Treatment Options

[Tamerlane60]

Diagnosed with Atrial flutter in January, 2023 . In December, 2023 went into Afib and had cardioversion which lasted until mid January, 2024. Went back into Afib Jan 15/24, tried Flecainide and 2nd cardioversion 2 days ago, which failed.

Are there other treatment options to get out of Afib ?

[mjames1]

Did you give the daily flecainide at least a few weeks at variable dosages? If so, other than perhaps, some lifestyle changes, ablation seems your best bet to try and keep you out of afib. Best person to see about all this would be an electrophysiologist if you are not already seeing one.

Jim

[Tamerlane60 in reply to mjames1]

Appreciate the advice

[Buzby62]

Hi, here’s a link to the treatment options booklet

api.heartrhythmalliance.org...

Hope this is helpful.

[Tamerlane60 in reply to Buzby62]

Thank you

[Ppiman]

I can relate to your situation a little. My highly symptomatic and fast AFl was cured by ablation in 2019 but around a year after that I started with AF. It wouldn’t be safe for me to take sotalol or flecainide, I’ve been told, but, luckily for now, I cope well on a small daily dose of bisoprolol.

I was told that a second ablation, this time for AF would be next, if I were to need it.

Steve

[Tamerlane60 in reply to Ppiman]

Thank you for your help

[secondtry]

I was 60yo and on Flecainide 100mg/day and still had 2 episodes a week. Cardiologist and EP then recommended an ablation but I suggested maybe we could try 200mg of Flecainide, which is a medium dose, and it stopped it dead for 11 years so far.

I should add I have Lone PAF, otherwise active with no chronic issues, no other drugs and have made continuous lifestyle changes since diagnosis.

Just one brief change example.....recently I started getting pre-AF feelings in the afternoon when I have a dip in energy, so I changed taking my Mg compound (incl.taurine) from breakfast to lunch and it worked...back to normal again 🤔.

[wilsond]

What dose of flecanide did you take and how long for? As a pill in the pocket response or as a maintenance dose 🤔 Flecanide can be very effective as both but takes a little time to load up. For some, not so good.

Worked for me ,but eventually had an ablation for AFib and Flutter.

Our patient leaflet is good.

Best wishes

[Tamerlane60 in reply to wilsond]

appreciate your advice

[Utahskier]

After a Nov 2023 ablation for chronic Afib I’ve had flutter with some severe episodes. 12 hours in one mid January sent me to ER. Not on blood thinners at the time so they tried drugs rather than a cardioversion. The “miracle fix” after 15 hours of terrifying flutter/high HR was 100mg Flecainide & 1 mg of Ativan. Since then I take a daily dose of Flecainide and when flutter symptoms occur, additional Flecainide (200-300mg in 24 hrs) & 1 mg Ativan. Not ideal but it seems to work. The after-effect of Ativan for me is depression for a day or two. Considering another ablation in May for this flutter thing, which is as bad as Afib was. No other cardio drugs currently, just a blood thinner. Hope this helps!

[Tamerlane60 in reply to Utahskier]

Thanks