A common opinion from contributors here is that the more AF you get the more you are likely to get, so those episodes need to be stopped now.
My personal circumstances: 50mg twice a day was not enough, so was offered an ablation but I requested 100mg/twice which has stopped it for 6 years. Also because my HR was under 60 and BP 110/68 he said the usual BB or CCB would make me feel unwell, so I take Flec on its own....and so far he has been right. I would also urge you to consider lifestyle changes including supplements, all mentioned frequently here.
Thank you. I too can’t take beta blockers etc as in the night my heart rate is 33 bpm - normal for me apparently but obviously can’t take anything to drop it any lower
Over a period of 5 years, 17 cardioversions, exhausting every medication, and 1 ablation .... finally increased to Flecainide 150 mg every 12 hours, no cardioversions in 10 months and no visits to ER. I did require a dual pacemaker to tolerate the metopropol 25 mg twice daily. My heart rate was too low.
Hi Secontry and Janey 55, What does CC and CCB stand for please? I have also taken Flecanide for 6 yrs but still get some episodes of AFib but I use it as PIP and it works well. I get a lot of symptoms with my AFib and have to stop everything and sit quietly after taking PIP and sometimes even take a xanax to help calm the anxiety. This works well. Had two 4hr episodes in the past few weeks which was a shock to the system. The first in just under a year...I also feel quite unwell for up to two weeks after an episode. I can very vulnerable and have terrible chest pain and exhaustion. I envy those who don't get symptoms during and after. Lucky ducks!!I agree re the suggestion to consider lifestyle changes Janey like knocking alcohol on the head and being careful with coffee and chocolate too. As someone said the more AFib you get the more you will get it. So It's best to take very good care of yourself. Difficult socially I know but it's, in fact YOU are worth it!!
Have you had the chest pain checked out?
(I have the impression that when angina occurs with the AF this can happen, and it does take much longer to recover from)
Yes I've had it totally checked out last march 2019 and was sent for all tests including an angiogram. there is some heart disease but nothing that needs stenting. The doc thinks it's anxiety. I've had a few admissions with chest pain and nothing found each time but when I get chest pain I do wonder what if it's a heart attack but I'm very slow to go to A and E anymore having spent a nightmarish 4 days and 4 nights there before being admitted the last time in March. (overcrowding) I got my first ever panic attack and I also got two episodes of A Fib while in Hospital due to stress which is always a big trigger for me. I went in with chest pain.... It was a horrendous experience but there were elderly people there who were suffering a lot more than me. Being an ex nurse I ended up looking after them at times.... Such is the health service in Ireland unfortunately.
CCB=Calcium Channel Blockers supposed to stop a rapid heart rate break out but I don't know anything about them.
Might be worth not drinking alcohol for a while as it is a known trigger.
I decided to take this option.
Whilst I have had a complex heart rhythm history and still take Flecainide daily, I have had no identifiable side effects. I also, when necessary, take Flecainide as a PIP.
My incidences of AF are now rare after numerous ablations so my view is that drinking alcohol is not worth the risk.
Be very wary of any suggestions of high dose PIP and ensure you only take any action following you EP’s advice.
Pete
I think you are right I only have 4 drinks a week as it is, but it does seem to sometimes trigger attacks. out of 22 recorded attacks 18 are linked to alcohol. Having said that I can drink and it doesn’t happen !
I used to find that if I drank when I was very tired that usually brought on an episode. I can usually tell when an episode is imminent by a feeling of exhaustion and a strange feeling in my heart. I take a little extra Flecanide and it can offset the AFibb.
Yes I can relate to what your saying, I've had afib for 5years I'm now 61 and 90% of my incidents have been alcohol related,I'm now on 100ml flec am -pm and 1.25 bisoprolol and waiting for an ablation. Sometimes it can be the day after the alcohol, dehydration and low levels but definitely alcohol is my major trigger,teetotal is the only way for me now.
