I am now in permanent AF. Fortunately up until now my HR goes but soon comes back down. Had my 24 hour monitor and Echo and now taking Flecainide 100mg a day along with Bisoprolol 5mg. Not seen a doctor or cardiologist throughout this. My question is - has anyone had problem with Flecainide? Nothing changed much but I guessed it was early days. Two days ago my HR went up to 177 - 185 and remained that way for an hour or so. I was due an ECG at the surgery shortly after this and my average pulse was 145bpm. Received a phonecall from the surgery saying I was to double my Bisoprolol as the GP had rang the cardiologist who advised him to do this. I am a little worried that the sudden rise in HR was due to Felcainide as I do understand it can cause arythmyias. I am also worried that doubling my Bisoprolol will not only make me feel lousy but it is it really necessary. I explained to the GP that it was the first time my HR had gone this high and could it be due to the Flecainide but was just told that they have to be guided by the Cardiologist. I feel a little confused by all of this because all I've had is short phone calls and feel no-one is really listening to me. It's difficult to say what my average HR is due to permanent AF but unless I'm out walking the dog it doesn't usually go above 140 bpm but is more often than not showing over 100 bpm. Sorry for the long post but I am very confused and was wondering if anyone else had similar issues. Thanks for reading x
Problems with Flecainide: I am now in... - Atrial Fibrillati...
Problems with Flecainide
Yes flecainide causes my arrhythmia to get worse. I was taken off it quickly.
Me too
I'm also on Flecainide and since then I'm in permanent AF. I was thinking F...would maintain the rhythm, I'm confused. I'm on Digoxin as well, which keeps my HR low...too low sometimes, under 50s
Me too. I lasted 3 days on it........... and 3 months on Bisoprolol.
Hi Cicek.
I'll say the usual disclaimer that I am not medically trained and can only speak from my personal experience of these med's.
Flec is a serious drug and can cause problems for some. I got two years of sinus from it and it worked well. I did though go in to flutter a month or so ago which the cardio said 'could' be a result of the Flecainde (100 mg twice a day). However it worked well and does for many (doesn't mean it will for you).
"I am also worried that doubling my Bisoprolol will not only make me feel lousy but it is it really necessary"
If a cardio has said to do this then yes - follow his / her advice.
Bis and I don't see eye to eye. The doctors stopped my flec and put me on 5 mg. It worked well regarding lowering my HR but it did make me feel rotten. Again though it doesn't mean it will have this effect on you.
"Not seen a doctor or cardiologist throughout this"
I have to assume you have been referred to see a cardio ? If not chase that one up - ask your GP to refer you asap.
Good luck.
Paul
Usual comments about not being medically trained but I’m wondering why you are taking Flecainide if you are in permanent AF………permanent AF suggests that it has been agreed that nothing will revert you to sinus rhythm and if the Flecainide has failed to achieve this, why take it……
Just to add, I think you need to find a way to contact your Cardiologist, either by emailing his secretary or via the Arrhythmia Nurse attached to the hospital (assuming there is one). It’s important to get the definitions right first. Paroxysmal AF (PAF) is when episodes of AF come and go and Persistent AF is when AF continues 24/7 but can be reverted by having a cardioversion or taking rhythm medication such as Flecainide (which clearly doesn’t seem to be working for you). Permanent AF is when all attempts to revert to sinus rhythm have failed and it mutually agreed between the patient and the doctor that only rate control medication such as beta blockers are used to keep the heart rate below 100.
I understand that communication has been difficult but you need to know where you are within these recognised variations of AF. Unless you have been told to the contrary, I would have thought that you should seek to have a cardioversion and if that doesn’t work, then at least you will know that it’s only your heart rate which needs to be controlled subject to the usual proviso’s.
If you are definitely in Permanent AF there is no point in taking Flecainide and there are risks associated with this drug. If all else fails, tell your GP that you have been made aware that you are in a risky situation and that you need professional advice as to how best you proceed. If all else fails and it possible, seek a private appointment but you really shouldn’t have to do that…..good luck
The other thing you could consider is contacting the AF Association helpline to see what they can do to help. Taking Flecainide and not getting any benefits is not a good idea….
Hi. I've just received a call from my GP who has now received a letter from the Cardiologist advising if nothing changes I am to go to A & E for a cardioversion. Been advised to wait 24 hours and see how it goes after taking another 5mg of Bisoprolol. No mention of stopping the Flecainide. If this helps then the Cardio will arrange an out patient appointment for me to have a cardioversion. It sounds like because the heart is jumping about so much (can go from 150 to 60 to 125 for example in a short space of time ) that it is the efficiency of the heart at the moment that is not working properly and can cause fluid buildup if ignored. I guess all this makes sense to a lot of you that have been here! I've been one of the lucky ones and had PAF for years taking only Bisoprolol so I'm now finding out what else can go wrong🤔. Thanks for the advice and I'll keep you posted.
