New to flec

[Kathyml]

I went to the cardio because I would have short episodes where my heart would be fast. After a negative stress, monitor and ekg he determined I had afib that wasn't bad. I didn't have high bp basically nothing medically wrong. He put me on 25 mg of metropol 2xs a day and I started having more episodes. He changed it to 50 mg and even more episodes that would last hours. Took me off that and started flecainide pip still having long episodes of tachycardia. I have been on flecainide 2xs per day for 2 weeks. I have had 2 episodes of tachycardia lasting over 7 hours. Has medication ever made this worse for anyone? I am exhausted.

[jwsonoma]

Hi Kathyml, My cardeologist insists I take a rate reducer (Bisoprolol which is like Metropol) as long as I am on Flecainide as rapid HR is a side effect of Flec. It happens when your heart tries to go into aFib. It's easier to prevent than to stop. I am not sure of your dose on Flec but they can up it to 300mg a day. I started at 50mg 2x/day and am now on 75mg 2x with 2.5 mg Bisoprolol. I have naturally low BP and HR due to a lot of cardio so I don't like the Bis. I keep 2.5 mg Bis and 75mg Flec as a PIP keeping that 300mg/day max in mind as a hard number. Both meds make me tired but it is better than progressing into permanent aFib.

Good luck

[Kathyml in reply to jwsonoma]

Metroprol made it worse and made my bp too low. I have normal bp 116/68 so they don't want to make it any lower. I take flecainide 100 mg 2xs per day.

[secondtry in reply to Kathyml]

My BP is similar and I have Lone PAF. My cardiologist put me on just 200mgs/day Flecainide and said the usual accompanying drugs would make me feel unwell. I checked this with him twice re the comments made on this forum about the risks but he didn't change anything and I have been fine on this for 7 years with lots of energy thanks in part to many lifestyle changes.

[Tapanac in reply to jwsonoma]

That’s so different to me. It slows and regulates my tachycardia.

[Hidden]

ncbi.nlm.nih.gov/pmc/articl...

Flecainide can convert AFib to AFlutter with 1:1 conduction and ventricular rates in the region of 300 bpm

Digoxin, diltiazem, verapamil and beta blockers may be prescribed with flecainide to prevent or mitigate this pro arrhythmic effect

[Kathyml in reply to Hidden]

They don't want to prescribe a beta blocker because my bp is normal and fear it would be too low. Metroprol made it worse. Getting a second opinion.

[The_Lord_is_with_Us]

Sustained for 7 hours? ..... what rate is your heart during these episodes?

I've had 4 ablations. After 10 AFIB-free years, it came back late last year with a new twist: rapid ventricular rate (RVR), a form of tachycardia. I would wake in morning and go 12+ hours at around 130 to 135 bpm. This went on for a couple of weeks.

When it spilled over to a 2nd day, I went to Emergency. They gave me Diltiazem (cardizem) IV to bring it down and sent me home with Diltiazem prescription, 4 times day 30mg.

That helped somewhat. After I went on Flecainide after seeing my Cardiologist, it took almost 3 weeks before it kicked in at 50mg twice a day, which is lowest effective dosage.

I experimented and stopped the Diltiazem to see what happens, To my surprise, the Flecainide controlled the tachycardia effectively. So .... no more cardezem.

I had an AFIB ablation on OCT 23 .... and both AFIB and RVR tachycardia are gone.

Emergency doctors treated the tachycardia as an emergency situation and said to seek treatment if 130+ bpm for more than 2 hours; however, my Cardiologist acted like that was overkill. I'm age 67, and he said since my heart is structurally sound ... he's not that concerned if it even went for weeks at that high rate.

10 years ago, I took Metropolol. It made my heart beat erratically, so I quit it.

Flecainide I've used both as pip (which was quite effective stopping AFIB) and continually, as noted above.

Flecainide was not very effective at controlling anything for 3 weeks. Glad I didn't give up on it. I asked my Cardiologist if I should up the dose. He said, NO. It has 'nasty' side effects.

At 3 weeks, it knocked my tachy and AFIB out very effectively. I was quite surprised after dismal prior 20 days or so .....

Good Luck!

[Kathyml in reply to The_Lord_is_with_Us]

My bpm fluctuated between 94-155 bpm for 7 hours but was mostly over 120-155. I didn't go to the ER because I have been 3 times in 2 weeks The first time I was only in metropol 25 mg twice a day. They gave me IV metroprol and the tachycardia went away but I didn't achieve sinus rhythm. Increased my dose to 50 mg twice a day and had a afib/tachycardia episode that went in and out for 24 hrs but didn't go to the ER converted at home. He took me off the metropol and did flec pill in pocket 50mg. Because I just stopped the metroprol (as he told me to) I had a episode where bpm were 185. ER gave me amiodarone which took many hours to convert and ended up in icu for the night. I went back to the ER after starting the flecainide 5 days later with tachycardia bpm 150. Because I was in Flec they just gave me fluids and let me sit for 5 hours until I converted on my own. 7 days later is when I had my last episode which was 7 hours until I converted. I had never has any of this until I started taking meds. I truly had few episodes and when I did they lasted about 15 min tops and went away. My heart is fine nothing wrong there (negative stress test).

I tell my DR all this he dismisses it but since I have had drugs (dec 1 until now) I have been a mess. He just says it's not life threatening but the episodes make me exhausted and it shouldn't be happening.

