Pill in the pocket drug Flecainide and AF

[LoquatPreserver]

I've been using Flecainide for my occasional AF episodes but they've recently become more frequent and the Flecainide is making my pulse race for hours after the AF has stopped. During the most recent episode my heart went from AF to Atrial Flutter (in the right atrium) after taking the second Flecainide pill. I'm booked to see a cardiologist next month.

[mjames1]

Of course no one here is medically trained and cannot advise you about medication's.

That said, if I was in your position, I would not take any more flecainide until you spoke to an electrophysiologist. And based on what you said, I'd be very surprised if they allowed you to continue with Flecainide.

(One risk of flecainide is)'organizing' AF into AFL can give rise in AFL with 1:1 conduction, resulting in very high ventricular rates, which can potentially degenerate into life-threatening arrhythmias and cause death.

PMCID: PMC8536867PMID: 34703982

This is one reason Flecainide is often taken together with Nodal blocking agents, such as a beta blocker or Diltiazem, which significantly reduce, but do not completely eliminate the risk of flutter, sometimes including life-threatening one-to-one flutter.

Jim

[BobD Volunteer]

Flecainide should normally only be taken alongside a beta blocker to prevent flutter. Strange if this was not done.

[Peony4575 in reply to BobD]

I have been prescribed flecsinide as pip without rate control . Probably because I can’t tolerate beta blockers ( didn’t do much for rate during episode when I was given them.) Not saying it’s ideal just confirming that it does happen

[TracyAdmin Partner]

Hello

I would suggest recording a 'diary of events' of how long the episodes are lasting and the frequency of how often they occur ahead of the appointment next month. The more information you have to share with the Consultant the better.

Kind regards

TracyAdmin

[DawnTX]

I am not sure if you’re asking a question about taking it or what because I don’t understand if you haven’t seen a cardiologist yet why you are even taking it my Cardiologist sent me directly to an EP because of my situation things happen very quickly, and I was put on an anticoagulant along with a beta blocker at that first appointment although I did have some testing done that same day also. A fib and a flutter are very complex. It may take several trials of things to get the right fit for you and it may change again just be prepared for that. I am in the states I was never given a PIP. I actually had my first ablation within days of everything happening and put on amiodarone. along with my anticoagulant. There is no one size fits all with any of this and there are no real answers or cures just so you know it’s a bumpy journey but hopefully you will get to where most of us have gotten to some type of peace and acceptance of things, it’s not terribly life-changing once you get to understand, but I will tell you until you get the gist of it. It’s a bumpy ride, so don’t let it make you crazy. A fib doesn’t kill as a rule that I know of, and I feel that I am a success story to what they can do for you. Just a year ago I could not even walk today the birthday of what I call my new heart lol I even saying happy birthday to it because last year I got a pacemaker specifically made for only me and I got back my life much more than I ever thought it would be able to.

Be thankful that it’s not acting up too much. Some people are lucky. That way a fib is different for everyone. I have a typical, and although my a fib has been dormant now, I also have a typical flutter, and even with the pacemaker I feel it and sometimes it really acts up for a while. In case you’re wondering, the pacemaker keeps it along with your AV not ablation from damaging your heart. It can flutter all at once, but it’s not doing damage. The problem with a fib and flutter is the damage that’s happening to your heart until they start working and controlling what’s going on

Depending on when you see your cardiologist, if it’s in the distance, maybe you should make a call because you’re a fib is changing. I don’t know if it would make a difference or not fear visit but it’s worth a call. They may still think it’s as it had been not that bothersome. I had a problem with a doctor, and because of the problem I went much longer without the proper Until I found my incredible Doctor Who saved my life. During the time I did not act on this, I started heart failure that’s why you don’t wanna let time go too long if you don’t have to. Please do what they tell you to do the majority of them Want nothing but to help you get better. I am a person that questions a lot, but I will tell you one thing I will never question my EP or Cardiologist now because I had a list of questions and I got the answers from them before I got to ask. They may not tell you everything but these doctors need to really know their stuff if you don’t like or trust you need to find another.

I have learned a lot in the last two years, and it is amazing with these men and women must know to be able to do the specialties that they do.

