Have recently been diagnosed with Atrial fibrillation after a scary trip to hospital with heart rate over 200 bpm. I’m now taking Flecainide & Apixaban to manage the condition Whilst I wait to have an Ablation procedure.
I’m feeling really fatigued and head feels ‘foggy’. Is this normal with AF? Or is it side effects of the new medication/ combination of my existing medication (I already take tablets for anxiety, depression and high cholesterol).
Any experiences of similar to share would be really helpful. Thanks…..
Written by
Nick1305
To view profiles and participate in discussions please or .
hello Nick and welcome to the forum. I’m sure you will understand the reasons why, but the vast majority of forum members are not medically trained therefore should not offer any direct advice on medication. However, we can share our own experiences which many find helpful because it can encourage members where necessary, to check out suggestions with their medics. Unless there are other health related factors to consider, it’s not usual for someone of your age to be prescribed an anticoagulant such as Apixaban. The need for anticoagulants is generally determined by process known as the CHADsVASC score which is best checked via Google. Generally a 0 score suggests that anticoagulants are not necessary, a score of 1 suggests they should be considered and most scoring 2 more take them to reduce the increased risk of having an AF related stroke. Flecainide, as far as I know, can only be prescribed by a heart specialist and not a GP. It can either be taken as a regular daily maintenance dose or as a Pill in the Pocket (PiP) dose when an AF episode occurs in which case the dose must not exceed 300mgs in any 24 hour period. However, if it’s prescribed as a regular daily maintenance dose, say 2 x 50 mg a day, then it should be taken in conjunction with either a beta blocker or a calcium channel blocker otherwise you could be exposed to the risk of other types of arrhythmias. If you have experienced heart rates in excess of 200 bpm, it’s a bit surprising that you were not prescribed one of these medications already. The fact that you are awaiting an ablation obviously suggests that you have seen a heart specialist but have you seen an Electrophysiologist (a cardiologist who specialises in arrhythmias). From what you have said, some elements of your treatment seem a bit unusual unless your AF episodes are few and far between, so it might be worth seeking a second opinion. It will also be interesting to hear what others say……..
Thank you. My AF episodes have been infrequent and I’m monitored by a loop recorder. GP and pharmacist have called out the potential side effects of my new medication with my existing anti depressants/ anxiety meds.
Now waiting for an cardiology outpatients appointment and date for the ablation.
I’m thinking that you may already be taking a beta blocker as one of your medications otherwise I would also be surprised that you have been prescribed Flecainide on its own because it can be proarrhythmic and cause very high HR as a result. So maybe some missing info? I’m assuming your ablation is scheduled to take place soon hence the Apixaban, or it could be in case you need a cardioversion in between now and then. How did the hospital reduce your heart rate?
In answer to your actual question the answer is both 😕 but if not in AF frequently my experience was the medication combo causing a general ‘wading through porridge’ effect.
Thank you. Not sure what the hospital gave me to reduce my heart rate? A couple of tablets which took about 3hrs to take effect.
The cardio consultant who saw me in resus indicated the ablation appointment should be as soon as possible however not heard anything yet.
‘Wading through porridge’ is exactly how I feel. By mid afternoon I’ve usually shattered at the moment. Due back at work next week and nervous as having a focused brain is key….. not something I have right now!
So are you frequently getting Afib episodes since your diagnosis and since being on the daily medication? Or Is the fleconaide keeping you in normal rythm now? It’s not quite clear from your original post, the frequency of your episodes since A&E. If you are in Afib a lot, for example, it could be that, that’s making you tired.
That explains it then, that it’s highly likely not the AF itself, if you’re in NSR. It’s really good though that they’ve offered you an ablation straight away, as that doesn’t usually happen, especially if you are in NSR since and newly diagnosed. They must think it will benefit you.
As Flapjack said we are not medically trained but I suggest you ask your pharmacist to double check your anti -depressants with in particular apixaban but also Flecainide. You can do it yourself on drugs.com for reassurance.
I suspect the shock of this diagnosis and your A and E trip would be enough to cause brain fog until you get your head round it. My first episode 11 years ago was with a similar rate which Paramedics said would stop before we got to A and E but didn't. I did get a beta blocker on that occasion but it was stopped and I was changed to flecainide soon after after a repeat performance which stopped while I waited for a cardioversion.
Nearly all the methods you use to control your anxiety help enormously with AF. You've found a good place for support.
Hi Nick, following my AF diagnosis in May I was prescribed Apixaban, Bisoprolol and Flecainide. I had an ablation in early August and have slowly come off the Bisoprolol (my HR was very low), and this week have stopped taking the Flecainide routinely (Consultant said to just take Fl+Bis if I get an occurrence of AF). To answer your main question though, yes I felt a general lethargy on this medication. I haven't been great at accurately recording how I feel over time, but I think it was slightly worse when I first started the medication (it settled down), and I think the Bisoprolol had the bigger affect on me.
My understanding is that both Bisoprolol and Flecainide can have side effects of tiredness - but as others have said, do get proper medical advice about what is right for you - especially if you are on other medication. Good luck with your treatment.
Hi Nick, I briefly took Flec. Pill in pocket briefly before ablation and felt foggy and like a zombie. I could not tolerate it. I had ablation and changed my diet by eliminating artificial sweeteners and wheat/gluten and all has mostly settled. Only had blips with thyroid meds, had to get those specially compounded to be able to take them. Occasional brief ectopics with caramel. I hated Flec.
Yes, it's scary. At first. Many of us have had AF for years, sometimes many years. Mine was around for five years, what with my reluctance to commit to an ablation and then with the pandemic throwing a spanner into the NHS. I've since had an ablation and seem to be somewhat better, although with old age comes other health concerns.
My solution to the initial worry, was to learn all I could about AF, and try to understand the risks and effects involved. The main source of good information and positive opinion came from within this forum. It's a fantastic resource, so learn to use it. There's a search function, and you can read back long threads on any particular detail about the condition or medication. Just remember that it is _opinion_ not medical fact, but there's a lot to be understood.
The main take-away is that AF won't kill you (unless you are a rock climber or something), but the company it keeps can be a problem.
Yes, if you are in AF, then you will be tired and fuzzy headed, as your blood circulation is not functioning correctly. Not all of those 200bpm are pumping blood, as the heart has not filled correctly before it happened.
Good luck on your journey, and try to relax about what can't be helped.
The first thing I can tell you is that everyone is different. So I'll share my experience.
I don't have them often but when I have had them, my afib felt like an alien crawling out of my chest and I would be VERY tired once they were over.
I am on flecainide and metoprolol and have no negative reactions. But everyone's experience is different.
I would talk with my provider and please read the information about both medications to see if the tiredness is a side-effect of either medication or both.
One thing- side-effects can sometimes last, sometimes pass.
Doubt Flecainide & Apixaban are causing the problem.
It did take my body awhile to adjust to 200mgs Flec.
Would urge you to research Lifestyle changes here and elsewhere, which in the medium long term can help AF and related issues such as anxiety & depression.
Content on HealthUnlocked does not replace the relationship between you and doctors or other healthcare professionals nor the advice you receive from them.
Never delay seeking advice or dialling emergency services because of something that you have read on HealthUnlocked.
Digoxin for persistent AF - side effects?
Medication Side Effects 
Medication side effects
Paroxysmal Af,flecanide side effects.
