Time for flecainide to work

[Profound15]

Had a terrible day yesterday with ectopics/flutters. It got so bad I was sweating profusely and breathless. I phoned 111 and all credit to the NHS they sent an ambulance. I was taken in to Frimley in Surrey where they carried out extensive tests but found nothing amiss, which was good news. Came home around 0130 and went to bed still suffering from ectopics. At 0300 I developed afib and in accordance with my cardio instructions took 100mg flec every hour to a max of 300mg. It’s now 0830 and haven’t reverted unlike previous bouts and wondered if anyone had an idea how long it takes to work please. Thanks fir your support. This site is a great source of information and help as I’m struggling at the moment.

[BobD Volunteer]

Sorry I have not used flecainide for 15 years so can't comment but please do not take any more till at least tomorow morning. Drink plenty of water and try to relax. If you feel faint or have any chest pain then call emergency sevices again.

[Profound15 in reply to BobD]

Thanks Bob. The cardio told me to only take 300mg in any 24 hour period. I’ll give it a couple of hours then phone 111 again. I suspect if I go in to A&E a cardioversion might be the best solution. Do you get knocked out with the sedation pls

[BobD Volunteer in reply to Profound15]

Not a course of action I would take . Deep breaths and relax first. Cardioversion is not without risks!

[Hidden in reply to Profound15]

I am not medically trained therefore I can only relate what I have been told about using Flecainide as a Pill in the Pocket which works for me. If I experience an episode, I wait 10 to 20 minutes to give it a chance to self revert. It it doesn’t, I was told to take 300 mg as one dose. I have had two ablations and now I normally revert within 2 hours. Before the ablations it could take anything up to 24 hours, but generally 12. You MUST not take more than 300 gm within any 24 period. It is a potent drug and must be taken as prescribed.

The question of dosing has been raised on this forum many times. Some are told to take the maximum dose in one go and others to stagger the dose like you. When the question has been raised at support groups I have attended, we are told the all in one dose is preferred because it gets closest to replicating the “jolt” the heart receives when you have a cardioversion.

Please do not change your dosing without consulting your Doctor.

[Profound15 in reply to Hidden]

Thanks Flapjack. That makes sense but I was told by my specialist to take one every hour to a maximum of 300mg which I’ve done. It wait and see now but hopefully it’ll revert back sooner rather than later

[Hidden in reply to Profound15]

Fingers crossed, I’m sure it will if you follow all the advice about relaxing, deep breathing and drinking lots of water.....best of luck

[jeanjeannie50]

I hate to say this, but your heart will calm down once you do.

Put the t.v. on to a channel that will hold your interest, perhaps a documentary - nothing exciting. Then, making sure you feel warm, sit in a comfy chair and let your body go loose and floppy, release that tension in your heart area - let it relax. Take some slow, deep breaths, letting your body relax even more on your out breaths. Keeping loose and floppy watch t.v. and do your best to forget what your heart is doing.

It will be back in normal rhythm in no time.

Jean

[Profound15 in reply to jeanjeannie50]

Thanks Jean. I must admit that I feel exhausted and relatively calm. I haven’t slept either so that compounds the tiredness. Thanks for your support

[jeanjeannie50 in reply to Profound15]

Do you think if you went to bed you could sleep, or is your heart too juddery? Or would lying (on your right side) on the settee with a quilt over you hold more chance of sleep? I feel sure you would wake in normal rhythm.

[Profound15 in reply to jeanjeannie50]

Thanks Jean. My heart rate is around 110 so I don’t think I’d be able to sleep with it at the level but thanks for your advice, it’s much appreciated.

[jeanjeannie50 in reply to Profound15]

110 isn't an awfully bad rate. Personally, I wouldn't go to A&E unless my rate was at least 120-130, had been that way for hours and was making me feel ill. Have had AF at over 200bpm, was diagnosed 15 years ago, but feel I had it long before then, plus ablations and cardioversions.

Hope you soon feel better.

[Profound15 in reply to jeanjeannie50]

I’ve been in touch with my cardiologist and he said to head in to hospital later today if I didn’t go back in to sinus rhythm. He works at Frimley for his NHS duties so he seems comfortable with that. I am so disappointed that flecainide hasn’t brought me back to sinus yet. Looks likely that I’ll be getting a cardioversion and I just wonder what sedative they use. I’ve had midazolam for colonoscopies and that works well as long as the dosage is enough

[Profound15 in reply to Profound15]

Went back to sinus rhythm around 10.45 so the flec worked eventually. I started at 0300 this morning with the last tablet at 0500. Taken a bit longer than I expected. Flapjack you’re a star as I started drinking some water and I think that did the trick, how I have no idea but a few minutes after drinking almost 500ml bingo.

Must admit that I get afib with very tough symptoms.

Thank you for all your help and support. This is quite truly an amazing and brilliant site

[Buffafly in reply to Profound15]

I can sleep at a much higher rate if I get comfy but it depends on the ‘judder’ - great description! I hope you get sorted today, let us know how you get on.

