Hi there! I have an upcoming first time appointment with an electrophysiologist this Saturday. What types of questions should I be asking at this point? Bit of background information on me...62, diagnosed with PAF in 2017, prescribed PIP . Increase in episodes in 2019, prescribed metropolol and flecainide. Summer 2020, Flecainide was increased and consult with electrophysiologist recommended after several back to back Afib episodes, necessitating trips to ER. Thanks so much for your help.
When I had lots of questions when first diagnosed, the AF Association was extremely helpful. I telephoned them with questions and they gave guidance and information. Have you tried calling them to give you an idea of questions you should be asking?
Hi Paul0208, thx for replying. I live in Canada. To the vBest if my knowledge, we don't gave an AF association here.
I'm in Canada too, near your age, seeing an EP. You can ask how many ablations they do in a year. Check their ratemd rating. Find a nurse - they are good at giving opinions. I've been helped by a cardiac nurse I've gotten to know. I'm curious where you are located. You are welcome to PM me.
I think Paul's advice is good. May I suggest that you ask about the apparent progression of your symptoms and if you would be advised to consider ablation sooner rather than later. (I'm not sure if the increased dose of Flecainide has stopped your episodes or if they are continuing.)
Thx for getting back to me Finvola! I am now on 100 mg of flecainide 2xday since end of August. No episodes that I can tell. I have just heard so many things about people who say that its better to have an ablation earlier than later. But one of my doctors, who is an internist with a subspecialty in Cardiology, said that having it done earlier is not neccessarily better. I was always under the impression that an ablation was offered when meds were no longer working. I guess I was just a bit taken aback when cardiologist immediately suggested ablation. Always worried that doctors are not always truthful as they get lots of $$$ for performing surgeries. Will say prayers that I fall upon a good soul🙏 Thanks guys.
It's great that you've had 3 months free of the beast - long may it continue.
I started 2 x 100mg Flecainide over 6 years ago, having had frequent debilitating episodes of AF. My EP advised me to wait with considering ablation as Flec was working so well and I've had no AF since starting Flecainide.
I was about ten years older than you when I had a long talk with my EP before he discharged me back to my cardiologist. I'm now 75 and would hope to remain on drugs - fingers crossed.
Another question that I asked at that time referred to progression of AF and how the chance of a more successful ablation could be affected. I might have kept my questions somewhere . . . it was years ago. If I find them, I'll post anything worth while.
Thank you so much for your help!! May you continue to be symptom free! 🤞🤞🤞
I found my notes from the EP visit:
I asked him about ectopics which were very frequent at that time.
About the drugs, especially Flecainide and its effects - one was that I was having short runs of tachycardia - he said the drug was organising the AF signals into tach and in my case, the maximum dose would be 200mg daily.
Bisoprolol was discussed as I wanted to use it as a PIP - no, no he said.
A long discussion about fatigue anad breathlessness - why was I so tired. I know now it was the dreaded Bisoprolol.
Side effects of the drugs was another topic - he warned me never to assume that anything was a side effect but to get any symptoms I had checked out.
I hope this might be of some help in formulating your own questions.
Oh wow Finvola! Thanks so much for being so helpful! That's great! I now feel better prepared. 🙏
Hi. I stopped taking Bisoprolol and asked to be put on Nebivolol. Bisoprolol is the cheapest option that’s why they start nearly everyone on them. Nebivolol is a more cardio selective drug it costs 3 times more than Bisoprolol. I’ve been 100% better since starting the Nebivolol
Yes, I was changed to Nebivolol two years ago and the fatigue and breathlessness stopped completely.
Hmm... my wife used to wake up in the middle of the night to make sure I was still breathing, is that a side effect? Or the feeling like a run down toy. I stopped taking the Flecainide and felt so much better. The Metoprolol was the next to go. The only benefit I got from the beta blocker was much lower BP. Now I have to rely on slow breathing to get the same low readings. I think I will stick with the slow breathing.
I too went with the drugs first to slay the beast. However, all drugs have side effects and I made the most of them. As time goes by, it take more drug to quell the beast. I did not want more side effects! My older brother had an ablation two years prior to me with no problems and no drugs. I decided to give up the drugs and give the ablation a try. The surgery was a success. Here in the US the doctors are all worried about lawsuits and will not take you off a drug even if you do not need it. I stopped taking the Flecainide about a year after the surgery, and stopped the beta blocker 3 years later. The only thing I do take is enteric Aspirin. Of course we did all sorts of lifestyle changes to increase the odds of survival. I wish you well while you live with AF.
As some have pointed out here, I should have asked my doctor about the Flecainide and my experience with it. Also the Metoprolol. It is not like they offered me a menu of drug options. Take this and take that, good bye. Next! When I told my cardiologist what I was experiencing and did not want more of the side effects, he said my only option was ablation. What more could I do? This is all water over the dam and years in the past. May your cardiologist be more accommodating.
I was roughly the same age as you and 200mgs/day Flecainide like Finvola has stopped my AF for 6 yrs. I was offered an ablation by an EP at the outset but postponed it. My cardiologist said to me if you go to a carpet salesman, he will sell you a carpet! My view is that I will know when to have an ablation as my QOL will be so poor I will be desperate for it. In the meantime, I am hoping the procedure/alternatives will become more successful and less invasive. Also that through Lifestyle improvements, I can start to slowly wean myself off Flecainide before any side effects are experienced. Good Luck.
Hi secondtry, thanks so much for sharing your perspective and experience with me. I will definitely keep in mind. Good luck to you too!
It is interesting that you use the term invasive. I did not find this to be the case. Yes, they have to snake their way from the groin to the heart and have to map the currents and zap the errant spot all without stopping the heart. Except for a few small incisions that I had nothing to do about, it was about as easy as could be. I know the difference between invasive and not invasive. Invasive was the traditional surgery I had for hernia the first time. 6 weeks of recovery time! The second hernia (other side) surgery was laparoscopic and only took 10 days of recovery. I also had Laparoscopic Prostatectomy which also healed nicely with small incisions. I am not sure how much less invasive they can do?
Questions
Question for those who go in and out of a-fib
A question about Flecainide 
A question about angiogram/ablation
