Flec 200mg and 2.5bisop and still in and out AF

[mjm1971]

Hi

So I should say I don’t really sufffer when I’m AF

My heart rate barely goes above 110 max and I get no real symptoms other than slightly light headed .

I am on 100mg flec and 1.25 of bisoporol in the morning and evening .

So should I still expect to go in and out of AF ?

I do still get brief episodes and I’m concerned this is an issue ?

[CDreamer]

If you are still getting episodes of AF it indicates that the you are getting what is called break through episodes which means the drugs/dose is not efficacious.

If you aren’t symptomatic I don’t think it’s anything to be concerned about. Are you on anticoagulants?

The biggest risk of AF is stroke risk so that would be of first concern. Treatments after assessment of stroke risk tend to be more about quality of life but most people prefer to stay in NSR so finding an efficacious treatment is best option.

[mjm1971 in reply to CDreamer]

Hi CDreamer

I have seen 2 GP’s

2 cardiologist

2 EP’s

All said I dont need a blood thinner due to age and the no other factors etc .

[CDreamer in reply to mjm1971]

Is your concern that you aren’t taking anticoagulants?

[mjm1971]

Hi

No I don’t think so ? Not with 5 experts saying I don’t need them ?

Should I be ?

My concern is the flex and Bisoporol are not working as well as they should be and what will happen now etc

[CDreamer in reply to mjm1971]

May I suggest that it’s not that the Flec & Biso aren’t working, more that the AF is progressing so you may need to return to your doctor and review the dosage or seek other treatment options. Flec was only effective at stopping AF for me for about 12 months, I then started to develop other arrythmias so I was glad to stop.

If you visit the AFA website you will find an explanation of possible options - other drugs, ablation or pacemaker or deciding to live with AF if you aren’t symptomatic in which case probably you will be advised to continue with the rate control - Bisoprolol and stop the Flecainide if it’s not effective at preventing the AF.

[Rubymurray25]

I had a similar situation where after I think about a year my flecainide and bisoprolol were not being effective so following a full on AF episode I was put on Amiodarone and that did the trick but after 7 months following an eye test it was discovered they had a negative with deposits in both eyes ( a generally noted side effect ) , I was then put on Dronedarone which has been really good for 8 months and I have had monthly blood tests for the liver and that has been fine.

[Hylda2]

I take 100 Flecainide morning and evening and 1.25 Nebivolol in the morning. EP has suggested 150 each time but then I would have no leeway so reluctant to try it at the moment

[secondtry]

I always maintain the episodes have to be stopped as the heart is likely to get used to and develop them. In your shoes (and I am also on Flecainide 200mgs) rather than go up to the top dose of Flec, I would tolerate the episodes for a year whilst working flat out on the myriad of lifestyle changes that can be made and are frequently discussed here.....throw the kitchen sink at it, as you can always re-introduce old beloved habits once you have stopped the AF. Good luck.

[doodle68]

I am sick of taking medication which appears to do very little but produce unpleasant side effects , with the exception of Apixaban I am tempted to stop the lot (gradually of course) .

I used to get symptomatic episodes of P-AF every couple of weeks and felt reasonably well the rest of the time, now due to side effects of medication I feel awful all the time and still have the episodes of P-AF.

[Buffafly]

If you are asymptomatic and don’t have high heart rate and don’t need anticoagulation the only issue is whether you are worried about your AF becoming permanent?

[mjm1971 in reply to Buffafly]

Hi Buffafly

Yes I guess that is a concern as once it’s full time AF my ablation odds are much lower .

I’m aged 50 so I still worry about a stroke as well even though so many experts have said I don’t need thinners

[KMRobbo in reply to mjm1971]

So why not get an ablation now? Hopefully you won't need drugs after. I have not taken anything since May 15 2018 , except paracetamol.

[mjm1971 in reply to KMRobbo]

Hi Robbo , I’m hoping to but only just started the process at St Barts this week

[Spoiler]

I have been on flecainide anywhere from 50-150 twice daily over a period of 4 years. Started with 50 and graduated up to 150, but for the last 16 months back to 50mg. My case is oddball I suppose, but the higher doses made me worse with much more and longer episodes. My EP said that the heart remodels and there is not an explanation, but if less works better that is what we will do. I take metoprolol 25mg twice daily also. My rates go much higher than yours (150)and I am symptomatic. I also take warfarin, a blood thinner.

[Simoni]

I'm age 57 also on 2,5 Bisoprolol once a day, and Flecainide 50mg twice a day and I get episodes of AF off and on...for no particular reason....its so unpredictable....and frustating...