Flecanide daily

[B172]

I was diagnosed with PAF in 2018 and was originally on Bisoprolol now changed to Nebivolol which suited me better. I was taking 5mg of Nebivolol with Flecanide as a PIP which kept my episodes to 2 or 3 a year. I had to drop the dose as started to deal faint, off balance and dizzy last summer and it was deemed I was over medicated. However once the dose was dropped to 2.5 mg ( which in itself produced reactions)episodes increased to 4 in the last 3 months, which is not a lot I know compared to some. E P suggested 50mg Flecanide twice daily as a trial still with extra Flecanide As a PIP.

As soon as I started taking it daily I got episodes lasting about 10 minutes at a time where my heart was missing beats. There would be a few regular beats then a pause and then a few more beats etc.

Has anyone else experienced this as I'm not sure whether to persevere with it or not.

Sue

[mjames1]

How long have you been on Flecainide. It can take a week or two to settle in. I had a very rough first 10 days on Flecainide but now it holds me in normal rhythm fairly well, even at a lower dose than I originally was prescribed. Of course, we all react differently to these drugs so always follow your doctor's advice.

Jim

[B172 in reply to mjames1]

Thanks for your reply Jim. I took it for 10 days and then stopped it because of the episodes I described. The only info I got from my EP 's Secretary after she messaged him was stop if I couldn't tolerate the side effects. I'm trying to ascertain whether the episodes of missed beats were a side effect before I give it another go.

[mjames1 in reply to B172]

Not medically trained, but if it's just a few missed beats, ie ectopics, I personally wouldn't be concerned. Like I said, I had a rough first ten days on Flecainide with multiple afib episodes, sometimes three in a row over a five hour period. But after a couple of weeks things settled down just fine. I've only had a couple of episodes in the last few months compared to weekly episodes before I took it.

If you want to know more technically what is going on, I'd get a Kardia 6L. It will generate an ecg at home you can share with your ep. I think they are especially useful when you're taking an anti-arrythmic like Flecainde which can on occasion produce arrythmia's might need looking into by your ep.

Jim

[B172 in reply to mjames1]

Many thanks for your input. These ectopics, as you call them ,made me feel distinctly peculiar and were accompanied by spikes in BP which also happened every time I slightly reduced the BP medication.

I do have an Emay machine which produces a 30 second trace but it doesn't categorise what's happening as well as a Kardia. I may have to invest in one of those.

Gosh you did go through the mill a bit when you started the Flec. I think I was expecting too much too soon maybe.

[Singwell]

I've found Flecainide pretty effective in controlling my AF with between 6-8 bouts a year that I can knock on the head with an extra dose (you need medical advice for this of course). The key thing as I understand it is it's 'partner drug' which needs to be some type of AV node blocker. I'm not familiar with this other drug you mention for you BP but maybe that's the problem? Some of us take Diltiazem with Flecainide as it's effective for BP as well as doing the AV node blocking which prevents the Flecainide from triggering atrial flutter.

[secondtry]

I'm with your EP on this one. No experience of partnering Flec with Biso or Neb as I was put on just Flec (200mgs) and the first 3 months was a bit of a blur feeling weird. Then I started a Mg compound and CoQ10 and coincidence or not I started to feel more normal. Personally, I would give it a bit longer trial and keep a diary as to the side effects, so you can see a trend and advise your EP.

[Hidden]

I was taken off flecainide 50mg twice daily due to worsening flutter on it. Nothing in its place, have PAF. Just anticoagulant. I felt anxiety having to take it and that’s gone now I’m off it. The anxiety was also there before at the thought of it all, all the ‘cardiac journey’ ahead of me, the flec just made it worse. Wishing you well ❤️

[Kennyb1968]

I'm on Flecainide and it took about 3 weeks to make a difference. At first I was still getting daily AFib break throughs. As I went on these at first lessened in severity and duration and then pretty much stopped all together. I do get runs of ectopics which are harmless but annoying. Stick with it, I think the body needs to adjust but once it does I am sure you will be fine

[B172]

Thank you everyone for your informative answers. My EP had me trial Flecanide daily without an A V nodal blocker. This alarmed me at the time because I had read on here that it should always be accompanied by a low dose A V nodal blocker. Perhaps that was the reason for the episodes I started experiencing as soon as I started a daily dose and stopped when I stopped the Flecanide. I'll get onto my GP for advice before I give it another go.