Continuous afib

[Cachito]

I have had afib for 17 years and have been taking Flecainide (initially 25mg and after few years 100mg) and Metroprolol 25mg. I had afib episodes every 6 months for one or two days and after that it went away. Each episode lasted for three or four hours.

For the past two years I have been taking Flecainide 100mg twice a day one at 10::00 AM and the other at 11:00 PM. On Sunday I had afib for 8 hours. Today I began with afib at 7:00 AM and it still is active at 10:30 PM. I just had my Flecainide 100mg and Metroprolol 25mg.

What may have triggered the episodes is that I forgot to take the 10:00 AM Flecainide two consecutive days. The readings in an EMAY monitor is 120 to 140 bpm. I don’t feel bad, just feel some minor palpitations.

Should I just wait it to end or should I get medical assistance?

[Nezzera]

Hi Cachito, I think that letting it go on like that may be hard on your heart.

I would go to the ER or at least call for advice.

Take care

[Cachito in reply to Nezzera]

Thank you Nezzera

[wilsond]

I think I'd get checked out but it is likely to be the missed doses

[Cachito in reply to wilsond]

Thank you Wilson

[Vonnegut]

I see it’s a bit late now but if you miss a dose again and an episode starts just take an extra 100mg of the Flecainide which I did on the only time it happened to me (as a PIP) and if you are on 100mg twice daily, as I am, you won’t be exceeding the maximum dose of 300mg and it should settle things in a few hours as it did with me on the only two occasions I had a breakthrough episode ( once when I must have been infected with covid and once when I’d forgotten the morning pill like you did!)

[Cachito in reply to Vonnegut]

Thank you Vonnegut. I did take additional 50 mg last night and it helped me to reduce the bpm. I also read that the maximum dose is 300mg, but since I was going to do it at night I decided to use only 50% of the dose.

[Vonnegut in reply to Cachito]

Can’t see why you decided on the lower dose as it was night time. Hope you get things sorted soon by taking the additional 50mg

[Bismark]

I'd definitely get medical advice because your AF has changed and if you're like most people causing you a bit of stress due to these changes. It may also be time to discuss an ablation proceedure with your heart specialist. I was on Flecainide and Digoxin for over 10 years and then had 2 Cardioversion and my heart specialist booked me in for an ablation.

[Cachito in reply to Bismark]

Thank you Bismarck.

I contacted my EP and also made an appointment with an ablation specialist to explore some options. My EP insists on the use of blood thinners, what I don't like due to their secondary effects. He asked me to take eliquist, which is a very expensive drug, but I understand that it is better than warfarin. I am waiting to see if my condition improves and if I get out of continuous fib during the next few days I will not use eliquist. I want to check with the ablation doctor if ablation is effective with persons my age ( 80 years old) that have had fib for 17 years and have been using Flecainide and metoprolol during all those years. I understand that the procedure has improve significantly and now is more effective than few years ago. Due to my age I wouldn't like to go through the ablation procedure several times. I also would like to know if the use of B. Thinners is necessary after the ablation.

Thank you again Bismarck

[Bismark]

My ablation went okay, I do get ectopic runs which only last for around 10 seconds to 30 seconds. I find now something like a cold or Covid cause my ectopic beats to increase and stress can also cause thes episodes. My cardiologist has put me on Eliquis because of these ectopic beats. So I'd guess how successful the ablation is will determine if you need to go onto bloodthinners.