What happens if I can’t take flecainide anymore?

[Rhiannonimity1]

Hi. I’m 54. PAF for 15 years. 17 episodes during this time. On the waiting list for an ablation. I have been taking flecainide for 6 months. 3 months ago it was increased from 100mg to 200 mg per day. I also take 2.5-5 mg bisoprolol. My heart is working fine otherwise. No issues on the echocardiogram.

About 5 walks ago, after a course of antibiotics, I started with ectopic beats, at least 6 per minute. They were constant during the day time for 9 days and then I started to get periods of time without. I don’t seem to get them at night. For the last 3 weeks, the ectopics have been worse in the morning, fading throughout the day, but I’ve also had a few palpitations and a few fast runs of regular beats lasting a few seconds only.

My consultant says that the flecainide may be causing the problems and I am getting a 48 hr monitor which will show if this is the case.

I am really quite worried. I can’t take Amiodorone because it causes me severe stomach issues. What are the options for me if I can no longer take flecainide?

Thank you so much.

[Hidden]

There are alternatives to Flecainide and Amiodarone but have you any idea about when you might have your ablation. Maybe they will push you nearer the top of the list. I’m sure your consultant will discuss alternatives with you after using the monitor......

[Rhiannonimity1 in reply to Hidden]

Thank you Flapjack. I've been googling and have got myself in a tizzy about proarrhythmias and sudden cardiac death. Do you know if a flecainide caused arrhythmia can be reversed? Thanks

[Hidden in reply to Rhiannonimity1]

Dr Google has a lot to answer for but we all still consult him....😉. Unfortunately I don’t know the answer your question but if you are unable to ask/email your consultant, try ringing the AFA help desk....

[Buffafly in reply to Rhiannonimity1]

Yes, by stopping it!

[Rhiannonimity1 in reply to Buffafly]

Really? I have been scaring myself stupid reading about proarrhythmias, pvcs and ventricular fibrillation. I had assumed that my EP is expecting to find some ventricular activity on the holter and that that is quite bad news, potentially derailing my ablation and pushing me into pacemaker territory. I’m flailing around trying to find info, most of which I don’t understand tbh.

[Buffafly in reply to Rhiannonimity1]

I recently posted a reply to someone else having a query about Flecainide, Frances123, with a link to Wikipedia. If you read her post it may be helpful. I can’t take Propafenone (older version of Flecainide) any more, alternative for me is Amiodarone, ablation or pacemaker. I don’t think those drugs have permanent effects as Amiodarone does.

[Auriculaire]

What antibiotic did you take? Somd antibiotics can provoke arrythmias.

[Rhiannonimity1 in reply to Auriculaire]

Hi. It was flucloxacillin. 4 days worth.

[Paulbounce]

I'm in the same boat ! The doc's stopped my flec as they said it maybe causing flutter (may not as well).

However all is not lost. I contacted my GP last week to express my concerns about stopping this med. He said he would contact my cardio and it only takes a few days respond. Bingo - the hospital called today and said to come along tomorrow and collect another type of antiarrhythmic med.

Rhian - I'll try and remember to update the thread and let you know which one. All I can suggest from there is it's one for the pot to mention to your GP.

This is just for me personally. I'm not happy about stopping flec and still think it's the wrong call. I'm now back in afib with no safety net - I'll see what tomorrow brings and let you know.

Paul

[Rhiannonimity1 in reply to Paulbounce]

Thanks Paul. All the best for tomorrow. My EP said the only other option was Amiodorone - which upsets my stomach badly, and has horrid side effects. Yes, please post back after your appointment.

[Paulbounce]

[Cookie24]

I take Propafenone. It is in the same "class" as flecainide but worked better for me.

[Coco51]

I so understand your anxiety! I too can get into a state by overthinking all this. Firstly it is good that your EP is taking you seriously and giving you the 48hr monitor to check if the Flecainide is giving you Atrial Flutter. So do post an update on that. To add to what's been said already....

Once you have an answer after the monitor then you can try other things. If the Flecainide is not to blame - it could be that Flucloxacillin has caused some inflammation in your body and irritated your heart temporarily. There are Sanjay Gupta youtube videos about inflammation on his York Cardiology channel.

Based on some research that he quotes, his suggestion is to take Vitamin C to calm it. Worth a try. I now take it.

Also he and many others here suggest Magnesium supplements. I take these and increase doses if I get anxious periods. In my experience if you go to A&E with bad AF the first thing they do is give you a Magnesium rich drip . So Magnesium is medically accepted as a factor in treatment and something which is depleted by anxiety, so again worth a try.

I too wonder about Flecainide sometimes. I think we all do. I still take it though.

Good luck and keep us posted !❤

[Pigleywigley]

I was having episodes until 9 weeks ago I started taking magnesium taurate & not an episode since. Could be purely coincidental but I’m convinced it’s that. My cardiologist told me I don’t need it but it’s my decision. Other things I have changed, no wine and reduced sugar, processed grains. I’m determined I reduce my meds. I’ve been recommended daily flec but at the moment I’m not taking it. My call.

[Paulbounce]

Hi Rhian.

As promised quick update. Off Bis and on Sotalol 40mg twice daily

Paul