I was diagnosed with A-fib in September 2021.
I have been taking Diltiazam for about two months in an effort to reduce horrible feelings from PVC’s. This, prior to a-fib diagnosis.
Doc now saying Diltiazam not effective for A-fib and is going to start me on Flecanide after review of tests. I fear this med. and am
Not too keen on any med. really.
I will appreciate your thoughts, advice, helpful hints, and practices to avoid.
Thank you
Hi and welcome
You don’t say if your AF is persistent - there all the time - or comes and goes - Paroxysmal AF or PAF.
Are you symptomatic with AF? Some people do not have any symptoms whereas others are very symptomatic and it prevents them from carrying on daily life. If no symptoms I would rethink taking any drug but if symptomatic you will welcome anything that helps!
These are my experiences and opinions (not medically trained) re: Flecainide
You should have had all of the tests - ECG, Echocardiogram, Bloods etc before making any decision on any medication.
Flecainide is a very powerful antiarrythmic- can be very effective for stopping and preventing AF BUT it has quite a few down sides so I would ensure you research very carefully as it can also cause other heart rhythm anomalies which are more serious so in the UK (not sure where you are based) can only be prescribed by a doctor trained in cardiology. It is a toxic drug so you will need regular blood tests for liver and kidney functions.
It is often prescribed with a beta-blocker as this some doctors believe can help prevent developing other arrythmias.
You can take a high dose to stop an AF episode and if infrequent - I would rather do this than take every day. Called a PIP - Pill in the Pocket.
You can take much lower daily dose to prevent AF. If it doesn’t prevent AF then it’s pointless to take Flec IMHO because of the possible undesirable affects.
First dose of Flec should be medically supervised - I had to spend 6 hours in the clinic to ensure I didn’t develop unusual rhythms but it seems I was unusual as many on this forum seem to have just been left to take at home without much guidance.
Max dose is 300mg in 24 hours - very important you do not exceed this dose.
I found it made me very nauseous if I took on full stomach so best taken on an empty stomach.
It doesn’t always work but it helped me limit ever more frequent AF episodes for about 2years but I did have longer lasting and undesirable affects.
You don’t mention the qualifications and experience of your ‘Doc’. I would only want a cardiologist or preferably an expert Electrophysiologist to be advising me on treatment options.
Has cardioversion or ablation been discussed?
You can read all treatment options on the AFA website - very helpful in helping to decide which is for you.
heartrhythmalliance.org/afa... I would suggest you start your research there.
Are you taking anticoagulants? If you haven’t already I would press for assessment of risk of stroke and discuss this with your doctor as a matter of urgency as an increased risk of stroke is you main risk factor with AF and this can be reduced by taking a prophalactic anticoagulant.
Hope some of that helps and don’t hesitate to ask questions as this is a very friendly forum with some very knowledgeable people and infinite range of interests so always someone you can relate to.
Best wishes CD.
Thank you so very much.I am paroxysmal A-fib. I feel every irregularity and it’s most uncomfortable . I haven’t fainted etc. but feel a tad off balance. I am seeing a cardiologist. He is not a big fan of ablation but at this point I am leaning towards that over medication side effects- they just all seem horrible.
I have an appt. at Cleveland Clinic January 4 ; mainly because if ablation is the way to go I want it done there.
I am currently on Diltiazam - calcium channel blocker- placed on that for BP control and PVC’s ( was not diagnosed with a-fib yet) Placed on Diltiazam about two months ago.
This is a scary new road for me.
I appreciate so much your response and I wish you well
Cannot add to CD’s reply but would emphasise the point that if you are taking Flecainide as a regular, daily maintenance dose then you should also be taking either a beta blocker or a calcium channel blocker. This isn’t the case if you are taking it as a Pill in Pocket as and when needed…
Thank you so much for responding.I much prefer PIP , and I will ask my doc about this.
I had hoped to get off the Diltiazam I have been on fir two months but you and others mention taking beta or channel blockers with Flec.
I wonder why?
I am grateful for your insight.
Stay well
The reason is that for some, it can cause other, potentially more serious than AF arrhythmias….
With Flecainide you need an 'AV node blocker' as well so that the Flecainide doesn't cause your heart to start beating too fast. It's also essential that your cardiologist checks your heart for any morphological changes before prescribing the Flecainide. Usually this is done with a procedure called echocardiogram. I'm guessing you've had one of these? As I mentioned above, I take Flecainide with Diltiazem - one to correct arrythmia, the other to control the rate. It does seem to work. The Diltiazem also assists with high BP if you have that. Often goes with AF.
Flecainide is my wonder pill and I take it daily alongside a small dose of beta blocker. It has decreased my AF and I can now lead a fairly normal life. Many other members on this forum can tell you the same thing.
None of us want to take medication, but believe me I've tried to stop many times and back comes high rate AF.