Sounds like it’s been taken seriously now - just keep on top of it ie if you haven’t heard anything then keep chasing!
The Flec may help the cardio version work but I too am surprised that you were put on Flec if your AF was persistent. Perhaps they think a conversion to NSR is possible & want to give the best possible go at it?
Good luck.
Thank you. Hoping not to go to A &E. Would rather wait and have a more relaxed appointment for the cardioversion.
You could have a very long wait for a ‘relaxed’ (pre-booked) cardioversion and in the meantime your heart will be worn out and getting stuck in a bad habit. (Sorry if I’m being too blunt ☺️) So if the extra Bisoprolol doesn’t help please do as the cardiologist advises. It is possible the Flecainide is causing flutter as well but a cardioversion would fix that too. I may be wrong but I think if the Flecainide was causing a dangerous arrhythmia you would not be walking the dog, you would be in an ambulance with blue lights!
If you are going to have a cardioversion then flecainide will give the cardioversion an increased chance of being successful. I know from my own experience when my EP prescribed flecainide a couple of weeks before a successful cardioversion and I'm still on low dose flecainide now 3 months later.
However, I asked my EP before the cardioversion whether if the cardioversion didn't work could I stay on the flecainide as I felt better on it even if in AF. He said that flecainide was not appropriate if in permanent AF so I totally agree with Flapjack on that score.
Hope all goes well with the cardioversion!!
Thank you. Unfortunately no-one has mentioned the Flecainide again. I did ask if this could have caused the sudden very high rates but apparently even the Cardio has not commented on this. I will definitely mention it when I go for my Cardioversion whenever it is done.
Try not to worry, now the you know you may NOT be in permanent AF, staying on Fleck will help the CV to be more successful. Also, being on a beta blocker whilst taking Flecainide helps to reduce the risk regarding other arrhythmias. A CV although may seem unpleasant, it is no big deal, so I suggest you take it as soon as it’s offered and not make conditions.
That’s really good news cicek, even if the CV only works for a short period, it means that you are more likely to respond well to other treatments such as an ablation and will confirm that you are not in permanent AF…..fingers crossed!
Thank you. Am I being a little dense here? My heart is never in NSR and hasn't been for many weeks now. This was the reason I was referred to the Cardiologist (phone app). He's never said I'm not in permanent AF. I thought PAF was when you have SNR and the heart only going out of rhythm on occasions? Sorry, like I said I've always been lucky with my PAF so not had much info really regarding anything.
Your not being dense, it can be very confusing. I was diagnosed with lone persistent AF back in 2014 but there is no way of knowing whether it is permanent or persistent until there is are attempts to get it back into rhythm which have failed. In my case, I had a CV which worked for almost a year but when AF returned, it reverted on its own without intervention and my Cardiologist said “ah, Paroxysmal AF”! You are right, as I mentioned earlier, paroxysmal AF (PAF) is when normal sinus rhythm changes into AF for a period of time but then reverts back to sinus rhythm. The symptoms for persistent and permanent can be identical. So don’t worry, you atr on the right track…..
Hi Cicek,
I was prescribed flecainide 3 weeks ago. I was diagnosed with atrial fibrillation. I was not told what type but I believe from what I have read it is paroxysmal. Before I was put on metropolol, my blood pressure got low when AF was active. My blood pressure had always been in the normal range and sometimes lower. But with the metropolol it has gone up. I read this happens to some people. I had to stop taking the flecainide because my heart rythm started to act up. The AF was happening more often and HR was higher and lower than ever. I also felt terrible. I stopped taking the flecainide, yesterday, and I have been feeling a lot better. I cannot understand why I was put on 3 meds, when my problem is not severe. The only one that makes sense to me is the blood thinner med (Eliquis). Going back to your problem, I read the prescription information that came with the flecainide and it reads: "Warning: This drug is only to be used to treat certain types of abnormal heartbeats. Other abnormal heartbeats have happened with this drug, which in rare cases can be deadly. This drug is not for use in people with certain types of abnormal heartbeats (chronic atrial fibrillation), or in people who have had a heart attack or heart failure. Talk to the doctor if you have any questions about this drug. I hope this helps you. Take care. Hope you feel better soon.
I am not medically trained. I had Flecainide with bisoprol for 10 years, Af reasonably controlled until last year. Ablation before Christmas so I have a bit of experience. When in Af with high heart rate have you thought about using 999, this was the advise from my GP you will then get an quick ECG. As soon as you get to hospital ask to see the cardiologist. Ideally you need to see an EP but there isn’t always one on duty. I am so sorry to hear you are suffering like this I hope you get the help you need.
Thank you. I have been advised to go to A & E. Taken extra Bisoprolol which has slowed the rate down but an echo and two ECG's have all shown very erratic change is rhythm. Now on 10 mg Bisoprolol a day but feel like a zombie! GP called today and said Cardiologist will contact with an appointment for a cardioversion which I would rather have done by appointment. Obviously, if things get worse again I have been told to go to A & E and I will listen to this advice. Hope you are well too.
