Afib/Ectopic Beats Nightmare - Atrial Fibrillati...

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Afib/Ectopic Beats Nightmare

27 Replies

Hi please bare with me first forum of any kind I've ever joined!!

I Have had Afib for over 7 years (on 10mg Bisoprolol since) recently had Second Cardioversion which led to regular Ectopic Heart Beats and slow HR of 29bpm at lowest which led to hospitalisation.

Now off Bisoprolol and After monitoring and further Consultation am now on Flecainide 50mg x3 Daily and Apixaban × 2 daily, have only been taking this medication (Flecainide) for 1 week but have seen no improvement, if anything currently feeling worse with constant Ectopics that can last for over an hour at a time (having constant ectopics as I'm writing this) before going back to sinus rhythm and then the cycle repeats, also bouts of Afib but not as regular,I find that just standing up or changing position in bed can trigger Ectopics.

Just wondering if this is due to the Flcainide taking time to kick in or if its just not going to be effective at all,

Just wondering if anyone else has or is experiencing anything similar or has an advise.

Many thanks.

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27 Replies
BobD profile image
BobDVolunteer

Sabine Ernst ( a top EP in London. ) once told an audience that ectopics were a good thing since they show the heart is trying to go into AF and failing. They are considered benign though many would argue that point. Strangely many people find them more anoying than full AF. Be that as it may you should try the slow deep breathing trick as this is great for terminating ectopics. Use your stomach (diaphragm ) not shoulders and slow your breathing down to six or less breaths a minute for at least five minutes. Longer if you can.

in reply to BobD

Hi BobD, Thanks for the reply,

Have tried the breathing exercise , works sometimes but unfortunately when it does work doesn't last,long I know Ectopics and Afib won't kill me but can be very disconcerting and debilitating at times.

But now back on Bisoprolo along with the Flecainide and Apixaban so fingers crossed will kick in soon!!

secondtry profile image
secondtry in reply to

Probably best to give Flecainide 3 months to let the body adjust. Try humming to reduce ectopics, it stops my 'flutter' type irregularities and my cardiologist gave his approval. I am afraid it is all trial and error as we are all different.

baba profile image
baba

The only time I was aware of etopic beats was when I was taking Flecainide, really strong beats. I know I still get them, evidence on Kardia ECG, but don't feel them.

in reply to baba

Many thanks for the reply Baba, unfortunately my Ectopics are really noticeable and go on for a long time.

kitenski profile image
kitenski

Can you reach back out to the medical team that prescribed the flecainide and see if they will do an ECG to check wether it's causing issues or not.

in reply to kitenski

Don't quote me but as far as I'm aware Flecainide helps control heart rhythm , and Bisoprolo helps suppress Ectopic beats,. Apparently that's why I was having a nightmare with Ectopics , now after 2 doses of bisoprolol can already feel a positive difference, so, so far so good but early days.

kitenski profile image
kitenski in reply to

Flecainide gave me ectopics after a few years usage!

in reply to kitenski

Have you tried Bisoprolol and Flecainide combined as mentioned above, might not work for everyone but worth a go.

kitenski profile image
kitenski in reply to

Yes flecainide made things much worse for me!

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JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to

Hi

If you can't have an ablation I can't understand how you were given Flec. Cardioversion NO, Ablation NO and FLEC NO.

CCB Diltiazem is an anti arrhymnic med which is OK. You can't have this one if your Ventricles are in trouble but like me your is atrium related.

I think Flec... is your problem.

cherio JOY

Singwell profile image
Singwell in reply to

It's kind of the other way around. The BBs are rate controllers and the Flecainide is an anti arrhythmic. I know how you feel about ectopics because they can be jolly uncomfortable. I found it took 10 days for my body to settle into Flecainide. I hope you settle too.

in reply to Singwell

Quite right Bisoprolol for HR Control and Ectopics, but alas crossing my fingers did bugger all good!! Ecto's back but way more suppressed and can't feel the pulsing in my neck so getting some sleep now at least, should be used to this after over 7 years but doesn't quite work like that.When I was in periods Persistant AF at least I could adjust to it sort of ish until next Cardioversion, but the random nature of Ecto's is a lot more disconcerting.