Jean
Thank you so so much for this reply!
Hi, I was diagnosed with AFib in August this year. I have had one Cardioversion that lasted a week I was then on to Solatol, kicking and screaming. I was AFib free for a week recently but now back in AFib. You mentioned PVC’s. I had them so bad I was on a anti- anxiety drug. There seems to be no correlation between the two problems but I disagree. I feel quite good as long as I take it easy but exercise stopped the AFib as well as meds. Good luck on your journey.
Welcome figbar. I’m sorry you find yourself here but you are in the right place. Ask any questions and someone can hopefully help you or direct you to the right place. I too am/was symptomatic PAF and have been on daily Flecainide, lowest dose, for circa 17 years. First dose was given intravenously in hospital under the watchful eye of the medical staff for the reasons already mentioned. I don’t though take a beta or channel blocker alongside. This was never mentioned or prescribed. I have had 2 ablations and almost a year of healing later the second one seems to have worked. I will still be taking Flecainide until my next review with my EP (electrophysiologist) next year.
It is a lot to take in and try and get your head around having just been diagnosed but it does get easier. I hope you can get a lot more answers at your appointment too.
Take care
Frances x
Hi Frances, you are in our very select club of taking daily Flecainide longterm without a BB or CB. May I ask 1) I assume you have Lone PAF with no comorbidities, correct? 2) You were under 60 when first diagnosed? My cardiologist didn't tell me much, he just said a BB or CB would make me feel unwell.
Yes to both but no to both now ☹️
Thanks, hope things look up soon.
It is a lot to take in.I feel defeated
Flecainide has been great for me for 7 plus years. Although regarded as a powerful drug, it is also a relatively old drug that has been tried and tested. Cant add much to what has already been said apart from my cardiologist was against Flecainide as a PIP probably because I had had 9 episodes in 5 weeks. Secondly if you do decide to take it wait 3 hours after a meal and don't eat for 1 hour after swallowing it. Lastly, I was started on 100mgs/day, which wasn't enough and so instead of an offered ablation I requested the medium dose of 200mgs/day which did the trick. Best wishes.
Hi and also to Figbar for me, wait 40 mins before eating, and drink plenty of fluid as it's fluid absorbed), I find I can tolerate taking it if needed 1.5 hours after eating.
CDreamer gives a good response. I'm on Flecainide together with Diltiazem (like a BB it slows the HR down) and pre-ablation that worked except for every couple of months, when I'd have to take extra pill in the pocket. I got on pretty well with that drug regime and preferred Flecainide to my original Beta Blockers. With meds it's a matter of getting quality advice and trial and error. ultimately it's about quality of life - what works for YOU and allows you to get on with your life? TBH all drugs are scary - it's a trade off against QOL and risk factors. Sorry if that sounds pragmatic - I do relate to how you feel.
I felt so unwell on beta blockers.Diltiazam better but effective? Certainly not against a-fib since after weeks of many PVC’s I entered A-fib.
I think they are totally related.
Thank you
With the PVCs have you tried slowing your breathing down to 6 times in and out a minute? If you check on the York Cardiologist YouTube channel there's a video about this and he explains a bit about the research into it. Look for Ectopics in the title as PVCs are a form of ectopic. It's a great series of videos from a bona fide cardiologist
I wonder if others have started Flecanide without direct hospital/MD intervention?My cardiologist said as long as my ECHO shows found structure and certain lab studies ok, I can just start the med.
I did, sort of. Started on Bisoprolol at A and E (ER) Then paid privately to see an EP taking my echo results and EGG readings with me. He offered Flecainide + Diltiazem as an alternative to the meds I was on. The pandemic hit and having had a couple of unpleasant events, one which ended in hospital, I decided to make the switch. Got my GP to approve the advice from the EP - all of which was in writing of course - and started it unmonitored. Bloody scary actually as at that time you couldn't get hold of your GP for love nor money. I think I had COVID around this time too just before I made the switch. I'll never know for sure as there was no testing available at that time and I did not have the classic symptoms. We now know there's a wide range of typical symptoms and I'm pretty sure I had it.
Long story short - yes, if you've had the Echo and a cardiologist approves the meds you can - as far as I know - make the switch. But you'll need monitoring - your platelets, kidney a liver function should all be mapped. None of which happened to me BTW due to pandemic - but I'm still here.
LOL. I started my life as a professional singer but I haven't performed for a while. I fell in love with teaching and now run a voice education company with my other half, who started life as a pianist and woodwind player.
Nice!
When my Afib stopped for a week it was after a rather difficult walk up hills. My Cardiologist said it was from my medication but I have read others, on here, that have stopped the Afib by aerobic exercise. I am going out this morning to try this out again. 😀
Do any other Fibbers get headaches during or after episodes?
New to 
New to this forum.
New to the AFib community.
Happy New Year and Potassium/AFib
