New meds advice or opinions please....

[Andyb7612]

Hi everyone...I was at the cardiac unit last Friday for an echocardiogram and was hoping to be able to ask one of the arrhythmia nurses a xiuple of questions about my new medication but was told their was no one available at that time and must phone back later !!.. anyway I thought I would ask on here to see if anyone would share their advice....basically I'm on 50mg flecainide and a 1.25mg of bisoprolol daily...been on it now for just over 3 weeks..my symptoms have improved massively where I was getting af episodes lasting from 10 minutes up to 3 hours every other day basically I now get what feels like a skipped beat lasting a couple of seconds every 3 or 4 days ...is that enough improvement to say I'm on the correct dose or should I have a stronger dose so I never feel anything at all ?I'm.just a bit confused at the moment and can't seem to get any answers from the cardiac unit ...thanks andy

[CDreamer]

A skipped beat or an ‘ectopic’ is a sign that your heart is attempting to go into AF but not doing so I would say it’s a good sign. These are potent drugs so IMHO you want to be on the lowest possible dose to be effective in preventing AF, yet not have unwanted affects.

Obviously we are not medics so cannot give advice about medications or dosages but if it ain’t broke, don’t fix it comes to mind.

Here is a link to a very good video which explains exactly what goes wrong in the electrical pathway and where to cause a skipped beat and other types of missed or extra beats.

Everyone has these every day, but most people don’t notice them unless they become multiples and happen very frequently every hour. We AFer’s tend to be super sensitive to feeling them but they are considered benign. If they continue and bother you or you are symptomatic, then I would contact your Arrythmia Clinic and ask for guidance.

Originally posted by Secondtry but I thought it the best explanation I’ve seen.

youtu.be/Hi7YWVU7kH0(Not working as expected?)

[Andyb7612 in reply to CDreamer]

Hey thanks for that cdreamer ..yes you are definatley right there , we afibbers are super sensitive to any changes in our heart pattern...I shall watch the video for sure....the missed beat feeling does not bother me at all...its 100% better than the afib episodes , I just didn't know if it was a sign the drugs wernt strong enough ...

[BobD Volunteer in reply to Andyb7612]

I agree with DC and further suggest that you try the slow deep breathing. Use diaphragm (stomach) not shoulders and slow breathing to less than 6 breaths a minute for at least five minutes. Stops ectopics for most people.

[Andyb7612 in reply to BobD]

Hi Bob thanks for that advice...I have always done that to help when my afib was bad before these new meds and it did help...but these afib beats I feel now dont last longer than a second or two at the moment and long may that last , lol ,,and seem to go on their own , but i was always under the impression which doesn't seem correct now that if the drugs are working properly you should definatley feel no symptoms at all especially at the beginning of the drug therapy...but it seems that might not be the case afterall...

[BobD Volunteer in reply to Andyb7612]

If only Andy. After my third successful ablation it took me probably a year to stop worrying about my heart and ignore every little blip but eventually I got on with my life till the next crisis three years later (prostate cancer) and once that was sorted I had another few years of peace and quiet before the next problem. Life is about managing expectations and accepting limitations.

[Andyb7612 in reply to BobD]

Yeah you are 100% right on that Bob for sure...I need to try and stop looking for every blip that my heart does and try and forget about it and live my life as best I can ...It is hard though as I am one of life's bad worriers which doesn't help ...all the best ...

[Kaz747]

My EP recently advised me to increase my Magnesium supplements and take some in the mornings (even though I was on a fairly high dose taken at night) to help settle my ectopics and it has helped immensely. I actually feel “normal” most of the time now and that is a wonderful feeling 😊

[Andyb7612 in reply to Kaz747]

Hi kaz thanks for the reply...do you just take magnesium supplements and no medication at all for your afib ?

[Kaz747 in reply to Andyb7612]

I take magnesium and Attenolol. I was taking 1/2 tablet a day and when I saw my EP in February, when he gave me the magnesium advice, he told me to take a full tablet every second day and a half tablet on alternate days so that may be helpful as well. I’ve had 4 ablations for various arrhythmias including AF. The last one was three years ago.

[Andyb7612 in reply to Kaz747]

Hi again , I shall try the magnesium I think , I don't know what the attenlol is , I guess it's your medication...are you afib free nowadays then after the abalations ? I'm on the waiting list for one but it will be over 12 months wait yet I've been told...

[Kaz747 in reply to Andyb7612]

Yes AF free (as far as I know) but get occasional tachycardia and ectopics.

