Stopped flecainide

[Bookgirl1]

Last week I stopped taking flecainide. I was on a lower dose of 50 mg twice a day. My cardiologist said I didn’t have to wean off if it because it is a small dosage. This week following the stoppage my heart rate has been very high. Just standing up it will jump into the 90’s. I called my cardiologist and he doubled my metoprolol and that keeps my heart rate down. However, by the time I get up the next morning it jumps up again until I take my morning metoprolol. Has this happened to anyone else who stopped flecainide abruptly?

[Paulbounce]

Hi Bookgirl.

I'm not a medic so this is based on my personal experience. Flec is a strong drug but it does the trick. 50mg is a fairly low dose. However, we all react differently. I think you need to consult your cardio - It might be helpful to discuss your concerns and symptoms in detail with him/her to ensure that your treatment plan is tailored to your specific situation.

Paul

[Bookgirl1 in reply to Paulbounce]

Thank you Paul. I have an appointment today with my cardiologist.

[Paulbounce in reply to Bookgirl1]

Good luck Bookgirl

Paul

[Hidden in reply to Paulbounce]

Thank you!

[Bookgirl1 in reply to Paulbounce]

Thanks, Paul. Back on flecainide as of tonight.

[AAJJTt]

Hi, that’s interesting. After my last review, I am about to start doing this next month but I was told to taper.

Since my initial diagnosis (4.5 years ago), I have been on a maintenance dose of Flecainide - 50mg (am) and 100mg (pm). The criteria for starting this, was maintaining a high exercise tolerance and remaining ‘Afib free’ for another 12 months (it’s actually been 3.5 years since any sustained episode), which I have achieved.

I will start with:

- 50mg am & pm for a month

- 50mg (pm) only for month

- then none

Basically, see how it goes. I don’t take a beta blocker and RHR stays around 55 bpm.

I have a PiP plan too. If an episode occurs

- an extra 100mg Flecainide plus 2.5mg of Bisoprolol

- after 1.5 hours take another 100 mg of Flecainide, if not resynced to NSR.

Leave it until the ‘morning’ (my AF has a vagal tone - late evening/early morning onset), if not back in NSR then present.

It’s a bit test & see, but if episodes occur with any regularity then I would go back on the maintenance dose.

Regards

[secondtry in reply to AAJJTt]

My cardiologist would have to present a very strong argument to change my mind from tapering. I am on 200mgs Flecainide, if I did decide to come off I anticipate I would do this over a year!!

[Bookgirl1 in reply to secondtry]

He said I was on such a low dose that I didn’t have to taper off.

[Bookgirl1 in reply to AAJJTt]

Good luck. I hope you stay afib free once hour off.

[wilsond]

Yes! I was ill advised to stop flecanide overnight by my GP in order to take anti inflammatory medicine.Result, prolonged episode of AF,extremely annoying as I'd had a successful ablation 6 months before.

My EP was aghast when I informed him. Said flecanide needs to be titrated up or down ( I.e slowly)

[Bookgirl1 in reply to wilsond]

Thanks.

[Thomas45]

I was on 300mg a day of Flecainide for 10 years, when I was found to be in persistent, though asymptomatic, AF . My cardiologist told me to just stop taking the Flecainide. I checked this with a very knowledgeable, of AF, GP, and then just stopped the Flecainide. Nothing untoward happened.I have since deemed the persistent AF to be permanent as I've continued to be in persistent AF for 7+ years.

[gorpo59 in reply to Thomas45]

Do you think flecainide dampens the severity of AF in any way-did you notice your AF more when you stopped the flecainide (even in the first few days)? General opinion seems to be that if you’re in AF and it doesn’t convert you out of it in a week or so even up to max dose, there is no point in continuing it but if you’re having a DC cardioversion it’s good to be on it for a few days before to give it the best chance of holding in NSR? I’ve been on 200mg daily for a year. Been in NSR most of it but twice needed DCCV as flecainide didn’t work. Thinking I’ll take a break for a few weeks to see how I feel (hospital OK with that so long as go back on it for week before DCCV). Of course there is a temptation to just go permanent as maybe less stressful…

[Bookgirl1 in reply to gorpo59]

I was wearing a monitor at the time. Afib started after stopping flecainide. No afib while on it.

[Vonnegut]

Why were you taken off Flecainide? I have found taking twice the dose you were on works very well for me and I only had an episode when I must have been infected with covid ( no symptoms just a positive test result) which was soon ended with an extra pill. That was almost a year ago now.

[Bookgirl1 in reply to Vonnegut]

He put me on it after one episode of afib. Haven’t had any afib episodes since so we’re trying to determine if I even need to be on flecainide.

[Vonnegut in reply to Bookgirl1]

Do you have a Kardia? That way you could tell yourself if you ever feel there’s something going on. I only got it prescribed by an EP I saw privately after the lowest dose of Bisoprolol proved too much for me to take daily and the surgery didn’t come up with anything else! We are all different and I hope you find what works for you ( if you need it and actually have paroxysmal atrial fibrillation).

[Bookgirl1 in reply to Vonnegut]

No, I use my Apple watch.

[Bookgirl1 in reply to Vonnegut]

Back on fleccainide after seeing my cardiologist today.

[Vonnegut in reply to Bookgirl1]

All the time as before? When it was first prescribed for me it was as a PIP as I mentioned before. Hope it works for you as it has for me.

[Bookgirl1 in reply to Vonnegut]

Thanks!

[JOY2THEWORLD49]

Hi

Speak to your Cardiologist about CCB Diltiazem. It controlled my h/Rate. Taken AM 120mg and 2.5mg Bisoprolol PM.

Flec is a risky rhythm drug. Never offered nor along with Cardioversion.

Metoprolol gave me pauses at night and breathless on any exertion. Very tired and slept alot.

No thanx to Metropolol.

I'm watching the latest that ???sabout whether any B.Blockers should be given to AF patients.

PRADAXA time.

cheri JOY. 75. (NZ)

[Bookgirl1 in reply to JOY2THEWORLD49]

Thank you.