Improved flecainide efficiency?

[Pommerania78]

Do you think improved diet and weight loss improves the efficiency of a drug like Flecainide?

[BobD Volunteer]

The LEGACY trials in Australia a few years ago showed that weight loss leading to a BMI of 26 or better reduced AF burden to the point where treatment was not needed.

It is also known that a more plant based diet with little processed food is also beneficial. Obviously no alcohol or caffiene.

[mjames1]

To the extent that in some cases, substantive weight loss will decrease your afib burden. Then, yes, Flecainide will become either more effective, or if you're lucky, it will not be needed. Unfortunately, weight loss and dietary changes do not help all of us with afib, but they certainly are a good first step, if so motivated.

Jim

[CDreamer in reply to mjames1]

Lifestyle is LOT more than diet James - I put in order of importance - stress management, sleep quality, moderate exercise alongside nutrition, breathing correctly ie: nasal breathing rather than mouth breathing. I don’t believe weight loss in itself is always beneficial for AF and was rather horrified at the slides that were used in a presentation of the LEGACY trial but really good nutrition is essential as is avoding UPF - if you can but that is becoming more and more difficult!

[mjames1 in reply to CDreamer]

CD "Lifestyle is LOT more than diet James"

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Certainly is, but I was addressing the OP's question re weight loss, which has been shown in trial to be a significant factor in afib burden. At least in the US, some ep's won't even offer an ablation if your BMI is over a certain figure.

Jim

[CDreamer in reply to mjames1]

Whilst I agree that sometimes for some people, weight loss can be helpful however some people would just see that outlook as fat shaming - which is anything but helpful if your BMI is high and when there is no signposting to alternative support and education as to how to make Lifestyle changes. In particular - guidance on healthy eating, how to avoid UPF - which is almost impossible these days and sourcing good fresh, organic foods and having the knowledge how to prepare and cook them. It’s a self perpetuating cycle - sell UPF which makes us addicted, overweight and ill - then sell the ‘cures’ to make more profit. BUT - no support because all our medical systems are set up to do is fire fight after the fire is alight.

What about prevention? We know and were able to do that with infectious diseases in the early part of the 20th C but seemingly unable to manage anything for better basic health education in society.

Cynical? YES - about the way the profit motive is the only ‘bottom line’ in Health care in both UK but even more so in the US.

There is a growing movement in the UK, mostly silent unfortunately, to improve and an emerging interest in getting back to basics BEFORE going to expensive interventions, including Flecainide use, which may help but which also comes with risk. Improving Lifestyle has little to no risk but requires investment, time and effort by the patient. There is no funding to educate and help as the only beneficiaries will be those who engage in the process and our environment. Who will invest in none profit making exercises? Not many it seems.

But I hope our OP will!

Rant over! Sorry James that just triggered something in me that needed to be let out.

Oh no, there is more:- I have less and less faith or trust in our fragile and selective medical systems which in themselves are in the ICU, especially this week in the UK. I suggest you don’t suggest to anyone in the UK to ‘speak’ or see their cardiologist (unless they have deep pockets or very good private insurance) or even their GP. There is a national 6 day junior doctors strike mean that ours is at breaking point. Whilst they undoubtedly people should seek medical guidance - it’s pretty difficult to even get the telephone answered by clinics - neighbour yesterday - 41st in the queue, then the telephone system crashed because it was overloaded and they had to start all over from scratch! Even getting through - could you book an appointment to physically see a doctor - no. A doctor will ring you to triage you in 3 weeks time - maybe.

[Popepaul in reply to CDreamer]

Your entry may be a rant but it does contain a lot of truth. I fear that that the situation with health services is likely to deteriorate further.Regards

[mjames1 in reply to CDreamer]

"There is a growing movement in the UK, mostly silent unfortunately, to improve and an emerging interest in getting back to basics BEFORE going to expensive interventions, including Flecainide use, which may help but which also comes with risk. "

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I consider myself a medical conservative. Did pretty much nothing for my afib but lifestyle for forty plus years. And like many things in life, first it worked and then it didn't.

When my afib became longer and more frequent, I still resisted both anti-arrhythmic like Flecainide and certainly ablation. I double down on lifestyle, but my afib was too far gone.

Looking back, I should have tried Flecainide and/or had an ablation, 3-4 years earlier than I did.

This doesn't mean I don't agree with much of what you said. I think lifestyle modification is a step many skip over. But at a certain point, at least for me and many others, got to be glad that medical and pharmaceutical technology are there to keep us going.

Yes, the healthcare systems are broken to one degree or another, but without them I would be in afib right now and not in normal rhythm.

Jim

[CDreamer in reply to mjames1]

Thanks for your reply, I was on a bit of a rant, sorry.

My AF journey mirrored yours to some extent but I felt very strongly that I was not given the education and support about exactly what Lifestyle changes really mean and believe had I had good education with explanations of consequences then I would have paid a lot more attention, a lot earlier, foresight I was not blessed with.

There are certain doctors who go out of their way to write blogs and books with excellent information, many who go out and lecture who I thank from the bottom of my heart as some have risked careers for challenging conventional thinking outside of the clinical field but none I have come across who will signpost, in clinic to education on well researched known.

We, who have been sufferers for 10+ years know that what works for one person, has little or no affect on another. AF is so individual and that seems to be a very difficult message to get across to recently diagnosed AF sufferers. I drink coffee with caffeine in moderation and find it helpful rather than harmful but many I know cannot. Flecainide and Bisoprolol were incredibly harmful for me but work for many others. This is why it is so difficult and so misinforming to generalise.

Thank you for your patience with me. Best wishes.

[Pommerania78 in reply to CDreamer]

Thanks. When you have time you should write down what does and does not work fo YOU.

[Pommerania78 in reply to CDreamer]

What is "UPF"?

[CDreamer in reply to Pommerania78]

Ultra Processed Foods

[CDreamer]

No but Lifestyle adaptations will mean you are will have better resistance, better health and well being so you will be less susceptible to AF.

[secondtry]

You may have hit on a very good point. I would certainly follow that theory. I have found the right dose of flecainide has worked long term for me with a BMI of 23.

[Pommerania78 in reply to secondtry]

What is "long term" and we're you overweight to start with?

[secondtry in reply to Pommerania78]

Long term = 10 yrs. At the start BMI around 25.

[Pommerania78 in reply to secondtry]

Thanks. What is your dose of Flec?

[secondtry in reply to Pommerania78]

200mgs