I used to love a glass of white wine but no more as it's a definite trigger for me. Strangely enough though a southern comfort doesn't seem to bother it so occasionally, as in not even once a week, I treat myself. I'd love a glass of wine but as has been said, I know before I even finish the glass it will trigger an episode so, it's just not worth it.
stay well
Blue 
Stopping drinking doesn’t really bother me but I just find it awkward in social situations. Difficult to find a decent non alcoholic drink
For the last fifteen years I have been drinking orange and lemonade in public, You can always say you are designated driver .I usually am! No stigma in that.
Doesn't bother me either. No stigma nowadays especially if you are driving off course! Try the fairly new "Nozecco" and pretend. Even the bottle looks like the real thing!! Cheers!
It sounds to me like your Doc wants you to take Flecanide 50mgs twice a day Janey on an ongoing basis. But you should check in with him re this.
I take 100 mg twice a day and it really seems to working (touch wood).
I was also on 50 mg x 2 when I was first put on it. I think this was to see if there were any side effects - luckly none at all to speak of. The couple of times I have had a-fib I took a 100 mg there and then as a PIP and it worked. My cardio said to only do it if necessary and 300 mg was max in any 24 hours.
Everyone is different but flec seems to work for many on this forum.
One more thing. I've heard that used as a PIP it will be most effective if taken within 20 minutes of a-fib returning. Not everyone knows when it returns - however for me now I can feel my heart pounding as soon as it kicks in. I always carry one in my back pocket when I go out. The old scout motto 'be prepared' springs to mind.
Paul
Very interesting as my situation is very like that of the original poster's. When I get an episode, it is not very noticeable and I just continue doing what I would normally do. An episode for me can be anywhere between 5 hours and 15 hours, but usually somewhere in between. I also came off bisop because my HR was dropping into the 40s sometimes when I went to bed, although I felt no ill effects from that.
It would appear Flecainide might be my next step if I want to do more to control episodes. I'm interested in the PiP use of it also. Can I ask how long it takes to revert back to NSR when a pill is taken? Up until now, I'll always been happy enough to let the episode terminate itself.
I also see that if you take Flecainide daily, you need to be on something else as well. I did take bisop for a number of years and suffered no side effects from it and so I wouldn't have a problem having to go back onto that.
When I last saw my GP about my AF, he said Sotalol or Flecainde would be my next choices. Is one more advisable than the other?
Alcohol is a definite trigger for me too - along with stress, hunger, eating too much, and caffeine- it’s tricky avoiding them but I have found a small gin with lots of tonic is ok usually- I quite like a Becks blue - I really miss an occasional glass of a good wine but I know it’s not good for me - it’s just not worth poking the sleeping dragon!
Meant to say half glass of champagne and small wine at Christmas.
Re - alcohol. Definitely a trigger for me but AF came on the next day, and I thought it might be dehydration rather than the alcohol itself . In any case, I have cut down and never get get really drunk anymore. Say about 8 units a week.
Janey1955• in reply to
I too have cut down maybe 5 units a week. It is a trigger but I still get attacks even when I haven’t had any
Jane
It does seem odd that some people do well on flecainide and others not. I have been taking 100mg twice a day for 34 years and cant imagine going back to slipping into AF frequently. Had no attacks for the last 5 years.
Janey1955• in reply to
Fantastic. I was on 50mg twice a day and it seemed to increase the frequency of attacks. So now have to take two 50mg when an attack comes on, but it has no affect whatsoever. Maybe I need a higher dose. With all this lockdown it’s hard to get a consultation but hoping i’ll Be contacted for a telephone appointment soon
Jane
Yes it really is odd. Back when first diagnosed, I got stuck in AF and was cardioverted at Birmingham City hospital. Doc tried Verapamil and that made things worse, then he tried another drug (cant remember what it was) and that was even worse. Needed cardioverting again and put on 100 mg flecainide twice a day. I knew immediately it was working. I just felt calmer and since then almost all attacks were due to excess alcohol or missing two or 3 doses.
Janey1955• in reply to
My afib isn’t bad enough they say for anything like an ablation. My heart goes to about 100bpm for about 12 hours with very little in the way of symptoms about once a month. Difficult for them to treat as my natural heart rate is very slow so they can’t give anything that would slow it further. Yet the heart itself is very healthy and they are reluctant to do anything to jeopardise that. Bit stuck
Jane
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