Atenolol is a beta blocker.

[mjames1]

Hi Andy,

No afib in 3 weeks -- I would say so far that is 100% improvement. '

An ectopic, assuming that is what it is, every 3-4 days is normal, even for people without afib. So my non professional opinion is absolutely no reason to increase your dose of flecainide, nor feel compelled to change anything else. Things seem to be working as is. As noted, a little deep breathing can be beneficial, especially should the ectopics become more frequent or develop into runs of a longer duration.

Curious, you say you're taking 50mg of flec a day. Not always, but Flec is usually dosed 2 times per day, 12 hours apart. Are you 50mg once or twice in 24 hours? Or perhaps taking 25mg twice a day?

Jim

[Andyb7612 in reply to mjames1]

Hi Jim yeah I'm on 50mg twice a day 5.30am ish and again at 5.30pm with the 1.25mg bisoprolol taken with the morning dose..sorry I should of been clearer on that...yeah I must admit it is a big improvement so far but I take nothing for granted and am always waiting for it to change negatively and notice everything with my heart patterns and time the days in-between what feels like an afib episode trying to start or etopics if that's what they are instead , as they only seem to last a few seconds then stop at the moment....would be nice if that continued for a long time , but we all know to well the unpredictability of this condition don't we....

[mjames1]

Just anecdotal of course, but I started Flec several months ago and found the longer I took it the more effective it became. Started with 50mg twice a day (bid). Then had a few episodes and got antsy and convinced my doctor to increase to 100mg bid. Didn't feel well on that dose, so then went back to 50 bid and it worked just fine. A few days ago reduced dose to 25mg bid and hoping the lower dose will work. So far, so good. Flec is strong drug. You really don't want to take any more than you need.

Jim

[Andyb7612 in reply to mjames1]

Thanks for that Jim, that's good advice , yeah ive only been on it for just over 3 weeks now so it isn't that long really...

[Andyb7612 in reply to Andyb7612]

Could I ask Jim how long were you getting a few episodes before it all settled down ? thanks

[secondtry]

3 weeks is hardly long enough to evaluate, more like 3 months.

[Andyb7612 in reply to secondtry]

Hi there, do you mean to see if it's effective properly or because it can take that amount of time to fully get into a person's system fully ?

[secondtry in reply to Andyb7612]

My system needed to adjust to the drug in the body and then some more time to settle.

[Andyb7612 in reply to secondtry]

Yes I think you are definatley correct there...like most drugs they can take 2 or 3 months to fully get to 100% efficiency..I have just read one of your past posts about flecainide and note you have been on it successfully for the last 8 years do you take any other vitamin and mineral supplements daily that you think is a positive benefit for your afib treatment? ..sorry for the questions but I'm still new to all this really and appreciate as much advice as people are willing to give thanks andy

[secondtry in reply to Andyb7612]

No problem asking Q's Andy.

I saw a Naturopath on diagnosis and he put me on (like all his AF patients) nutriadvanced.co.uk/megamag... (note all the ingredients) and CoQ10; initially I tested my levels with a simple blood test (private BioLab London) every 6 months as he said they need to be at the top of the normal range. Note the Mg level test is not the GP test but the Red Cell Mg test. Before starting I did run it pass the medics who just raised their eyebrows as expected.

I also take krill oil and lately with Covid around Vit C, Vit D & a multi vitamin/mineral for Oldies (Lamberts) and fresh garlic most days as I am not on AntiCoags and think this may help.

Of course I have no clue what helps and what is unnecessary but you have to do lots of trial and error and when you reach good QOL you tend to stick there rather than rock the boat....anyway that has been my policy.

[Andyb7612 in reply to secondtry]

Hi thanks for the info again..I think your policy is a good one to have...the garlic is something I shall look at for sure as I am not on anticoagulants either due to ep saying my chadvasc score is 0 but I can't see any harm in taking something that might help in that way...thanks again for taking the time to reply and all the good advice...all the best ...

[Hidden in reply to secondtry]

Wow, thanks for the garlic tip, secondtry! Having seen your comment I've been reading up on it, and it does all sorts of wonderful things (like lower cholesterol for example) as well as preventing platelets from clumping (ie anticoag). I'll be eating garlic from now on.....plus apple, lettuce or mint....which apparently do some magic chemistry in the body to prevent the garlic whiff. What do you use?

[secondtry in reply to Hidden]

Green mint tea.

[Hidden in reply to secondtry]

Do you drink it before? With?

[secondtry in reply to Hidden]

After.