Just wondered if anyone has experience of taking Flecainide 150 without Bisoprolol 1.25 After wearing a holster for 24 hours my cardiologist is concerned that my heart rate drops to 30 during the night and said it would be okay to try taking Flecinide without Bisoprolol.I have stopped taking Bisoprolol for two days before a stress test and certainly feel much better.
Very interested to hear the experience of anyone else who has tried this. Thanks
I have been taking Flecainide for a number if years without Bisoprolol.
The reason……
I have a slow heart rate (Bradycardia) and my consultant told me not to take Bisoprolol as it is a Beta Blocker and has the effect of slowing the heart.
I have experienced no known problems.
Pete
Have you asked if you can try a small dose of a CCB (such as diltiazem) instead?
To be honest I have absolutely no idea what CCB is.
Pete
OK, Google it is then!
i have no intention of changing anything in my medication regime. All is well right now and I want it to stay that way.
Hi Pete has the flecainide continued to work for you preventing afib pls. I’m on flec and 1.25mg bisoprolol for two years now and just wondered if it continues to work long term.
For me I believe it has been a major contributory factor. I am somewhat unusual as I had AF for over 30 years and over the period 2009 - 2017 I had 7 ablations. My EP and I agreed that I should still continue to take Flecainide. From 2017 to now my incidences of AF are very rare the last one last March. In times gone by I would have an episode of AF 2 -3 times a month sometimes even more frequent.
My condition now is that I do have Bradycardia and my EP wants me to have a pacemaker. However, this is on hold until I have some testing of the components of a pacemaker as I had severe allergic reactions to the various electrodes stuck to me during ablation procedures in the past.
Pete
thanks Pete.
Sorry, I didn't mea' you, I meant me
CCB = calcium channel blocker - another kind of pill for BP/ arrhythmias etc
Thank you Pete that is very reassuring.What is CCB?
It's a Calcium Channel Blocker, usual drugs given are Diltiazem or Verapamil
Doesn't that still slow the heart rate down?
A little but not as much as Beta Blockers, they work to keep the heart at your usual rate really but as we know effects vary from individual
Thank you for that. I will ask about them at my next consultation
Yes Diltiazem and Calcium Channel Blockers are rate controllers. Flecainide is fir rhythm control
I have taken flecanide for over 10 years now no problems with it. I don’t take bisoprolol but take verapamil.
Whenever I did that during an atrial fibrillation episode the Flecainide turned atrial fibrillation into atrial flutter (or tachycardia as shown by by Kardia). So I always took Flecainide with Bisoprolol, even as a PIP.
I have taken 200mgs Flecainide only for 8 years without any problem; same circumstances as Pottypete.
I take diltiazem with flecainide works a treat for me. I originally was on bisoprolol, which I didn't really like but soon came off as I found out it was not suitable if you had an epipen. since then I've taken CCB and things have been pretty good, certainly worth asking about. Best of luck
Hi Summerlily, I have taken Flecanide for a number of years now, generally works well. Recently the af has got worse and I was given bisoprolol, the effect was similar to yours, by the sounds of it, heart rate exceptionally low which made it difficult to do everyday tasks, I gave it a few days before I realised the af was better than the bisoprolol effects on me. Now I just take Flecanide again but waiting for a review and possibly an ablation in the future , best wishes.
After a few months on just Flecainide a holter showed that whilst it was fixing the afib, it was also causing flutter. Apparently there is a low chance (I think 5%) that the flutter could lead to ventricular tachycardia so I was put on Bisoperol to prevent this. I could not function on Bisoperol so had to stop it. I have been prescribed Diltiazem as an alternative but haven't started to take it yet as I'm too worried about the side effects. I monitor my heart rate closely at rest and during exercise and have never come close to tachycardia so I'm reluctant to take a CCB for what I think is a theoretical risk.
Hi Lily.
I too was put on flec without bis. I was afib free for two years then developed flutter. 1.25mg of bis may well have stopped this. However we are all different and I think it's best to follow your medic's advice.
Paul
After my successful cardioversion I had to stop bisoprolol on the advice of my cardiologist as my heart rate was around 30bpm like yours. I took flecainide without a beta blocker for over a year with no issues. I’ve now been weaned off the flecainide too. Hope this helps.
Very helpfulThank you all
I took flecainide only from 2015-2022. Betablockers make me feel terrible even at tiny dose.
All I can add is that I was given flecanide without a betablocker,as a daily dose. A week later bluelighted into another hospital,with tachycardia. Promptly out on bisoprolol as this had instigated Atrial Flutter.
I took Flecainide for 12 years without a beta blocker. I started at 50mg x 2 a day which reduced AF episodes, went to 100mg twice a day which reduced them further and for 10 years took the maximum dose of 150mg twice a day which cut episodes to one or two a year lasting twenty minutes, usually just before I was going to bed. At the time I was 19stones in weight, and had a very busy life. (I am 6'7" tall).For several years I've had permanent AF which is asymptomatic and doesn't trouble me in any way. (I am now retired and weigh 16 stone aiming at 15 stone).
hi Thomas
Well done with your weight. You know the answers with determination and grit.
Weight can be a main trigger but often reasons for the overweight is personal and often missed.
Keep up your determination but know you need to feel well.
cheers JOY
I was on Flecainide only for 2 years that totally stopped my Aflutter.
Thanks for sharing this, Summerlily, as my cardiologist would like me to add 12.5 metoprolol to my 2xdaily dose of 100 Flecainide and it’s helpful to read everyone’s experiences. After an ablation I was using 150 Flecainide with 25 metoprolol as a PIP for episodes about once/month for a couple of years. Then I tried 50 Flecainide (2xday) and then went to 100 (2xday) Flecainide alone and have been AF free for two years. My heart rate is usually about 60 at rest, 50s in sleep, and metoprolol drags me out. My cardiologist would like me to take 12.5 metoprolol with my 100 flec each day but I don’t feel well with it. I do take 12.5 metoprolol if my heart rate starts to rise due to anxiety or doesn’t fall back after exercise, but so far that only happens about once every month or two.
