I'm wondering whether to consider packing in Flecainide as all its seems to have done is replace Afib with atrial flutter and the initial benefits appear to be waining, especially now that I'm supposed to take Bisoprolol too. Has anyone else decided to live with Afib on no drugs (other than anticoagulants) rather than have flutter on Flecainide?
What's the point of taking Flecainide... - Atrial Fibrillati...
What's the point of taking Flecainide if it gives you flutter?
Written by
MisterMagoo
To view profiles and participate in discussions please or .
Read more about...
40 Replies
•
You didn't give a lot of information, so not sure if a dose change would help or not.
But I did previously read that bisoprolol is changing you into a "zombie". Does that to me as well.
I therefore took my flecainide with diltiazem, a calcium channel blocker instead. It performs the same safety function as bisoprolol, but for me I feel a lot better on it.
Jim
Thanks for the diltiazem suggestion. I'll try and talk to my nurse about that. I do wonder want the real risk of ventricular arrhythmia is. Before Flecainide my max heart rate regularly exceeded 200bmp at the start of exercise and this was normal for me before it settled down to about 170. On Flecainide with flutter it has never gone above 170. My Flecainide dose is 50mg twice a day. Bisoprolol is one dose of 1.25mg. Since taking Bisoprolol my max heart rate is 132 and resting is 45
Not sure I follow. You said you exceeded 200bmp. I'm assuming that was in afib? Not sure I'd be exercising at that heart rate.
Some here, take flec without a nodal blocker but personally I'd be scared to at normal doses not to mention my ep would not allow it. A lot depends on your doctor and I assume your age and the structural condition of your heart and yes, how some of those studies are interpreted.
Currently I'm on 25mg flec twice a day and at that dose I was allowed to go off Diltiazem. At one point I was on 25mg evening dose and 50mg night dose. There, I only took fast acting diltiazem at night and no diltiazem during the day, so most of the side effects from the diltiazem I slept through.
Jim
Interesting about taking the diltiazem at night. I wondered about taking Bisoprolol at night but thought that, being on a low dose, the protective effect would be lost in the early evening when I need it most as that is when I'm generally exercising.
The 200bpm when exercising has been perfectly normal for me and calms down after about 10 mins. Docs never been concerned
To clarify, I didn't take the fast acting diltiazem tabs at night because I could sleep through the side effects, I took it at night because my evening dose of flecainide was 50mg and I needed nodal protection. My morning dose of flecainide was only 25mg and my ep decided it was low enough that I didn't need nodal protection. That said, the side benefit of taking the diltiazem at night was that I slept through most of the side effects.
So back to your 200bmp heart. Were you in afib when it was this high or were you in sinus rhythm. Also, if I may ask, about how old are you? While I've read that some people convert by going for a run, I'm in my 70's and would be concerned about exercising at such a high heart rate.
Jim
I'm 57. If anything, the running brings the Afib on.
You've given me alot to think about WRT drugs, dosage and timing. Thank you, much appreciated
Well, I'm impressed you can get your HR up that high in normal rhythm, as your predicted maximum heart rate is onlyn163 compared to the 200 you work out at. I assume then that you are an elite runner for your age group? In any event, if working out at that rate brings on afib, maybe think about working out at a lower rate, maybe somewhere in the 120-140 range.
Jim
I take Flecainide daily. I used to be taking Bisoprolol as well but my EP stopped it because my heart block and Bradycardia meant my heart was already beating too slow.
Pete
Makes sense Pete.
You're on the lowest dose of both Flecainide and Bisoprolol.have you discussed with your EP or cardiologist?
