Flecainide v Bisoprolol?: I was... - Atrial Fibrillati...

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Flecainide v Bisoprolol?

Sunnyday2022 profile image
17 Replies

I was diagnosed with AF 18 months ago and put on daily Bisoprolol in April last year. Unfortunately though it reduced my episodes it also made me tired and lethargic and gain quite a bit of weight! After seeing my cardiologist I came off it in late October but since then have had 9 Afib episodes lasting between 4 and 15 hours.

The cardiologist recommended daily Flecainide but after reading all the negative side effects people seem to have I am reluctant to say the least!

My GP wants me to start anti coagulants as well though the cardiologist hasn’t pushed for that yet.

I am seeing him again shortly and am just looking for advice from fellow sufferers as right now I don’t know which way to turn and am feeling quite down. I am a very active 63 year old and think up until now I have been a bit in denial and the reality of having a ‘heart condition’ is beginning to bite 😫

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Sunnyday2022
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17 Replies
pottypete1 profile image
pottypete1

I am an active 75 year old and have taken Flecainide for over 30 years with no obvious side effects. I don’t take Bisoprolol because in my case it slowed my heart rate too much

Often however they will diagnose Flecainide and Bisoprolol together. The Bisoprolol is a beta blocker to steady the heart rate.

Pete

wilsond profile image
wilsond

Before anything else,please listen to your GP and get on anticoagulation. AF carries a higher risk of stroke,which ACs protect against.Bisoprolol is for controlling heart rate, you dont say what dosage you had .

Flecanide is for trying to control arrythmia and it is usually highly recommended to combine the two. One reason is that Flecanide can sometimes provoke atrial flutter ,fast rate arrthymia,which bisoprolol guards against. I was given flecanide in hospital without bisoprolol ,and did develop flutter a week later.

Flecanide has been very effective for me,with a tiny dose 1.25mg biso taken at NIGHT so I dont notice any effects.

Flecanide,no side effects.

I will be off it later this year hopefully ,after what seems a sucessful ablation

There are some questions here that I would be asking. Have you thought about being referred to an Electrophysiologist( cardiologist with specialist training in arrythmias)

Remember AF wont kill you although scary!

You will find great support on here, great info too.

Xxx

Sunnyday2022 profile image
Sunnyday2022 in reply to wilsond

I know it won’t kill me and so I have never gone to hospital with it, but it is absolutely horrible when I have a long episode. With a heart rate of between 90 and 150 for hours at a time I am quite debilitated. It is also the higher risk of stroke that is starting to worry me too, though no one seems to know how much higher the risk is.

wilsond profile image
wilsond in reply to Sunnyday2022

Yes I agree its scary and horrible.Your stroke risk us calculated using a scale CHADSVAC,between 1 and 5.It is advisable to be ACd if score 1+ as AF stroke risk is 5 times that of non AFers

BobD profile image
BobDVolunteer in reply to Sunnyday2022

Having AF makes us five times more at risk of stroke. PER YEAR!

Sunnyday2022 profile image
Sunnyday2022 in reply to BobD

😱 that’s food for thought re the anticoagulants!

stoneyrosed profile image
stoneyrosed

If your AF is troublesome I would go along with the flecanaide but in most cases they prefer you to take a bisoprolol alongside it as flecanaide alone can cause other arrhythmias. I took them for 12 mths successfully until I had an ablation. If you do decide to go ahead please stick at it for a few weeks as it can take a wee while before your system gets used to them. If you feel really ill taking them call your GP. They seem to work well for most people. Good luck.

Teresa156 profile image
Teresa156

Hi Sunnyday2022,

I totally understand your predicament. If you have been prescribed fleconaide by your cardiologist, I would trust them and try it. Fleconaide is not like Bisoprolol in that you won’t suffer any withdrawal symptoms if you decide it’s not for you. You can but try. In the position you are in at the moment, your episodes are becoming more frequent, so it might be worth seeing if you can limit them.

