Reactions to Flecainide and Amiodarone?

[JumpingDo]

I am so glad to find this forum. Really validating to see how incredibly different people’s experiences with Afib are and the willingness to share. I’ve been in Afib persistently for a little over three months now. It returned several months after my first cardioversion, and hasn’t stopped except for a second cardioversion which lasted only three or four days. I am 79 and my mother had a heart condition; these are my only factors, as I am very active, normal weight, eat healthy, and have a pretty stress-free life. Even while in Afib my BP and pulse are normal.

My cardiologist had me on metoprolol 50, and Eliquis 5x2, for occasional episodes, and he did the 1st cardioversion during a several weeks-long episode. He referred me to an EP when I went into Afib again. EP added Flecainide to my meds and did the second cardio. I felt the flecainide initially increased the symptoms I was feeling of weakness and inability to exert myself without getting short of breath. After the failed 2nd cardio, the EP prescribed amiodarone 200, and had me stop Flecainide and Metoprolol. So I’m 4 days into the new meds and the symptoms of weakness, etc., seem even worse. Anyone have similar experience on amiodrone? Does the heart/body adjust to it over time, and maybe even get back into normal sinus? EP is giving it two weeks and then scheduling another cardioversion.

[mjames1]

Welcome to the forum and sorry you haven't yet found a fix for your afib. You are not alone.

A lot of people don't react well to Amiordarone and you may be one of them. It could get better with time, but not necessarily.

While it can't hurt too much to try, not sure another cardioversion will hold any better than the previous ones unless you stay on an antiarrythmic drug like Flecainide or Amiordarone, both of which you haven't done well on.

Has your cardiologist referred you to an ep yet and discussed ablation? Depending on how persistent you are, they can evaluate if this option might work for you.

In the meantime, why don't you speak to your cardiologist about using Flecainide or another anti-arrhythmic, as a pill in pocket as opposed to being on it daily. So instead of taking it daily, you will only take it when you go into afib and if it works, you will convert usually within hours at home. That way you won't have to deal with the daily side effects and if it works it will save you from multiple electro cardioversions. Flecainide requires a structurally sound heart and your cardiologist should be able to guide you there.

Jim

[JumpingDo in reply to mjames1]

Thanks for your reply. I believe my EP's design is to do an ablation if the meds and cardioversion don't work. I'm feeling better now so I'll stick it out for a while. I am in Afib all the time, but my pulse never races, so the pill in pocket is what I hope to get to!

[Fullofheart]

I have been on both. Flecainide didn't work so well for me and I developed a severe allergy to it over time....this was about 15 years ago. I can't really remember too well but I think it generally made the dizzinessand fatigue worse until the allergy kicked in.Amiodarone was a more recent experience. I was put on it to try for another cardioversion...( I've had 2 failed cardioversions and 2 failed ablations over the last 6 months).

Amiodarone was a fantastic drug for my AF. Only thing that has ever worked and brought me back into sinus rhythm (a miracle) but unfortunately I developed underactive thyroid as a result so had to come off it. This is a known potential risk.

I'm a different age to you though (mid 40s) and have underactive thyroid in the family. I think the issues with Amiodarone are usually linked to long term use so they are especially reluctant to use it long term in younger folk. You need regular blood tests for liver too. They usually use this drug to support a procedure such as cardioversion or ablation as a short term measure. You probably already know that. Sorry if I'm stating the obvious.

I'd definitely keep an eye on things and report back to your cardiologist. Wishing you all the best!

[Visigoth]

My own experience is that years ago when I tried flecainide it made my arrhythmia worse, whereas amiodarone has been like a wonder drug. For the first two weeks on it I felt really weird though. I’m aware of all the potential side effects but I have blood tests every six months and am just praying they stay ok! NB I have paroxysmal AF not persistent so I’m not in the same situation as you.

[Madelyn-8613]

I was amidiadarone for several mos. then I had an a stroke in my optic nerve on right eye and went blind. Researched my meds to see if they could have caused it and amidiadarone can plus it causes calcium deposits on your cornea. Very bad stuff. FDA even put out a warning on it I switched to flecanside and I do ok on it but it doesn’t seem to keep my heart rate as low as the amidiadarone but I’m studying with flec.

[Ren912]

I was given a prescription for amiodarone several years ago, early on. After researching I chose not to use it. After speaking with a neighbour with experience with it who advised me to avoid it I am now in persistent a fib. Not sure next move.