[Gowers in reply to Buffafly]

This time last year I was in exactly same situation as you have described. As a result I had 2 planned cardioversions. I know we are all different but, having a hr of 180 + af flutter + ectopics + no sleep for 3 nights - Flec put me into af flutter according to my cardiologist & he told me to stop them. I couldn't wait to get cardioversion done. The sedation was through a canula in my arm & after briefly feeling relaxed & very drowsy next thing I knew it was all over & heart was back to nsr - the feeling was just wonderful! Allowed home few hours later (you have to have someone drive you) the cardioversion effect only lasted few weeks but I expected that and, cardiologist already booked me in for ablation no. 2 - (6 weeks later.) Today nearly year later I am so much better compared to how ill & exhausted I felt. Cardiologist & gp prescribed mild sleeping tablet (think?? Jeannie also had them for short while) which were a great help until I had ablationDo let us know how you get on

[Profound15 in reply to Gowers]

That’s interesting about the sleeping tablet, never thought of that. Having a think about the flecainide I took this morning. It was a new prescription and the manufacturer was accord. Do you think that this brand of flecainide might be different from the other pack I got in 2018 because I’ve used the older ones earlier this year and reverted in the two instances pretty quickly (couple of hours and 45 minutes). How long does flec last for do you think

[secondtry in reply to Profound15]

I have used Accord's Flecainide daily for a long time, no issues. Re drinking to stop AF, as my Lone AF is vagally mediated I think it helped when I drank a long cold drink (normally never do) as it stopped my last AF episode 3 yrs ago. Hope you are feeling back to normal.

[Profound15 in reply to secondtry]

Thanks secondtry. Could you advise me what you have done to stop afib please. I had been taking magnesium daily (natural rhythm) but ran out and changed brands to Swanson magnesium taurate two days ago. That’s when the ectopics ran wild and I ended up in severe afib. I’m not taking anything over the next few days to see what impact no magnesium will have. Got my cardiologist appointment this evening so I’m looking at asking him to prescribe me something to prevent ectopics and afib if that is at all possible.

[secondtry in reply to Profound15]

The most important I have found is to identify your individual AF triggers. Next focus on Lifestyle changes. Despite this over nearly 7 years I have had two AF episodes; one I stopped by relaxing on the sofa and focussing on a slow heart beat on YouTube and the second one I stopped by gulping down a long drink of coconut water from the fridge nb I don't think the coconut part was relevant as I was back in NSR before it would have had chance to be absorbed into my system. Good luck with your appointment.

[Profound15 in reply to secondtry]

Thanks secondtry. Are you on a maintenance dose of anything pls

[secondtry in reply to Profound15]

I wanted PIP but my cardiologist said a medium dose of Flecainide 200mgs/daily was best, nothing else. 100mgs wasn't enough to stop it but hoping to reduce to that once I have done all the Lifestyle changes that are practical.

[jeanjeannie50 in reply to Profound15]

Accord Flecainide is the make I insist on having and is the best as far as I'm concerned.

[Profound15 in reply to jeanjeannie50]

Thanks Jean that’s good to know

[secondtry in reply to jeanjeannie50]

Thanks Jean I remember you saying this a while ago, which prompted me to insist on that brand as well😁

[Gowers in reply to Profound15]

I'm not sure about the different brands of Flec but, I'm sure your pharmacist could advise. Yes, the sleeping tablet Zopiclone 3.25mg (there is a stronger one too) was life changing when I was exhausted through af. My gp knew I would be sensible & my cardiologist had no problem with me taking it. Also, had one in the hospital after 1st ablation which helped me get some sleep on the busy ward

[doodle68 in reply to Buffafly]

Me too. Buffafly 😊 I am always delighted if an episode starts around bed time .Once I got over the fear of going to sleep in AF, even with my 150bmp and the pounding in my back and chest I put the radio on very low so I have to strain to hear it and go to sleep . I have to get up regular to spend a penny but find my 10 hour episodes seem much shorter.

[Gowers in reply to doodle68]

Agree - having the radio on has helped me through many long nights of af

[Profound15 in reply to Gowers]

Met with my cardiologist last night. I had a very good day heart wise yesterday with no ectopics at all. That is very unusual for me. I was fitted with a 24 hour holter monitor to check what’s going on in the ticker and whilst feeling good about the ectopic free day went home thinking nothings going to happen. How wrong could I be because as soon as I had a small bite to eat the heart went in to sustained and regular ectopics. I bought a kardiamobile and it recorded afib a couple of times and unclassified regularly. I spent the whole night going through this and I must admit to being shattered this morning. It’s still going on now so I’ve asked him if a should take some flecainide to try and settle it down. This is the same feeling I had on Sunday prior to going in to full blown afib.

The cardio discussed possible causes and he mentioned that perhaps a possible pacemaker issue. Has anyone had experience of this at all please.

[Gowers in reply to Profound15]

Did the ectopics & you feeling poorly again happen after the 24hr holter was taken off?

[Profound15 in reply to Gowers]

I had a flecainide tablet this morning and have felt good throughout the day. I’ve taken the holter off this evening and had a couple of minor ectopics presumably due to the flec wearing off