I am going to go to a EP DR and get a second opinion.

[Canada01 in reply to The_Lord_is_with_Us]

Hi i started Flec last week and 6 days later i went into AF/ Flutter not sure which as feels different to how i used to feel before 2 ablations my HR went to 100bpm this went on for 2 days tgen reverted back to 60bpm and regular apart from feeling totally exhausted you say it took awhile before flec had a good effect i do hope so because i will have to have a PM and ablate

[cuore]

Yes. Taking medication can cause arrhythmia. So, when you are prescribed a pill, look up the side effects to see whether arrhythmia is one. For example for metoprolol drugs.com lists "slow or irregular heart beat," and rxlist.com states "irregular rapid heartbeats" as a side effect. Thus, it is surprising that your dosage was increased from 25mg x 2 (which is already a high dose) to 50mg x2. I was prescribed metoprolol with very adverse effects so I refused to continue to take it. In fact, I believe metoprolol made my condition worse, and there is a site that explained that metoprolol was contraindicated for vegal AF. Whereas I could feel no palpitations pre metoprolol, I felt big time palpitations with metoprolol. For me, it was a dangerous drug.

You could get a second opinion for your med. treatment because it appears you are on a loose trial and error path. Maybe you could ask why that drug and why that increase for future drugs. You have enough problems having AF without further aggravating the problem via drugs.

[Kathyml in reply to cuore]

I agree. I didn't have tachycardia I has irregular heart beats occasionally on monitor. He prescribed it to make it stop but wasn't dangerous. Now I take flecainide 100mg twice a day..which is a lot and now I have heart problems I never did before. 3 visits to ER in the middle of a pandemic. Time for a second opinion.

[The_Lord_is_with_Us in reply to cuore]

Yes, how right you are ... my sensitive vagus nerve can set off AFIB. And ... metropolol caused many continuous uncomfortable ectopic beats. I quit it ......

[Tapanac]

Flecainide to me is a wonder drug. I have read that it could cause different sorts of arrhythmia and is a black (?) drug but it sorts me out and I have seen on here how pleased people are with it and no problems. Also it is one that can be used as a pill on the pocket.

[Kathyml]

Thanks for all your feedback. Took my flec 100 mg this am and within 45 minutes was afib. Heart rate was 264 if I just walked to the bathroom at home. Sitting in the ER (4th time in 2 weeks) waiting in an iv to get the heart rate down. Going to call for a second opinion first thing in the AM as the ER doc agrees that things have gotten worse with the drugs.

[EngMac]

If you gradually stop all the drugs and go back to the way you were, is that better or worse? Sometimes doctors over-treat and when the result is worse, they over-treat some more since they seldom under-treat. Sometimes you need to listen to your smart body and not less than smart doctors who don’t listen to what you tell them; one of the things medical practitioners are beginning to learn they should do. You should decide based on what you know; and, after a fair effort of trying the doctor’s way. Your doctor will likely try to scare you so you should be prepared for this. You can always go back to your doctor’s way. Good luck!

[Kathyml in reply to EngMac]

Yeah that's what I want to do. I was definitely better without the drugs. What wasn't a big deal has become a big deal. ER doc just told me to find another cardiologist because this should not be happening. Going to call a new one tomorrow and I want off of these drugs.

[EngMac]

I had to do it without any doctor or pharmacist willing to guide me. Their insurance coverage will not cover them if you have a bad result and sue them. My doctor told me this. You may need to do some research and do it on your own. When your doctor refuses to help you do something not dangerous, then you will know you may not have the best doctor. The most dangerous thing now is most likely weening off the drugs. So if you are going to do it, do it sooner than later.

[Hidden]

Are you taking an anticoagulant?

[Kathyml in reply to Hidden]

No they said I didn't need it. I really don't want to like I said I never had a heart problem. I had episodes sporadically which would last minutes. Now I have episodes that last hours ever since I started meds on Dec 1st. I would rather have a sporatic episode every now and then rather than the weekly and bi weekly episode I have now. Going to see a new dr and get off the meds😀

[Magson]

I would get a second opinion. Flecainide is a great drug for many AF sufferers but not all. Been there got the T shirt. Definitely not for me and made things worse. My GP prescribed Flecainide on instructions from my Cardiologist . I read somewhere that you should be monitored when starting this drug for the first time. Even if it's just a discussion with your GP .That did not happen in my case.

Go well.

[Kathyml in reply to Magson]

Thanks. My GP hasn't really been involved and my Cardiologist is too busy to take more than 5 minutes to listen and dismiss me. You are right I am going to find a cardiologist for a 2 nd opinion. I live in a very rural town and there is only 1 cardio office. Going to look more towards the city where there are many choices. Honestly I just feel horrible today and I am exhausted. I can't keep going to the er or I am going to end up with covid. Ugh

[Kathyml]

Update:. I got right into a.new cardiologist while I was in afib/tachycardia. He added a drug to the flecainide (he can't just stop it). Flecainide alone was the issue. Took the verapamil 120 mg which stopped the tachycardia/atrial flutter within an hour. Go back to the dr tomorrow so he can see how it's working. So relieved as just walking across my living was giving me a heart rate of 284 bpm.

Thanks everyone for your experience and advice.