Advice on switching from Daily Flecainide only to Daily Beta Blocker and PIP Flecainide

[BigArnie]

Hello, so after 4 weeks of trying first 50mg x 2 and then 100mg x 2, myself and my cardiologist have agreed that a new approach is needed. (Basically a LOT more episodes, although they terminated relatively quickly either on their own or with a further 50mg Flec PIP. Net result = A lot worse!)

I also noted that the daily Flec has increased my resting HR by about 10 bpm and after a few suspicions I used a home Blood Pressure monitor today that showed 150/88 (and some higher numbers before I improved my technique...) I'm still not sure about it because historically my BP has been very good, so will be monitoring closely.)

Anyway, the net is that the cardiologist has suggested a low daily dose of a beta blocker (I don't yet know which one or how low...) and reverting to use Flecainide as PIP only.

I guess a helpful side effect should be to reduce the BP as well.

Has anyone tried this particular regime with any success?

Many thanks.

EDIT: Unsurprisingly he has prescribed 2.5mg of Bisoprolol

[secondtry]

I am not sure what others will say but I think raised BP & particularly HR is not connected to Flecainide; my HR went down 5 points with Flec & my BP is stable. My cardio wouldn't put me on BBs as well as Flec as my HR was already under 60. However, we are all different and if there is one lesson I have learned over 7 yrs AF experience it is that there is a lot of trial and error/individualism involved. 🤞it works for you.

[BigArnie in reply to secondtry]

Hi secondtry, well my cardio said the higher HR was the Flec, but high BP was not, but as you say, who knows! I am a tad concerned about my resting HR being quite low because before the 4 weeks with Flex it was typically around 55-58 on a relaxed day, (probably because I am a runner) so I suppose I would not want it to be too much lower...

[KMRobbo]

Beware the home BP monitor! I have one and do find it useful, but I actually get "white coat" syndrome taking my own BP! Post ablation I was taking my BP 3 times a week for a year ish. And every time I would do three readings as the first was usually way high , and sometimes the next one, sometimes all three. It fluctuated a lot over time as well.

So despite not having Afib anymore I spoke to my GP and showed her a graph and print out of this . She just said it's a normal variation, don't worry about it and don't take so many readings , a couple a month is enough. If something changes and they are always high come back! over the period the highest I had was 179/111, the lowest 105/65.

Fyi I actually took my BP initially as my OMRON M6 COMFORT IT , has an arrhythmia detector so was using it for that purpose mainly particularly if I had been for a run earlier or I was feeling stressed ( ie 2 hour commute home on jammed motorway ) , just to check that I was not missing any afib occurrences. (I bought the monitor when I had afib )

The high BP figures concerned me so i think i began to obsess about it.🤔😁

I am cured of that now! .I still do some readings but have gone months without bothering between reading.

If you are worried I would log readings for a period and have a chat with your GP based on those.( don't wait a year)

Worry causes a lot of heart problems IMO. Not medically trained.

Bisoprolol is a BP drug anyway so that should reduce your blood pressure

Best wishes

[BigArnie in reply to KMRobbo]

I think you are right on the BP Monitor and I have already seen some major variations in the last few days - not as wild as yours yet! Anyway, the Cardio doc has asked my to monitor it every few days for the next two weeks before my next appointment, so I guess I will do that and see how it goes. I think there is also a bit of just getting used to the equipment and the feeling as the sleeve inflates.