At my last office visit, my Cardiologist suggested I quit daily Flecainide, and use only as a PIP. Since I had not had any episodes in the past four and a half years. He also thought the Flecainide was keeping my heart rate too low, which is what originally brought on his suggestion. So far it has been six days since I quit. The last two days I have had some very short episodes. Last night was the longest. Dog woke me up to go outside around three AM. After we came back, I was thinking, all seemed well, no PAC's. Sometimes I think I bring on this stuff. About ten minutes after going back to bed, I felt a few PAC's which turned into Afib. I waited though before taking any medication. In a little less than a half hour, it subsided to a few PAC's now and then, and I went off to sleep. Was not awaken again. Usually they wake me up, as I really feel them. I am still curious about the PIP. When to take it, at the slightest flutter, or only after Afib has not stopped within a certain amount of time. In the past, I always just sat them out, but then I was taking a daily dose of Flec. So a bit confused as to when to do the PIP, as it still scares me to take two pills, just for a few hiccups.
Stopped Flecainide: At my last office... - Atrial Fibrillati...
Stopped Flecainide
No cookie cutter protocol. Depends on both the frequency of your episodes, how long your episodes tend to last and how you recover from them. For example, if you frequently naturally convert within an hour, then waiting an hour before taking the PIP Flec seems reasonable. In my case, I've rarely had an afib episode naturally cardiovert in under 12 hours while off Flecainide, so I generally took the PIP within 30 minutes. I would probably take it sooner, but I like to pop an extra diltiazem for nodal protection prior. That said, factor in what your doctor advises because he's a doctor and has your full medical history.
And please keep us up to date on how life off flecainide is. Currently I'm on 25mg, only at night. So far, so good, but it's only been six days on this tiny dose and I know from my history that afib can lull you into a false sense of complacency for many months and then come roaring back stronger than ever. So I'm being realistic. I'm also planning on getting an ablation soon.
Jim
I do not take any Beta Blocker. I originally took 25mg Metoprolol with my Flecainide, then a Cardiologist said that was what was causing my occasional episodes. He took me of it, and I have not had any since then. That is, before I stopped taking anything at all. My Doc here in Germany as well, says it is totally unnecessary to take a Beta Blocker with Flecainide.
Seems to depend on the doctor and the country. Also, might depend on how structurally sound your heart is. In the US, many doctors require an exercise stress test and/or an echo before starting flecainide, with follow up ekg's once on it. Others apparently just give it out. Personally, I've used Diltiazem instead of a beta blocker as a nodal blocker, to prevent 1:1 flutter, a dangerous arrhythmia that those that prescribe nodal blockers are trying to prevent. Whether that is necessary or not is above my pay grade.
Jim
That is interesting 'totally unnecessary' to take a BB. My cardiologist just said a BB 'would make me feel unwell'. So I have been on 200mgs Flecainide only for years. I do have a lowish pulse at 55-60 and lowish blood pressure around 115/65, under 70yo and no comorbidities. As you are probably aware in UK the majority off medics seem to partner a BB or CB with Flecainide in case there is a rapid HR breakout with an episode.
As mjames1 says do keep us informed how it goes.
Life off Flecainide is good 👍 but I'm post ablation. Was on 75 a day for 12 months after 1st ablation, recently did a month on 25 x2 post ablation 2. Arrhythmia nurse advised coming off altogether 2 weeks ago and all is fine. I feel differently but I couldn't say why. Still in Diltiazem because we're titrating 1 by 1 due to me uploading levothyroxine for hypothyroidism. I feel well advised. Definitely recommend ablation!
Hi, I'll share my experience. Recently off Flecainide for about 2 weeks but that's post ablation with no AF since last May. Previously was on lowest dose, using extra as a PiP for breakouts. I was advised - wait 20-30 minutes to see if it calms down - if not take 1 extra pill of 50mg. (You may need more as I'm a small 66year old female. ). Wait 40 minutes. If needed take more. It takes around 40 minutes to kick in in my experience but that does depend on absorption. I you've not long eaten for instance, it will take longer. If I needed to eat after my PiP I'd always wait an.hour then eat something with carbs, buy not too heavy on fat or salt. Often worked for me. We're all different though. Other will tell you no food during AF. You'll have to experiment.
flecainide makes my heart rate high...i do wonder about meds at times
Hi Budken, I used to only take Flecainide as a PIP but since last July I take 50mgs twice a day plus 120mgs of Verapamil. This change has had a very good effect on the quality of life because I have had only 2 Mara sums since starting the new regimen. When I was taking it as a PIP I would wait 5 five minutes or so before taking a tablet and then a further period of about an hour before taking a second one. I was usually quite sure it was a paroxysm but always hoped it would simply revert. However, I was lucky in that they seldom lasted for more than an hour. I hope this helps and wish you well.
I have searched medical terms and med dictionaries to no avail. Could you tell me please what PIP refers to?
PIP - Pill In Pocket
Weaning of Flecainide
Flecainide...side effects
Flecainide vs. propafenone
Experiences with Metoprolol 
