Need a little reassurance: Currently... - Atrial Fibrillati...

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Need a little reassurance

Fight-the-good-fight profile image

Currently having a PAF episode - HR 125

Reluctantly taken my very 1st Flecainide tablet (50mg) 10 mins ago as PIP as per instruction from consultant.

If this doesn’t convert to NSR within a couple of hours take another in 12 hours. If this doesn’t resolve then take on a regular basis.

Obviously my anxiety levels have gone through the roof I am terrified in case I suffer adverse reaction to this drug.

I so don’t want to take it, but my PAF is so uncomfortable, I feel I don’t have a choice.

Thanks for listening…

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41 Replies
Rainfern profile image
Rainfern

I just want to say I hope your AF has settled down now and that the Flecainide worked without too much side effect. I’ve never taken that particular med, but can fully identify with the anxiety at taking a new pill and the fear it could make things worse. Let us know how it goes.

Thomas45 profile image
Thomas45

I took 150mg x 2 every day for 10 years and had no side effects. It reduced my episodes to one or two ten-minute episodes a year. It was nothing to be anxious about.Yes, we are all different. I have had side effects from other drugs, such as two bisphosphinates, Risedronate and Alendronic acid, both to treat osteopoenia, but gave me excruciating knee pain. Bisoporol was fine for 7 weeks, then I started with painful skin rashes, which despite treatment with prescribed antihistamines still took 4 years to stop. Bisoporol also caused a sudden exacerbation of asthma, causing ambulance admission to hospital for 3 days. None of them caused anxiety.

The nearest I've been to anxiety was when my body rejected one DOAC, causing the auto-immune condition of Polymyalgia Rheumatica. It took medics 5 weeks after numerous blood tests to diagnose. The pain was intense during those 5 weeks.

Fight-the-good-fight profile image
Fight-the-good-fight in reply toThomas45

Thanks Thomas45, happy to report that I converted to NSR within 4 hrs.

Was able to sleep, it reduced my symptoms, and no side effects.

Doggiemomma profile image
Doggiemomma in reply toThomas45

So glad to hear your long term use of taking 150 mg twice a day for 10 years was without issues!

Hylda2 profile image
Hylda2

I too took 150x2 Flecainide a day for years with no side effects. It gave me my life back until I finally started having breakthrough episodes and ended up with a pm and an AV node ablation.

Fight-the-good-fight profile image
Fight-the-good-fight in reply toHylda2

Thanks Hilda2, happy to report that I converted to NSR within 4 hrs.

Was able to sleep, it reduced my symptoms, and no side effects.

Hylda2 profile image
Hylda2 in reply toFight-the-good-fight

Brilliant

Tapanac profile image
Tapanac

hopefully the flecainide has kicked in now. 125 is not too bad so the one pip should help fingers crossed

I have been on flecainide 50mg x 2 since 2017 and no side effects. In fact once when I was in hospital for something else I felt my afib starting and checked with the doctor if I could take an extra one and he said yes no problem and it was fine.

I would say I had to have a pacemaker as my heart rate kept going down to 30 and I was told I could stop all tablets, but after a while I was certainly better with the PM and no more faint and steady 60-70 but afib kept coming back snd fast heart rate so back on flecainide and low dose bisoprolol. Plus of course apixaban not stopped

All the best to you snd try not to worry as it doesn’t help

Pat x

Fight-the-good-fight profile image
Fight-the-good-fight in reply toTapanac

Thanks Tapanac, happy to report that I converted to NSR within 4 hrs.

Was able to sleep, it reduced my symptoms, and no side effects.

Pommerania78 profile image
Pommerania78 in reply toTapanac

Would you say that Flecainide was effective at stopping the Afib? Thanks.

Fight-the-good-fight profile image
Fight-the-good-fight in reply toPommerania78

Hi Pommeriana, from my initial experience, Flecainide worked for me.

Previously, my PAF would last for hours and leave me totally wiped out for a day or so.