I took 100mg twice daily for 5 years. No beta blocker. Then as I was getting short runs of regular tachy in 2016 my GP tried me on 1.25 bisoprolol again, I couldn't function on it so it was stopped and flec reduced because of this to 50mg bd very slowly. All good til 2021 when started feeling rubbish, fatigue nausea ( ? related or not) runs of fast regular tachy.. Saw Cardio Sep and flec increased to 100mg twice daily for same reason it was reduced!!. This has settled everything down. Hey ho
How confusing! All seems to be guess work and trial and error. All well and good but I have to function at - for me - a high level, every day at work and all this mucking about with dosages is stressing me out
Well,all I can say is I am surprised that you have been given flecanide without a betablocker. I was given a chemical conversion with flecanide without beta blocker and developed flutter exactly one week later. I was told this( by hospital B) was very unusual and quite an oversight by Hospital A.Please do NOT self medicate with this powerful drug and please do take the Bisoprolol or other beta blocker m
Flutter was my worst arrthymia. X
Thanks Wilsond. What I don't understand is why give Flecainide to relieve Afib if it replaces it with flutter which is as bad if not worse and then needs a beta blocker to stop an even more dangerous condition?
I won't be exploring any options without the express supervision of the Afib team at my hospital.
Tough call this one. I found flec wonderful and had two years afib free on it. No beta blocker with it (wrong call IMO). I was on 100mg twice a day and it worked well, I think were I went wrong was taking extra (for example after a big meal) and not knowing what a serious drug it is. On the dose you are on I wouldn't think it would cause flutter, However I am not a medic and think you should discuss this with your doctor.
Good luck.
Paul
Thanks, Paul
My dosage of Flecainide does cause flutter, as a holter and 3 subsequent ecgs have shown.
So I now find myself questioning the point of taking Flecainide as I'm left with a condition that is just as bad and made even worse by the side effects of Bisoprolol.
I understand MM. I wonder if Sotalol might be better for you ? Certainly worth a mention to your medic !
Once again good luck and I hope it's get's sorted soon.
Paul
I could see the point of trying another beta blocker if having flutter was better than Afib but it's at least as bad so I think I might as well just live with Afib and not need any beta blockers
I don't the answer to that MM - I think this a decision only you can make. I'm off to bed soon but will reply to any further comments in the morning. You do know don't you that ablation for flutter has a very high success rate ? Maybe this is another option to consider ?
Best,
Paul
Thanks, Paul.
Ablation for both flutter and Afib were mentioned as a possiblity at my last consultation, when they pointed out that I've had Afib for 12 years now and only in the last 6 months have they looked at treatment. That was a month ago and I've heard nothing since. Don't hold out much hope unless I raid the pension fund to pay for it myself, as seems to be the trend nowadays.
Sure MM. It's not cheap though if you go private - still it's your health but expect your pension fund to go down a little if go down that route. Whatever you decide I really hope it works out well.
Paul
As with all drugs, Flecainide won't work for all comers. I think the record holder on this Forum has taken it for 35 years. I have taken 200mgs for over 8 yrs now without CB/BB and have been absolutely fine. Conclusion: Everyone reacts differently.
I didn't have afib but wpw so different situation. I didn't know I had wpw but was put on flecanide and experienced flutters, palpation etc that I didn't experience before so after 6 weeks I spoke to my midwife and I stopped. This was 25 years ago and I was only the 2nd pregnant lady to be seen with wpw and was a bit of a guinea pig at a university hospital. They actually admitted that when I got pregnant again.Don't just stop, speak to the cardiologist.
Hi MM ,
Sorry to hear about your situation.
Just to say I find myself in the same position as you , I feel I have swapped Afib for another beast , just as bad.
No solutions for me so far but I’d be interested to hear how you get on.
Good luck & I hope it gets sorted soon .
Jayne
Thanks, Jayne. I'll update the forum as and when I get any progress. I'm going to try and talk to the cardio team about the option of coming of Flecainide and Bisoprolol as I no longer see the point of taking them. BTW I have no blood pressure issues and a low resting heart rate.
If your AF is causing you so little problem that you are prepared to stop all meds then I can’t see why you would qualify for an ablation. On the other hand, very high rates are bad for your heart in the long run so maybe your exercise regime should be tweaked instead.
My Afib causes problems of fatigue that affect my ability to do my job and be a good father but the flutter is just as bad. The Bisoprolol is taking it to the point of incompatibility with work and family life. Ablation is a pipe dream in my postcode along with knee replacements and hernia repairs.
