When to take PIP flecainide?

[Daisy2908]

Unfortunately my paroxysmal AF has significantly worsened lately and I am awaiting an ablation. In the meantime my consultant has put me back on flecainide 50mg bi daily plus an additional up to 100mg as PIP if AF kicks in. I’m now in AF almost every week for a few hours. Before it starts I frequently feel my heart being different, I can’t explain it but it’s sort of ‘bumpy’, not quite palpitations but I just know it’s likely to progress to AF. When I use my watch to monitor my heart at this point it’s normal in terms of rate and the ecg says sinus rhythm. I just wondered if it would be beneficial to take my extra flecainide as soon as I have this feeling rather than wait till AF starts? Has anyone got any advice based on similar experience? I will ask my cardiologist but as he is private and my nhs electrophysiologist has left and I’m awaiting a replacement I thought I’d also ask here first. Thanks in advance.

[BobD Volunteer]

Sounds like a plan . Not medically qualifie but can't see why not but do remember MAX OF 300MG IN ANY 24 HOUR PERIOD.

[Daisy2908 in reply to BobD]

Thank you, noted.

[wilsond]

Yes that's what I did,to try to nip it in the bud. But as Bob said watch the total dosage in 24 hours xx

[Daisy2908 in reply to wilsond]

Thank you for replying

[mjames1]

I did something similar, however not everyone is allowed to take 300 mg in 24 hours. My maximum allowable dose was only 200 mg. So best check with your prescribing doctor on your 24 hour limit.

Jim

[Daisy2908 in reply to mjames1]

Thanks Jim will do

[Lenlec]

I take 200mg as soon as I go into af I feel my pulse and check with my Apple Watch. My ep did say I can take upto 400mg flecanide. But usually it’s a max of 300 mg

[Daisy2908 in reply to Lenlec]

Thanks up till now I’ve done the same just at a lower dose which has worked well. Just wondering if I can stop the AF arriving at all if I take it earlier.

[Ppiman]

I can't answer your question, but I do seem to be mirroring your experiences and was given flecainide 50mg three weeks ago. However, I took only one dose and had a day almost free of arrhythmia for the first time in many months. However, during the day I had prolonged and very strong palpitations which worried me. I later phoned my GP and on his advice took no more flecainide and resumed my daily bisoprolol. When I used my Apple Watch during the palpitations, it indicated NSR but showed an unusually widened peak.

I have since spoken to my heart specialist and was told that the drug can do this to an ECG, but that the palpitations were of no consequence, and that it will be safe for me to take as confirmed by my recent cardiac MRI.

Oddly since that single dose, my heart has been far calmer and so I decided not to resume flecainide to see what happens. This week, my troubles are back and I am going to ask my GP if using it as PIP would be a good idea, rather than daily. It seems that taking it regularly might not be needed since, as I understand it, the drug is for symptom relief only.

I look forward to reading of others' experiences and suspect my anxieties got the better of me.

Steve

[Daisy2908 in reply to Ppiman]

Thanks it took me a long time to feel confident about taking flecainide so I understand completely. I’ve had so many tests on my heart I also feel confident the palpitations are ok even if they are alarming at the time. I hope you get a way forward agreed.

[Ppiman in reply to Daisy2908]

Thanks, Daisy. It's good to know that I am not alone in this. I emailed my specialist to ask him if he would write to my GP, but he hasn't. I suspect questioning him has irked his pride! I hope not as he's an excellent doctor.

Steve

[HotGuacamole]

You said, "Before it starts I frequently feel my heart being different, I can’t explain it but it’s sort of ‘bumpy’, not quite palpitations but I just know it’s likely to progress to AF...I just wondered if it would be beneficial to take my extra flecainide as soon as I have this feeling rather than wait till AF starts?" When I was taking flecainide PIP, I could also tell when it was coming on. Just a strange feeling, but no palpitations. I took flecainide then, before it developed fully. The difference for me was that when I used Kardia, I was usually able to verify, but my heartbeat was still low - not up to 160 or 170 as it gets when it gets going.

[Bismark]

Hi Daisy,

I've just a little bit to add to the good comments made already. My Cardiologist warned me not to take single doses of Flecainide or for just a couple of days . He said that taking Flecainide for only a couple of days can cause AF. He advised me that the minimum period he would like me to take it was 5 days. I'd ask your heart specialist this question on how short a period you should take it.

What I have found is that earlier when I had ectopic beats after my Ablation I would get concerned and a little frustrated that the Ablation hadn't worked properly. My Cardiologist advised me that after he had viewed my 24 hour Holter reading that he wasn't concerned with the amount of ectopic beats I was having and the best way to reduce them was to try and relieve as much stress as possible and I had to stop worrying about these missed beats. Easier said than done but not worrying so much has greatly reduced my Eptopic episodes

[Daisy2908 in reply to Bismark]

Hi thanks for your reply. I’m back on flecainide 50mg twice a day now and just take the extra dose on top of that when I have AF. I did think I’d ask if my daily dosage was right next time I see the cardiologist in case it needs to go up.