Unfortunately AF is like a Demented Lop Eared Puppy, keeps following you around and got it for life.

P s. Thanks for replies and hope you all find some sort of middle ground you can cope with.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Singwell

Hi

Not with me.

BBs DID NOT CONTROL my rapid Heart Rate and left me up at 186 Metroprolol and 156 Bisoprolol Day Rates.

BBs controlled my BP best taken at Night.

CCB Diltiazen 120mg AM controls my H/Rate. Within 2 hours down to 51 on 180mg.

so we are all different. The CCB controls Day and leaves my 47avg bpm Night Rate.

cheri JOY

Singwell profile image
Singwell in reply to JOY2THEWORLD49

We're all different. BBs don't act directly on the heart is my understanding- whereas Diltiazem as a calcium channel.l blocker does. Diltiazem is also a rate controller though.

JOY2THEWORLD49 profile image
JOY2THEWORLD49 in reply to Singwell

Hi

Beta Blockers do act on the heart to stop the body's reaction to 'flight' adrenaline. CCB stops calcium from entering the heart muscles.

BBs are sometimes used with folks who are anxious. I was reading a book where on first dates and stands the female took a beta blocker to stop her feeling anxious.

When I was diagnosed with essential tremor Mr Simpson Specialist in that field after diagnosing me said, I would prescribe a beta blocker or a glass of red wine before an anxious event. I was playing competitive outdoor bowls.

I do notice that the left hand tremors late afternoon but in the morning much quieter.

There are many different blockers about. Research them and learn the differences for your own interest.

I am not an anxious person. At the PET /CT SCAN I was asked if I wanted a sendative. I said no thanks I want to drive to my hoet and I said let me know when you about to push me in and when you take me out of the barrel. I listened to ELVIS.

Essential Tremor is in my genes although my immediate family did not display my cousin was bad, came from both sides of her parents.

Its all very interesting.

Diltiazem is also an anti-arrhymic med and much safer than Flec....

cheri JOY. 75. (NZ)

Singwell profile image
Singwell in reply to JOY2THEWORLD49

Thank you Joy.

Ppiman profile image
Ppiman

Welcome to the world of AF, ectopic beats and anxiety! ;-)

I think flecainide, if it is going to help, will work immediately. Your dosage might be too low, but that doesn't sound likely given what you report. I have pretty much a similar background to yours with lots of ectopic beats and less frequently, AF. I haven't had a cardio-version but do get spells of bradycardia (not as low as yours - my that likely worried you).

The cause of all our ills is atrial, with some kind of over-excitability in the conducting cells and nerves there. The answer is, I am told, an ablation, but the success of this depends upon where the ectopic "focus" is, I gather. I am on the waiting list for one.

I was prescribed flecainide a few weeks ago but only took it for a day. It worked well for that day but caused me some odd heavy heartbeat like feelings and so I have left it since.

As far as breathing exercises go, they are worth trying but I think these and the "valsalva manoeuvre" help only in specific cases - often tachycardia (SVT). They do nothing for me.

Steve

in reply to Ppiman

Thanks for your reply Steve,Not a candidate for Ablation or Pacemaker unfortunately due to Left Atrium Volume, so unless some other procedure pops up Meds it is!! Hopefully Flecainide kicks in soon but at least seeing some improvement with Bisoprolol, although was on it long term originally.

Same here with breathing exercises only very short lived fix.

More frustrated these days than anxious, but suppose its all part of the (never ending) AF journey!

Ppiman profile image
Ppiman in reply to

Being phlegmatic helps. I could do with being better at that. It’s a hard going life at times. I can add in insomnia to it, which worsens the ectopics.

I hope the flecainide and bisoprolol do the trick sufficiently at any rate. What kind and level of symptoms do you get?