Flecanide did not work for me either so I am currently taking Dronederone and this is helping!
Not medically trained but I would say no point at all.. I was asymptomatic except high heart rate in afib, but coukd not get breath when walking in flutter.If I were you I would be looking fir other options.
I was tired of. Taking Flecainide and Diltiazem, too, so signed up for the clinical trial and had a pulse field ablation. Wish I would have had an ablation YEARS ago.
That's great news. Where did you have the ablation and who did it? If I'm going to have to raid my pension pot, I'd like to view all options and providers of care
Reading through all the responses, it is clear there is a lot of variation in treatment and responses to Flecainide. So it will add mine…I had an ablation two years ago, was prescribed 50mg/2 daily (along with a beta blocker that I was already taking for high blood pressure). Had no issues until two months ago when I began to get occasional periods of palpitations in the middle of the night. Some of these evolved into Afib, which I then handled by taking a PIP (another 50 mg of Flecainide) and deep breathing. Episodes went away in and hour or two. Still, irritating to have them. So my electrocardiologist suggested upping the flecainide to 100 at night, staying at 50 in the morning. So far, this is working fine, no palpitations or Afib, and no side effects.
Did they put you on a beta blocker? Are you on anticoags? I'm on both of these as after thoughts to the original Flecainide prescription
Yes to both. Had been on beta blocker way before Afib to control BP. And it turns out it complements with flecainide. And on Elliquis since diagnosed with Afib. 78 years old, hi chads score
Perhaps the AF was masking a flutter as well so that the Flecainide in treating the AF revesled the flutter ?
That's not what the cardio team said. They told me the flutter was probably caused by the Flecainide. I'm also sure they would have noticed any flutter along with the Afib. They may not be the best but I don't think they are that bad.
Hello Mr Magoo 
I just take an anticoagulant and the beta blocker Nebivolol having tried Flecainide and found it didn't work for me it increased the frequency and duration of my episodes . The Nebivolol just reduces my heart rate I guess making my frequent episodes of P-AF (approx every 10 days) easier for my heart to cope with.
I live with my AF, it does impact on my quality of life and AF days are miserable but I am used to coping with it now. I am retired and don't have to be anywhere which helps.
Doodle, that's what I was considering until zombie mode hit me. At 55bpm I think my resting heart rate is low enough but Bisoprolol does help keep my max down to a very low level, possibly too low at 130. I'm just going to stay on the anticoag for the next few days to see how things are after tapering the Flecainide down to zero over the last couple of days
Strange. I was put on 100mg x 2 Flecainide for flutter. No BB as I had bradycardia. It was godsend and completely halted my acute flutter.
I was started on Flecinaide along with my beta blocker (Nebivolol) and I immediately got flutter every time I took it. After 3 days of it I stopped taking it. I changed Cardiologists because the one I had told me to keep taking it and give it time to settle down. 😳. No thanks!
My new cardiologist, an EP this time and a very good one told me to take the Flec as a PIP. In other words when I have an episode to take 100 mg. I did that the next time I had one and it worked great to convert. I take 50 mg and then half hour later take another 50 mg. It has worked well so far for me that way and is now my best friend.
Not what you're looking for?
You may also like...
Atrial flutter and increase in flecainide
morning. Any advice on whether I should cut back on bisoprolol or flecainide ?
Flecainide converted my fibrillation to flutter
prescribing Bisoprolol to mitigate the risk of flutter causing ventricular arrhythmia. I'm now...
Flecainide eventually produces SVT or flutter?
2/3 times a week a 3 second or so flutter like feeling rather than a more pronounced ectopic, \\"...
Taking Bisoporol still getting Fluttering heart beats.
Bisoporol and still have fluttering wobbly heart beats. That last a long time . Not in Afib.
Atrial Flutter caused by Flecainide
cardiologist says is Atrial Flutter caused by Flecainide changing AF signals into AFlutter. I have...
What happens if I can’t take flecainide anymore?
Magnesium when you are also taking Flecainide 
What is your Flecainide experience?