Also know every day they are working and trying to find new things for us. Maybe someday they will be a cure. A year ago Christmas it appeared I was probably going to die. because nothing had worked and I had a cardioversion that not only failed but worse than that. Reason my GP actually told me he didn’t think I was going to make it. We can talk about it now, because I am in such a good place now. By February my EP saved my life devising a pacemaker that did not exist. He told me I was unique and he wasn’t kidding. I thought he was. My doctor has a passion for what he does And many of them do that out there Best of luck with everything. Thank positive as much as you can and get out of your head about it because if you think about how bad etc. you’re only making it harder on yourself because stress and anxiety are going to make everything worse physically. My EP told me not to use devices stop checking everything I know the big thing is to have watches etc. but just using an oximeter I discovered I was hooked on checking myself and your heart rate changes constantly so if you don’t know what the doctor knows you’re gonna be nervous about it. You can live your life or you can live it for you and mess you up. It’s up to you.

[RepublicofFlaxpool]

Was the Pill in pocket Px by Cardiologist? I think I needs to be. I got a short run of VT when I went up to 100mg bd from 50mg bd. All anti arrhythmia tabs can cause arrhythmias. On 50mg bd, ablation booked. Can’t take b-blockers as long QT. It can be complicated and I used to work in medicine.

Always get the best opinion you can.

[LoquatPreserver]

Thanks for all your replies and sharing of experiences.I was put on a beta blocker and an anticoagulant (by a cardiologist) when I was given the PIP and still take those. I never felt comfortable about taking the full dose of 2-3 Flecainide (especially as I'm a small build) and relied on 1 or at most 2 to stop the AF . It's nearly always 2 required now and that's when the trouble starts.

I was just wondering whether other people have experienced the same as I have.

My doctor expects the cardiologist to find an alternative to Flecainide but from what I've read, there aren't many safe alternatives. He may recommend ablation and I'm not comfortable with that after reading of other's experiences.

[secondtry in reply to LoquatPreserver]

Try and get to see your cardiologist earlier to sort this out. I presume you had all the tests before you were given Flecainide PIP but as Jim says any sign of Flutter or other issues I understand means more professional advice asap.

I was one of those few here put on just Flecainide (200gms) daily due to diagnosis of Lone PAF and lowish BP & HR. It is a relative old tried & tested drug, which has worked for 11 years for me but each individual has to be assessed and I understand there are successful alternatives.

[Speed in reply to LoquatPreserver]

I would caution about being over concerned about having an ablation. I strongly suspect that you only really hear of the bad experiences on here, the good ones which make up the vast majority of experiences are not posted about as they are routine. Myself, I’ve had 2 for flutter and they have been very straight forward, the one where I was for a short period in discomfort under light sedation, I mentioned it and they just gave more more sedative and I just drifted off. I am more apprehensive about going to the dentist than the prospect of having another ablation but still go to the dentist religiously. Follow the advice of your EP, they will have seen an awful lot of ablations and will be able to put it in perspective.

[mjames1 in reply to LoquatPreserver]

My doctor expects the cardiologist to find an alternative to Flecainide but from what I've read, there aren't many safe alternatives.

Flecainide may be one of the most effective anti-arrhythmic, but not necessarily the safest. Others exist. There's a reason there's a black box warning on Flecainide in the United States. And one of the reasons is that it can cause a life threatening 1:1 flutter in rare cases, even if you're taking a beta blocker. So again, you're best not taking any more Flecainide until you discuss these flutter episodes with your cardiologist, because 1:1 flutter is a lot worse and far more dangerous than an afib episode.

Jim

[Tapanac]

Flecainide is a rhythm control drug. . Are you taking a rate control as well which is normally recommended?

All the best

[LoquatPreserver in reply to Tapanac]

Yes

[Vonnegut]

How different we all are. When the lowest dose of Bisoprolol proved too much for me to take daily, I was prescribed Flecainide to be taken when an episode occurred but as episodes increased it was suggested I take 50mg twice daily and now 100mg twice daily has virtually put an end to episodes for me- just the one over a year ago around the time I must have been infected with covid (no other symptoms but a positive test) when an extra pill ended the episode in a few hours.

[LoquatPreserver]

Update on Flecainide: the fast pulse brought on by taking this drug as a PIP became Atrial Flutter (right atrial arrhythmia) so was taken off it.

[LoquatPreserver]

Are there other PIPs available? I don't have one now that I can't take Flecainide so I was taken off Metoprolol tartrate and put on Sotalol to slow heart rate. I still had AFib episodes, less frequently, but then an ECG showed the QT interval was lengthened by the Sotalol. So back to Metoprolol tartrate 100mg/day (double dose from what I was on). Seems to be affecting sleep. I read that beta blockers work on that part of the brain where the pineal gland is situated. Interesting!