Verapamil

[Mish-da]

Hello everyone following on from my response to Klags post this morning another alternative to Flecanide that was suggested by my cardiologist is Verapamil. Would love to hear others responses to this treatment. Are the side effects less & response good for AF?? Many thanks

[Paulbounce]

Hi Mish.

First off I'm a not doctor so this is just my view.

I researched Verapamil to use along Flec. Some medical journals strongly recommend the two used together work well - some clinical studies have shown used together greatly reduces the chances of afib returning.

I pointed this out to the cardio when I last saw him in person (before covid). At first he suggested to have it as a PIP alongside Flec - should I return to afib. These where the day's when you could travel and I called the GP to get a prescription before my flight. My GP was 50/50 and wrote to my cardio to 'double check'.

The answer was no and I was told to take an extra Flec as a PIP should afib return. Looking back it was the right call.

Here's why. Verapamil can lower your HR. There have been times when it's hit 46 at rest - I don't want it any lower.

For me personally I find Flec has worked very well. The few times I went back in to afib an extra dose soon saw it packing. From my point of view Flec works wonders and I'm sticking with it.

We are all different though - I think the final decision (for you) must be made by yourself and your cardio.

Enjoy your weekend.

Paul

[Mish-da in reply to Paulbounce]

Thanks Paul. .. interesting! I’m really struggling with Flec so don’t particularly want to go back on it. The cardiologist recommended Verapamil as an alternative in her letter if I can’t tolerate flec I can’t take beta blockers due to sever asthma. I think I’ll contact Papworth next week and speak with the secretary . Enjoy your w/e too!

[Paulbounce in reply to Mish-da]

Sure Mish - I think contacting Papworth is your best bet. Your cardio is best to advise you with this.

For me I started on Flec 50mg twice a day - this was then upped to 100mg twice daily which I'm on now. Should I start in afib again then I can take an extra 100mg as a PIP - worked so far.

It's worth noting that any med's can take time for your body to adjust to. I'm not qualified to give medical advice so this is only a suggestion to discuss with your cardio. If you do go down the Flec route maybe you could take a low dose ie 25mg twice daily and let it build up in your system - then it could be increased maybe ?

Please note I'm not suggesting you do this - just something to discuss with your cardio.

I hope you enjoy your w/e too. I'm climbing the walls at the moment stuck in the UK under lockdown.

Cheers Paul

[Mish-da in reply to Paulbounce]

Cheers!

Me too Paul & been shielding for much of the year!

[KMRobbo]

HiNot medically trained but have been on both drugs prior to ablation.

I was intolerant to beta blockers when initially diagnosed, so tried verapamil. This is a CALCIUM CHANNEL BLOCKER.

It is a rate control drug. I liked it as it had no side effects at 120Mg mod release. But it was not that great at controlling my Hr , when I had afib attacks it would go to 165bpm.

Flecainide is a Rhythm control drug. I was put on this when my AFIB progressed and it was difficult to get me out it high rate afib. I was at the same time moved to 200mg diltiazem, another calcium channel blocker as rate control. I did not like this latter drug as it had several side effects but it did keep my heart rate down. 137 to 140max.

Note rate control drugs are often used with flecainide as although it keep a your heart rate in rhythm, it can promote other fast heart rates.

As I said I am not medically trained but am surprised you are replacing a Rhythm control drug with a rate control drug

[Mish-da]

Thanks KMRobbo for getting back to me. I’m not quite sure either after you’ve said that. 😞

[Snowgirl65]

Hello Mish-da -- I was on Verapamil for a couple years during my early days of a-fib. Everyone is different of course, but I have to say it was the worst pill I ever took. It turned me into a zombie at work and I could hardly function. As years went by, I was then given Bisoprolol, then Flecainide which made me gain weight which I lost immediately when I was changed to Digoxin and Dofetilide years later. Lots of people endure Verapamil well and not Flecainide. As mentioned, everyone's different.

[Mish-da in reply to Snowgirl65]

Thanks snowgirl. Well I do hope I don’t suffer with the side effects you have suffered with. With all the other meds I’ve been on can’t afford additional zombie feelings! I struggle to function many days as it is with my other condition. I’m glad you are on a treatment regime that works for you. Again thanks for sharing your experiences. ☺️