Flecainide breakthrough

[Hairem]

I have been on Flecainide for nearly 3 years. I have lately been having breakthroughs, every month or so. I called our Health Line and spoke to a Pharmacist who informed I could take a half dose. I am currently on 100mg twice a day. I then added half a tablet and that seemed to do the trick. Is anyone else in this same situation.

My heart doctor is difficult to reach now and am told that you need to go through your family doctor for a referral. That alone could take weeks.

Thank you in advance,

Susan in BC. Canada

[wilsond]

Yes ,at times I had to supplement my 100 twice a day flecanide. Never go over 300 a day .It sounds as though the AF is getting the upper hand and maybe a new treatment plan is needed longterm . I had an ablation last year ,a few blips on the way. I had to continue with flecanide until 12 months passed then reduce by half. 2 episodes of AF,so watchful waiting but thankfully all seems to have calmed .

In the meantime, use the dose as directed to keep you stable and push to be seen ASAP.

Please let us know how you get on zxx

[Hairem in reply to wilsond]

Thanks for the reply.

My cardiologist said to call him if things change but you can't talk to him unless I go to my GP and get a referral, waiting months! Health care in Canada, BC particularly, is broken.

I will let you know how I make out.

[Budken in reply to Hairem]

It simply is not that the healthcare system is broken. It is that way for a reason. If not you would have outrageous costs like in the US. I live in Germany, and the system is the same. If I have a problem I see my GP, and if she feels it is necessary she gives me a referral. However I still have to wait to see the cardiologist. I am curious though. Do you take anything along with your flecainide? I originally was taking the same dosage, but also taking 25mg Metoprolol as well. During that time I moved and had to change Cardios. My Doctor in North Carolina said he though my outbreaks were caused by the Metoprolol and told me to stop taking it. The first week or so was a rollercoaster ride. I honestly thought I was going to die ( help was over an hour away, where I lived ) However within a week or two everything settled down. The outbreaks also stopped. My Doctor was right, taking Metoprolol with Flecainide was causing my outbreaks. Have not had one since. My Doctor here in Germany even suggested PIP rather than taking it every day. I have had, only one episode. Went back to 50mg daily, ( suggested by my GP )and so far so good. I don't see the Cardiologist until the end of January.

[Hairem in reply to Budken]

Thanks for your reply. I am taking nothing else except for blood thinners.

Our system is broken, ER's with no Doctors. ER's closed on weekends around the province.

[secondtry]

Because it worked for me I am a proponent of the 'hybrid cure' of AF ie drugs & better lifestyle choices.

Ten years ago I was diagnosed with Lone PAF to which I have added vagally mediated. From the beginning (still taking it today) I was put on only 200mgs Flecainide per day, which stopped the episodes but I regarded this as only buying me time to look at my lifestyle choices. I consulted a Naturopath and other Alternative Practitioners to get my digestive system, mind and body generally in a better place. I also took action to reduce all forms of business and personal stress. I continue to improve my lifestyle as it is a journey without any end destination.

Result just 3 episodes under 1 hour since diagnosis.

[wilsond]

Difficult here too. I had an 18month + wait for my ablation! I would start the ball rolling for a referral perhaps now?

[jd2004]

I have been told a couple of times to stop flecainide for a time then restart on a reduced dose. Each time it has been replaced by digoxin. This is one of those times. I guess it depends on how the heart is behaving. From what I understand if it is in flutter then flecainide is not useful.

[TopsyJones in reply to jd2004]

When I started having breakthroughs my cardio nurse suggested that I split my dose into 3. I now take 50 mgm at 11 am, 5pm and 11pm. It hasn’t stopped them completely but I now only have about 5 episodes a year which last about 3 hours. I take extra tablets when I do have the breakthroughs.

[Hairem in reply to TopsyJones]

That is very interesting as your total is less than I take now.

Thanks,

[willec49]

Like everything else here, treatment and meds affect us differently. I was diagnosed with paroxysmal afib in 2019. Metoprolol was tried but didn't stop episodes. Then Flecainide was added which helped a lot. I had an ablation in March of last year (2022) and, had two episodes after flecainide was stopped. On 50 mg. of Flecainide twice daily for the past year with no episodes other than a few ectopics. Then, just this week I had the first episode (2 hours) after over a year. Doctor recommends adding metoprolol but I am reluctant to doing that because I've been that route before. Overall, Flecainide seems to have been the one, consistent intervention that has made a difference in my quality of lilfe.