AFib and flutter/meds/heart rate…. All new and would appreciate insights

[Cazza06]

Hi everyone. Newly diagnosed with AFib and Atrial Flutter. Cardiologist has put me on 180mg diltazem of a morning and (recently from 50mg) now 100mg Flecainide morning and night. 2 weeks now and still having many AFib episodes throughout the day with heart rate spending 30% of time over 100. Just after advice if anyone has been in similar situation, is this a high dose of medication or normal and should I be seeking assistance if the AF continues before my next appointment with Cardiologist in 6 weeks. Thanks in advance, any insights would be appreciated.

[Hidden]

Hello Cazza and welcome to the forum. What you are experiencing in terms of initial treatment after diagnosis is not uncommon although drugs used and doses vary in accordance with patients needs. The important thing to do first is to get the heart rate down to near normal and assess the need for taking an anticoagulant which is generally assessed by applying a CHADsVASC score which you can do so Google it and come back to us if you are not clear on anything. All this is normally down prior to seeing a Cardiologist who would normally determine a treatment plan based on your individual needs so everything so far, seems to be on track. Normally, we encourage newly diagnosed patients to read the mass of information available on the AF Association website but at the moment it’s being worked on and isn’t going to be available until early July. I know you are in Oz, but in the meantime it might be worth looking at the British Heart Foundation website which also provides information about AF……others here will come up with lots of suggestions too, there are a number of members from Australia so they are better placed to offer help which reflects the capabilities of your healthcare providers……

[Cazza06 in reply to Hidden]

Thankyou very much for your response

[mjames1]

HI Cazza,

I see you edited your original post to reflect the addition of Flecainide, so in like manner I edited this response for continuity.

100mg is a normal dose for Flecainide. Same with Diltiazem which is often prescribed with Flecainide as an AV Nodal Blocker for safety reasons.

Are you sure you're in afib 30% of the time? I ask because recently another member here also thought Flecainide wasn't working, but then bought a Kardia device and found out that what he thought was afib was actually ectopic beats.

In any event, Flecainide should be monitored carefully, especially in the beginning, so given what may be frequent afib episodes, I would not wait another six weeks. But rather would call the cardiologist Monday and explain exactly what is going on. Also, at this point, a consult with an ep might also be in order.

Jim

[Cazza06 in reply to mjames1]

Thanks. Just realised my typo error. I’m on Flecainide 100 mg morning and night plus the 180mg diltazem

[mjames1 in reply to Cazza06]

Cazza, thanks for the clarification. I therefore edited my original answer to reflect the addition of Flecainide.

Jim

[Cazza06 in reply to mjames1]

Thanks Jim.

[Ppiman]

Those doses sound reasonable, Drugs such as diltiazem (broadly similar to beta-blockers in their effects) are used to slow the rate to at or below 100, and also in the hope that doing this will help return the rhythm to normal.

I would be asking for an echo-cardiogram so the cardiologist has a better idea of what effect the AF is having on your heart overall. The private cost of these (in the UK) seems reasonable these days given that the NHS is in a poor state. I'm not sure what the Australian situation is.

Steve

[Cazza06 in reply to Ppiman]

Thanks Steve