Yes thank you so far after the ablation mostly good. You may be interested I was taken off Bisoprolol because of my asthma and put on Diltiazem. It wasn’t till I was off bidoprolol that I realised the bad effects it had. Also with Flecainide I found I had bad reactions to brand changes for a few days afterwards so I had the branded version Tamborcor which made a huge difference. I find hydration most important to avoid episodes as well as small meals never late at night. I hope things settle for you.
I was diagnosed with AF last year with episodes of 166 bpm which came on about once a month. My cardio put me on metoprolol. After several months (and not much help in controlling the episodes) she did a 48 hr holter monitor to see if the meds were working. While wearing the holter I had an episode like I’ve never had before nor have had since. It started with many many palpitations and then went into AF. So…. My cardio decided Flecainide is what I should take. She gave me the lowest dose I think 50mg twice a day. The first pill I took sent me into wild arrhythmias that I never had prior. And they were constant which again I never had. I called the doc and told her about this and her answer was “give it some time”. What? I’m suppose to have 24/7 arrhythmias while taking it to give it time? I think not. I stopped the Flecainide after two days and haven’t had one arrhythmia since. Needless to say I am seeing a new cardio who is an EP next week to figure out what meds I should be taking. My point to this looonnng story is I am here to attest the Flecainide can absolutely cause arrhthymias and in my humble opinion are not to be taken lightly. I did get changed from metoprolol to Bystolic some months back and it has worked much better. I upped my dose on my own since I have an incompetent cardio and I feel much better on the upped dose of beta blocker. I will discuss this with my new EP when I see him. I hope you get the Flecainide sorted out. It’s no fun at all!!
Thank you for this. Unfortunately no=one has still answered my question as to whether the fact I have been taking Flecainide for two weeks has caused my problem to worsen. I will be asking the Cardiologist myself.
I was badly allergic to flecainide so heart rate went up face swelled and i looked like I'd been scalded. I stayed on just bisoprolol until i had my ablation which was the best thing i ever did. I hope you get sorted soon as no one but a felow sufferer realises how debilitating this is
Interesting post. I was taking 100mg of fleicanide and it had to be reduced back to 50mg as it was causing AF. I was told if I went into permanent AF you have to stop taking it. I was also told that it does not affect heart rate but it does for me. I stopped taking it for a week and my heart went up quite a bit and then down again when I started taking again. I have also had an incident similar to yours where my HR shot up for about 4 hours. It was the day I was getting my CoVid jab and I thought I felt a bit anxious but not a lot. When I was back at home it went back to my normal - so was that anxiety? I have noticed my heart registers anxiety a lot more than my head and my HR can really shoot up for hours when I only think I am a bit anxious. Odd.
I am not medically qualified. I was told to stop taking Flecainide once I had gone into permanent AF. I take only an AntiCoagulant because of the AF. I once took Bisoprolol for eleven weeks but it caused readmission to hospital due to asthma, plus it caused urticaria. My GPs did research which showed that all beta blockers would have caused me to have the same reactions so I don't take any.
I must say I agree with FlapJack, I use flacainide only when in Afib. 1 used to work but now after 7 yrs of in and out of Afib 5 to 6 times a year it takes 2 100 mgs of flacainide and a 3-4 rest period or overnight sleep to get back into sinus. Flacainide works well for me when out of sinus. I'm no doctor but if I were you I'd increase the bisoprolol and use the flacainide only when necessary to get back into sinus. I'll probably get a lot of flack for this suggestion but taking flacainide everyday is not the way to go.
I went the other way. I was, amongst other meds, on Bisoprolol 5mg twice daily, this made me feel absolutely rubbish. So they (gp/Arrhythmia Nurse and Cardiologist in agreement) then halved my Bisoprolol to 5mg morning and also put me on 100mg twice daily. This has had the effect of reducing episodes from 2/3 a week to one every 2/3wks.
Due to effects of condition/medications I am now at the point of waiting to get onto the waiting list for an Ablation.
One thing I have learnt is that it takes a bit of trial and error to get medications as right as it can be.
I wish you well.
Rob
Hi there please be careful with Flecainide. If you read my story on here you will see the awful time I had with it. Many of these drugs can cause potentially very dangerous arrhythmias. If it doesn’t feel right stop it xx
Hi Cicek, I had that very problem with Flecainide and got very worried as I was going into fast tachycardia every weekend. I developed a pro-arrythmia with taking this medication so went to see an EP privately who immediately took me off Flecainide and Bisoprolol and put me on 40mg Sotalol twice daily. Touch wood not had a problem since I changed last November other than a few ectopics. If you can afford a private consultation it's well worth it! Good luck and let us know how you get on
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