I have been taking Flecanide 150mg a day since 2009. I have been absolutely sympton free. It was recently suggested I added Bisoprolol in a letter from the cardio clinic - no discussion or reason given. I looked it up and decided there was no good reason for me to upset my routine and that I might get unpleasent side affects, and GP agreed. " ... if it ain't broke, don't fix it"
Hi Summerlily. I am in exactly the same position as you. When my AF started I was put in a low dose of Bisoprolol. This would take my heart rate at night down to 30. My cardiologist reckoned that this triggered ectopics which then triggered the AF. I have been on Fleconide 2x50 mgm for 2 years and have just increased it to 150 mg as I was having breakthroughs. No problem s with taking the Fleconide on its own so far.
This is all sooo interesting, thank you all for your comments.To be honest it wasn't the cardiologist who suggested to take Flecinide without Bisoprolol, it was me who suggested it to him!
I felt so well the 48 hours before the stress test without taking Bisoprolol, and then when he said my pulse was so low, to me, it seemed the obvious thing to do. However, in spite of him saying ' I could try it and see' I felt a bit worried about what the consequences might be.
These chats are fantastic and so helpful,seems we are all such individuals when it comes to what works, but you have given me the confidence to try.
Now looking for a 24 hour watch type monitor to read rate, rhythm and maybe BP.
Thanks once again and good luck to you all
Medication is not one size fits all. It's all about what works for YOU. A good cardiologist or EP knows this and should be open to hearing your experiences.
Hello,
I have been on Flecainide and Xaralto for over a year with no problems. It is working very well for me. My heart rate is in the normal range.
That sounds like pretty sound advice. I am on 100mg Flecainide daily and no beta blockers and so far than God so good.
Very interested in this thread. I am recently diagnosed with AF. Was started on bisoprolol xarelto and ramipril. Could not function on even the lowest does of Bisoprolol so it was swapped to Sotalol. I have a slow heart rate normally around 55 during the day dropping to low 40s and below in the evening. I have no idea what it is when I am asleep but I think the bradycardia is triggering ectopic beats and ccasional palpitations. Heart structurally sound apparently. Consultant (who I have never seen since this all started in Feb) has suggested Flecainide and digoxin to replace the Sotalol. No explanation as to why Digoxin and I am very reluctant to take it has anyone got any ideas? I have asked about ccb waiting to hear.
Hi
What a scenario. It seems high and it's control is easier than low.
I only dropped down to 156 H/R day but no change from the night rate of 47 avge at night.
cheri JOY
Hi Joy2theworld49. Thanks for replying, but what seems high?
Hi
The Flecainide but a friend had it as PIP pill in pocket.
He was up to 4 diff meds for his Parox....
He finally underwent an ablation and bingo the surgeon said that he had 2 firing electric currents. They sapped both.
Almost a year and no more AFs episodes.
He is in his late 40s and had had AF episodes for many years.
Lucky!!!!!
cheri JOY
Thank you Joy2theworld49. 🙂
I have been on Flecainide mainly 100mg twice a day for 11 years with no other meds apart from anticoagulant ( and a selection of supplements inc. Mg taurate.)
Hi
I'm a bit different taking Diltiazem 120mg morning and 2.5 Bisoprolol pm will was on the latter.
I turned up for a 12.15 pm appointment and Dr said I was a little low so stop the Bisoprolol.
I go out my BP monitor.
I found that at 5pm my BP Systolic was high at 150.
I went back and said that I was cutting Bisoprolol in 1/2
The Bisoprolol makes no difference of my 47 at night H/R.
Its stayed the same over 3 years since measured from stroke in 2019. I had the stroke at night. 2am whilst asleep waking up with a massive sore head.
On Metroprolol I had 2 pauses of 2 seconds.
Not on Bisoprolol or Diltiazem.
I think that my heart rate at night slows because I've always got cod shoulders unless well covered in a sleeve or cardy.
I personally don't think stopping Bisoprolol will be the answer. Bisoprolol is a rhythmnic and H/R rate regulator.
I would question the flecainide. Is it a BB beta blocker as well?
It is usual to take 2 meds but they are different types.
cheri JOY 73. (NZ). Be patient in getting the right combo - relax as you try them. 30 avge at night is very low. The Ecrin. wants it brought up. As you can see I'm even taking Bisoprolol at night. I've gone back to 1.25 Bisoprolol.
my understanding is that Bisoprolol is a Bata Blocker and slows the HR. Flecainide is for Rythem control. Flecainide on its own for AF can instigate A Flutter and so generally a small dose of Bisoprolol is prescribed alongside Flecainide to mitigate this. I personally hated the Bisoprolol as it decimated any attempt at serious exercise (maxed out HR at low level) and so for QOL reasons (57 y.o.), in agreement with EP, dropped it to go solo on Flecainide. Resting HR in evening is 47.
Hi
Bisoprolol does both control of both rhymn and H/R. But I said made no difference with my low night rate. My day rate was avge 156 and resting 120s too high. Uncontrolled.
Diltiazem made the difference and controlled my H/R under 100-... 77-88.
BP sorted at last too.
cheri JOY. 73. (NZ)
My answer comes a bit late 🙂My husband took Flecainide but not Bisoprolol as he had a naturally low HR and Bisoprolol pushed him into Bradycardia I suppose it depends on your HR ( without medication).
Take care
Reducing to stop Flecainide and Bisoprolol 
Flecainide v Bisoprolol?
