Flecainide x 2wks now put me in flutter. EP says means better chance of next cardioversion sticking this time. Anyone else similar

[Turquoise19]

My HR is more up n down but regular. Last cardioversion lasted 4 days, 3 weeks ago. Hope is to keep me on Flecainide 100mg BD. Also on the list for a 2nd ablation.

Be interested in your thoughts and experiences ?

[jwsonoma]

I don't know if you are taking a rate reducer with your Flec buy my Cardiologist insists I take Bisoprlol with Flecainide so the Flec won't put me in flutter.

[Turquoise19 in reply to jwsonoma]

Yes thx Jwsonoma, I am taking 10 mg of Bisoprolol as well and still getting the flutter.

[steve60]

Flecanide didn't work for me at all been on bisoprolol 1.25 for many years now. According to ChaDs2 not due for an ablation for 5 yrs

[lacolyn]

Hi, sorry to hear that. I was initially on F & B after my ablation about 5 years ago, now nothing but a blood thinner. I very occasionally take a Flecanaide if I feel a bit peculiar! It's a feeling that I can't really place, not fluttery or afib but just not right in a way that reminds me of the old afib days. As a Pill in the Pocket it seems to have some effect, or maybe the feeling would have gone anyway! Good luck.

[Turquoise19 in reply to lacolyn]

Were u ever in persistent Lacolyn ?

[lacolyn in reply to Turquoise19]

No, I 'only' had two serious episodes of Afib spaced over a few years, both needed emergency evacuation, one was by helicopter - which would have been more exciting if I had been more aware of what was happening. Good luck.

[Coco51]

Some of your experience strikes a chord. Flec has worked for me in the past as a PIP. Before my second ablation I was in persistent AF. A dose of 100g Flecainide 3 times a day cardioverted me back to NSR but I felt so awful I had to stop!

So I went back down to the same dose as you - 100g 2 times a day with 1.25 of Bisoprolol - it didn't stop the AF just made it feel less chaotic. It felt better.

I had a cardioversion while on Flec and Bis to take me up to the second ablation but it lasted only 6 hours! Big disappointment as one the previous year had lasted 3 months up to the first ablation.

I came out of my second ablation ready to take Flec with Bisoprolol as a PIP but had such a rocky recovery I took it all the time and still do. But I don't seem to be getting much AF now and I am thinking of cutting down on the medication and maybe phasing it out.

Don't know if that helps you. Best of luck.

[Turquoise19 in reply to Coco51]

Yes thanks Coco, good to hear you. My first cardioversion lasted only 4 hrs before my first ablation. 4 days 3 weeks ago. I am v scared of it not lasting again on the Flecainide also cos my HR is higher now than 3 weeks ago. I am also on 10mg bisoprolol. Massive impact on quality of life. I usually exercise daily.

So how long now have you been 'maintained' on the Flecainide. How comes your 2nd ablation didn't work ?

[Coco51 in reply to Turquoise19]

Well, I ave been on the Flec & Bis combo off and on for 4 years - since the re-currence of the AF after the first ablation. Persistent AF is harder to treat.

But actually I really wouldn't say the 2nd ablation hasn't worked. It has. My AF is very infrequent, slow and manageable now. Before the 2nd ablation I was in persistent fast AF controlled by Flec. Now I'm mainly in NSR. But the recovery period after it was slow. My heart was very irritated and there were 4 months of awful AF and that was when I went back on Flecainide.

Trouble is my regular heartbeat is very low around 43 bpm and went down to 36 once. So now I have a pacemaker. That's why I'd like to wean off the meds so the pacemaker works less often. 1.25mg Bisopfolol slows me down and 100mg bd Flecainide too. To use a driving analogy it's like driving with the handbrake on. No oomph! 10mg Bisoprolol sounds like an awful lot and I'd be passing out on that. How do you cope?

[Turquoise19 in reply to Coco51]

Thanks Coco, yes very good to hear you. Can I ask you a bit more about how you felt the Flecainide held you before your 2nd ablation? I have a 2nd try cardioversion on 16th Nov and now on the waiting list for a 2nd ablation.

Be very interested to know how the Flecainide worked for you before and after the 2nd ablation.

I also get quite a low HR in NSR but somehow tolerate the 10mg bisoprolol. Just can't exercise on it,

[Hidden in reply to Turquoise19]

Please don't hesitate to contact AF Association for support & information should you need it: [e-mail] / 01789 867 502

[Coco51 in reply to Turquoise19]

Hi again. Before the first ablation I gave up on Flecainide because I had gastric problems and it made them worse.

I didn't feel I needed it till 9 months after the first ablation when the persistent AF returned. So I was booked for the 2nd ablation and told to try 300mg Flecainide ⁰ (100 mg ×3 daily) for three days and amazingly I went back into NSR for a whole month! During that month I was on 200mg daily (100mg x2 ) till AF again returned. The 300mg worked again and got me another month of NSR.

I stayed on 100mg x2 then, even when the AF came back. But when I had an ECG the AF looked less chaotic and the nurse said that the ECG looked better "more organised". So I kept on with the Flecainide and the Bisoprolol was put up to 2.5mg. At that point, in fact, I did consider not having the next ablation, but in the end decided to go ahead.

After the 2nd ablation the Flecainide was withdrawn and I went home with instructions to take it as a pill in the pocket, so if I started to have AF I was to take Bisoprolol, wait 20 mins and then take 100mg Flecainide.

Well after 5 days I got AF again, did the PIP routine, but AF went on for five days. So I kept taking the Flecainide. I had several more bouts of bad AF with nasty pauses over the next 3 months ( the so-called "blanking period"). Whether it would have been worse without the tablets I don't know. But then suddenly it stopped and I had a long period of NSR . Bliss!

I felt so well the consultant suggested halving the dose. Sadly after 3 weeks I started getting bouts of AF again. So I eventually upped the dose again and that's where I am now 4 yrs after the 2nd ablation. Getting very little AF thank goodness but feeling fatigued. My QR interval has got very long, hence the PM. I think the tablets cause that. So I might have another stab at weaning off them.

I don't know if that helps or is simply too much information! All the best.

[Turquoise19]

Very helpful to hear you Coco. Golly it has been quite up and down for you. Glad you feel so much more in balance now.

It is horrible isn't it, when bam you're back in AF.

Since yesterday my HR has come down a bit, now 70 odd v 100/110 resting yesterday.

Like you say the Flecainide does seem to steady it . Consultant said the other day I was in Flutter thx to the Flecainide... he was happier about that.

Just have to see how I go next Tuesday for my electric cardioversion and wait for ablation no 2.

I like to do a lot of exercise when not in AF/on these meds so would like my energy back, like you say they do leave u fatigued.

Can you remind me about the QR and PM what they mean ? Aware the QR is something to do with slowing the intervals of the conduction in the atria, if I am putting it right?

Will you be reducing your dose any time ?

Thx a lot

T