Steve

in reply to Ppiman

My Symptoms tend to include, fatigue Intermittent breathlessness depending on severity of Ectopics/Afib bouts, (sometimes heart has felt like a golf ball rattling around in a tin can) poor blood flow to extremities (winter a nightmare) periodic visual disturbance and extremely vivid dreams when I finally manage to sleepHopefully though the future will look brighter for all of us as new meds come on line.

Take care.

Ppiman profile image
Ppiman in reply to

Let’s hope so. Bisoprolol has given me cold toes. It’s a small thing but one more symptom.

Steve

Tiburon profile image
Tiburon

An electrophysiologist told me Flecainide can help with AFib but can cause ectopics or make them worse . In my case, the drug made the ectopics worse. I stopped it after 3 days. My ectopics are now controlled by a daily low dose of Metoprolol. I have found that breathing exercises, as described by Bob, can help with ectopics, but Metoprolol has pretty much eliminated them for me.

Ppiman profile image
Ppiman in reply to Tiburon

You've been very lucky as, I’ve read, beta blockers are not often that effective with controlling ectopic beats.

Steve

dogsneedwalking profile image
dogsneedwalking

Welcome to the forum and welcome to our world. It can be a very scary experience getting these symptoms but I to spent 10 days in hospital after unsuccessful ablation and had to get Amiodarone administered through IV to get my heart rate back to regular rhythm. I was also prescribed Bisoprolol along with 200mg oral Amiodarone after the 'leading dose.' Every time I would turn over in bed the ectopic/skipped beats would rear their ugly heads but they were happy that my heart was happy and so I just got used to them as I couldn't and still cannot sleep on my back. Most nights my heart 'thumps' along albeit deafening in my ear and pressure on my throat but usually too tired to keep me awake and perhaps the fact that I no longer panic probably helps but if it lasts for hours I stick on my headphones and listen to my favourite music tracks. I hope you find this forum informative and helpful as we all share our experiences with this condition. Take care.

BigDunc profile image
BigDunc

I have suffered with AF for around 18 years and Flecainide worked for me for around 15 years. I had to come off Flecainide due to mild coronary artery disease.

I then have suffered with Bigeminy and Trigeminy ectopics over the years horrible experience and was always a precursor to going into AF. I was actually glad to go into AF

I have tried various breathing exercises square breathing etc the one that helps me is breath in to the count of four and breath out to the count of four.

My heart rate has always been low around 40 BPM due to being quite athletic and probably overtraining over the years. I have been saying that I had Vagal AF for many years and was eventually put on a drug called disopyromide that has alleviated my symptoms and AF.

Not been in AF for 3 years and ectopics controlled with breathing exercises

Hope this helps

Good Luck

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

Unfortunately Flec is an anti-arrhymic med and is highly risky.

Anything abnormal is the structure of your heart needs to be discounted first.

No cardioversion, ablation or an anti-arrhymic med should be done until an ECG, ECHO and 24hr Heart Monitor should be done.

I can't have any of the above.

At Stroke I was diagnosed with AF Rapid & Persistent & within 4 days Thyroid Cancer causing the former - a rogue blood clot.

BBs did not control ,my rapid heart beat of 186 with Metoprolol & pauses at night avg 47bpm & Bisoprolol 156.

2 years 3 mths struggling I was recommended to see a private heart specialist by Locum.

He introduced 120mg CCB Diltiazem.AM. Within 2 hours 1/2 dose 180mg brought me down to 51. Treaked I am now on:

120mg AM Diltiazem. CB to control H/Rate Day but it leaves my normal Night Rate 47avg bpm at that level.

2.5mg Bisoprolol PM to control BP.

I've been on this 2.1/2 years.

I lost 5 kgs within the first year and now my H/Rate Day avg 60s & Night 47avg bpm stays.

Diltiazem also comes in 30mg & 60mg. But discontinued in NZ.

A Heart Rate under 40 is serious whether asleep Night or Day.

Discussed might be a Pacemaker which would stop the low low Heart Rate.

Take Care.

JOY. 75. (NZ)

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