Should I just accept this?

[Rhiannonimity1]

I’ve had PAF for 17/18 years. Up until late last year I averaged 2-3 episodes a year and was cardioverted in hospital. Then the medics decided I shd stop going to hospital and convert on my own - or not. They knew in AF my heart rate is upto 130 particular just after an episode starts and said that was fine. Since then I have had 4 episodes, which have all converted spontaneously on day 9 after onset. I know my HR prob runs at about 120 most of this time. I sleep better in AF and although slightly more breathless have a better QOL than in Sinus, with trigeminy, ectopics, nervousness etc. This last time I was only in sinus for two days, but only had 1 episode last year - so it is variable dependent on IBS status I think. I take 200-300 mg flecainide a day and 5 mg bisoprolol. It is the variance between AF and sinus that I find lowers QOL. Should I be quitting the flecainide with a view to staying in AF all the time? I am too heavy for an ablation.

[BobD Volunteer]

Any and all treatment is only for quality of life so I question the wisdom of taking such high dose of flecianide if it is not keeping you in NSR. That said, rate does need to be controlled and preferably below 100 so maybe speak to your doctor(s) about changing your drug regime.

I will say that life style is the most important and powerful tool you have so some serious thought needed I fear.

[Rhiannonimity1 in reply to BobD]

thankyou Bob. I have an extra question for you if that’s ok because I’m finding it a bit scary. My af has just changed into a regular beat running at 97 bpm. Although Af at 120 didn’t affect me much, this regular beat is making me a bit breathless, even though it is a lower rate. I have taken an extra bisoprolol 2.5mg an hour ago which has seemingly done nothing. Do you have any advice please?

[Lilypocket in reply to Rhiannonimity1]

I think a lot of people on here would be very happy to have a regular heart rate of 97 bpm 🙂I have no advice to give relating to Bisoprolol as each person is different and reacts differently to the doses.

[JOY2THEWORLD49 in reply to BobD]

Hi Bob D

The new regime for those in persistent H/R AF is to keep H/R below 65 at rest.

I was worried at 60s at rest but better with walking elevation. No more stops, heart beating fast - sweating or fatigue.

Have you heard this?

cheri JOY

Interesting about Brits and 1 in 45 with AF. Anxiety can give one AF.

[Singwell]

My brother is in persistent AF now. He's only ever been on Bisoprolol but they increased it once he went into permanent AF because they wanted to keep his HR below 100. Flecainide is a potent drug so if you're taking that much and it's not doing the job I'm inclined to agree with Bob.

[secondtry]

You say 'the medics decided' have you actually seen a cardiologist recently to discuss options?

If not suggest you book a private appointment .

[Tommyboy21]

I take the same 2 X 100 mg of flecanide and 2 X 60 mg of diltziam.. still get daily AF . Seems to stop it after I take my dose but doesn't seem to actually keep me out of AF. It seems to keep my heart rate below 130 in AF which I is an improvement. Just been diagnosed with arthritis of spine which I've always thought my posture was a trigger.

[Witchmama]

There are many other anti-arrhythmics and beta blockers that you may have better luck with. Yes, lifestyle is your number #1 defense. Talk to your cardiologist and come up with a better plan. Remember, ALL drugs have side effects! All the best to you. I hope you can find some solutions and improve your quality of life.

[JOY2THEWORLD49]

Hi

See if you can try CCB Calcium Channel Blocker and drop out the Flecianide.

Stay on Bisoprolol at night. Try 2.5mg only.

Try Diltiazem 120mg AM.

Works for me.

I was at 120 plus at rest with only Bisoprolol now 62-68 until 7pm then BP regulated.

Chat to your heart specialist.

cheri JOY

[Racquet]

Sorry, Rhiannonimity,

My experience with PAF is vastly different than yours as is my dosage of Flecainide which is 50mg am & pm and only upping it IF and when I have an episode. So I am not a resource or your questions about Flecainide. Sorry and good luck.