I have Fleconaide as a PIP and I’ve taken quite a large dose of it, but only once so far…and I live to tell the tale 😊 . There are many others on here who swear by it. Often they do prescribe a beta blocker with it ( which is what I’m told to do) and in your case, they haven’t, perhaps due to your reaction previously when you were in bisop? please can I ask what dose of bisop you were originally on?

Teresa

Sunnyday2022 profile image
Sunnyday2022 in reply to Teresa156

Thanks for replying Teresa. I was on 2.5mg daily which I know is not a high dose. I think the cardiologist may be suggesting either Flecainide daily, or daily Bisoprolol and Flecainide as a PIP. It is so hard to decide what is best. I am working so hard to lose the weight I put on with Bisoprolol before that I am very reluctant to go back on it, but I see some people say they put a lot of weight on with Flecainide too 😩

Teresa156 profile image
Teresa156

Hi Sunnyday2022,

Thanks for coming back. I had a feeling you were given 2.5. You might be surprised to hear that for many, 2.5mg is and can be quite a hefty dose and for me it was as well. Don’t let the small number make you think it’s tiny 😊 Since reducing to 1.25 mg daily, I have noticed I feel much better, have more energy and sleep better, though my HR is virtually the same as it was on 2.5mg. I have never gained any weight dince taking but, but I know we are all different. It might be because you were tired and sluggish on the 2.5 that you gained weight before ( just a guess)….

I’m not saying to try again as it’s not easy coming off it, (which is why I’ve stayed on it, because I tried 😳)

I take it daily now as it seems to have really helped my episodes - I only had one episode last year (and was having them every 3 weeks before). The hospitals always seem to prescribe 2.5mg to everyone, but it’s not always a ‘one size fits all’. They did the same for me.

Yes, for me, I was told to take bisop with the flec as a PIP too.

Sunnyday2022 profile image
Sunnyday2022 in reply to Teresa156

Thanks that’s very helpful. Maybe I could try the lower dose and see how that works for me….

Teresa156 profile image
Teresa156 in reply to Sunnyday2022

It would be worth discussing with a cardiologist or a GP first though.

mjames1 profile image
mjames1

A lot of us don't tolerate beta blockers like bisoprolol. Ask your cardio about switching to Diltiazem. It' a calcium channel blocker that does basically the same thing in terms of rate control. It can be taken either by itself or with Flecainide. No reason for you to sit around in fast afib. Either you should get the rate down ASAP with a rate control med like Diltiazem or try and convert with an anti-arrythmic like Flecainide.

Jim

Sunnyday2022 profile image
Sunnyday2022 in reply to mjames1

Thanks for the advice I will certainly discuss with my cardiologist

secondtry profile image
secondtry

I have followed 'Flecainide' posts on here for many years and I would say well over 50% do well on it.

At you age assuming a structurally sound heart & no other complications/comorbidities chances are you will be fine. As heart drugs go it is a relatively old tried and tested one and I no longer look at the leaflet that comes with it. If you do start on it make sure you always take it 3 hrs after a meal and then don't eat for an hour.

The priority is to stop those episodes completely and 200mgs Flec did that for me. 9+ years down the track no side effects yet and last 5 years active lifestyle.

Whitechinchilla profile image
Whitechinchilla

When I was diagnosed in Autumn 2020 I was horrified to learn I had to take anti-coagulants. Now I wonder why.!!

It’s just a pill and the reduction in the risk of stroke is amazing.

I am puzzled why a patient would not be given that at diagnosis. When they calculate your stroke risk the nurse told me it was automatic. AF = blood thinners.

I pan view of the benefits I would ask to be put on them asap.

As for Flecanide, I was using it as a PIP abut then started getting episodes every other day, albeit short duration, and my nurse put me on it 5 days ago , twice daily. So far, so good.🙏

I have learned that whatever you decide needs addressing, to do it sooner rather than later.

good wishes

Whitechinchilla profile image
Whitechinchilla

P.S. I am a Newbie here!

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