If you take the pill in the pocket only, what frequency and duration are your AF episodes?

[OzRob]

If you only take Pill in the Pocket, for example Flecainide 100mmg, I would be interested how often you have AF episodes, how long they generally last and if you always medicate with the PIP or do you do other things to resolve the AF episode. Do you have a recording monitor?

Also, how long have you had AF since diagnosis? Has it stabilized or better managed since when first diagnosed?

For example, I have AF every day and very rarely take a PIP, perhaps once a month, the only time I do is if I have been in AF for at least 45 minutes while sleeping and cannot resolve with other methods.

My AF burden is very low, I may be in AF for 20 minutes daily, and those minutes are spread out usually while sleeping. For example the AF could begin as soon as I lie down for sleep, for 60 seconds and resolved with a Valsalva maneuver. During sleep it seems to self resolve each time it starts and rarely continues for more then 5 minutes at a time.

Keen to hear other peoples thoughts\experiences...

[marcyh]

AFib varies from person to person so there will be a variety of answers.

I only take a PIP, but I honestly can't relate to your situation because my episodes are sudden, fast and furious. I have to take a rhythm-control med in order to convert and that takes several hours. For that time, I'm bedfast to avoid passing out from shortness of breath.

I was diagnosed in December, 2018 and it got steadily worse over time, becoming incapacitating. I had several episodes a month and leaving the house became a concern. I had an ablation and was fine for several months but now it's back, as sudden, fast and furious as ever. Not as often, but the flutters and ectopics are worse.

Hopefully your AF burden will stay low.

[secondtry]

I have found it helps to keep a diary of what you haver taken (med & supplements) and what you have eaten/drunk. Also , as AF is very individual, what is important is your individual trend more so than others experience eg are your episodes increasing in the day, night or both? The consensus here appears to be the more episodes you get, the more chance of them increasing, so the main aim becomes to stop them completely.

I only take Flecainide and at the outset was very reluctant to agree to take it daily, requesting instead PIP. However my cardiologist said he didn't favour PIP as it encourages an unstable heart or as he put it, its like a 'roller coaster'.

[Hidden]

hi. I had first episode 9 yrs ago, next was jan 22 and then had one at beginning of December. Previous 2 episodes I ended up in resus due to fast pulse, IV verapamil and home. Last one I took 100mg flecainide but it still took about 4 hrs to calm. Had ECG at gp surgery next day, inverted T waves in v1-4 snd ischaemic changes and was admitted to cardiac unit via gp surgery. Told nothing acute and monitor. I have to take anti inflammatory drugs for severe arthritis so blood thinners are a no no. I get runs of ectopic frequently. I’ve been told now to take 200mg pip if happens again and not to leave it so long. Best wishes Take care 🦊

[irene75359]

I was diagnosed in December 2015 and prescribed 100mg flecainide daily by the cardiac unit. However, my episodes numbered only three or four a year and my GP was very supportive to me using flecainide plus 1.25mg bisoprolol as a PiP. That has worked extremely well for me, in fact in 2022 I had only one episode. My GP did say if I were to have many more episodes then it would made sense to take flecainide daily to keep my AF under control but I have been very lucky as nothing has changed.

If you are having AF daily, then I would question using flecainide as a PiP even though you do only take it once a month. It may be that taking it daily would prevent any episodes at all. But I am not medically qualifed, why not see what your treating team suggests? Best of luck.

[MalJam]

I sit cross legged leaning forward until it actually hurts, then breathing fully in and fully out. It brings my heart rate down and out of AFib in a 3-5 minutes. The fully out is the most helpful part, fully out and shallow breathing part stops my rapid heart rate into conversation. Try it and write back.

[Winnipegsculler]

I was diagnosed with paroxysmal Afib two years ago. Bisoprolol didn't work so my cardiologist prescribed 100 mg flecainide twice a day. Initially I was hesitant as I read fleainide can in some people provoke Atrial flutter. But so far it hasn't in me and I've been able to have a normal healthy life with no episodes of Afib for more than a year. If you're experiencing fairly frequent Afib episodes I would talk to your cardiologist about taking it at their prescribed dosage every day. But everyone is different and what works for me might not work for you. Good luck and keep us posted!

[OzRob in reply to Winnipegsculler]

I am seeing a new electrophysiologist today and will be discussing what I need to do.

[jedimasterlincoln]

I've been on a PIP since the summer of 2019 after my 5th Ablation in the January of the same year.

I was quite debilitated with episodes of PAF or flutter happening monthly to 6/8 weeks apart or whenever I got a cold/virus. It was only after this 5th ablation that the PIP really worked for me, before that my episodes were still as debilitating as ever.

Now I can at least climb a flight of stairs, put my shoes on etc and walk around without feeling like I'm going to collapse. The ablations did what they said - reduce the frequency and/or the intensity of the episodes.

I take the max dose of Flecanide advised for rapid rate control plus up to 12.5mg of Bisoprolol and the episode usually reverts withing 8-30 hours. I've been told if I need two days of consecutive doses of Flecanide I'm to report to ED to be checked over anyway, but I've never gotten to that point.