Contact1 profile image
Contact1 in reply toFight-the-good-fight

Can I ask is Flecainide a beta blocker? My episodes seem to be happening more regularly and last for hours, which do zap me but I deal with it so wondering if I should ask Dr about this meds at some point. Thanks

Fight-the-good-fight profile image
Fight-the-good-fight in reply toContact1

Hi, Flecainide is an anti arrhythmic drug, beta blockers slow the heart rate, different functionality.

I take Diltiazem (calcium channel blocker) I could not tolerate beta blockers.

Whilst Diltiazem reduces heart rate, it takes a while before NSR resumes. My PAF episodes occur every 2/3 weeks and are very symptomatic, hence the reason Flecainide has been prescribed…

Tapanac profile image
Tapanac in reply toPommerania78

Well flecainide as you probably know is a rhythm control drug whereas bisoprolol or similar is a rate control

Flecainide won’t actually stop afib itself but especially in my case it helped tremendously. Many people on here say that they have a life back.

Having said all that I have also heard on here that flecainide could cause other flutters.

To me it is a miracle drug.

I don’t know if my answer has been much help

All the best

Pat x

Pommerania78 profile image
Pommerania78 in reply toTapanac

How effective, percentage wise, has Flecainide been at stopping Afib for you? Thanks.

Tapanac profile image
Tapanac in reply toPommerania78

Afib will never be cured, but I would think the symptoms have been 80% easier

Also with my pacemaker probably 95% but it is still there snd I’m told I now have permanent afib, but to be honest it seems better that way.

I was off flecainide but I got COVID, one through the vaccine booster and then a few days later the normal covid snd I was really ill. This unfortunately cause my heart to play up, but I went back on flecainide and touch wood…..

All the best

Pommerania78 profile image
Pommerania78 in reply toTapanac

You say that the Afib is 95% suppressed, yet you also say that you now have permanent Afib. How can that be? Thanks.

Tapanac profile image
Tapanac in reply toPommerania78

Earlier I said afib is never or rarely cured.

What I meant for me is that although I have been told that I am in permanent afib, I would never know except for rare occasions like when I had covid. The flecainide seems to have stopped the tachycardia side of afib and the pacemaker stopped the bradycardia. Before I started flecainide I had terrible occasions 11 times by blue light ambulance in hospital within a month. I would sit on the settee or sit up in bed and it was as if the bed or sofa was moving snd beating snd my heart was going to come out if my chest. My heart was beating at 240 like an uneven and rocky stream. Dreadful time.

The hospital started me on flecainide and within a couple of days it seemed as if I was a different person. I’m not saying at times I still feel breathless and can’t walk far snd as if I’m being strangled snd tight chest, but not the awful other way.

I’m probably not explaining this very well, but personally flecainide was my miracle drug. Others don’t get on with it, but some people cant even take paracetamol so it’s a personal thing

Bob D always says afib begets afib which I believe is true as no cure but it can be controlled and “they” say it won’t kill you!!

Best wishes

Contact1 profile image
Contact1 in reply toTapanac

Just noticed this thanks for explaining. 😊

ozziebob profile image
ozziebob

I also use flecainide as a PIP, but wasn't offered the dosage and timing advice (wait 12 hours before a second 50mg dose) you have from your consultant. So I've had to learn from my own experience and from others PIP flecainide experience on the Forum.

Admittedly with only limited experience, a single 50mg dose of apixaban didn't have any effect on my AF, but, reading the experience and consultant advice given to others on the Forum, I have found an immediate dose of 100mg converts me back to NSR within 2 hours. I don't think this larger initial PIP dose is unusual as reported on the Forum.

Remember, the max daily dose of flecainide is 300mg, so my dose is still well below that. Perhaps you can ask your consultant about this larger initial dose regime if your single 50mg dose doesn't work.

Fight-the-good-fight profile image
Fight-the-good-fight in reply toozziebob

Thanks Ozziebobo, happy to report that I converted to NSR within 4 hrs.

Was able to sleep, it reduced my symptoms, and no side effects.

ozziebob profile image
ozziebob in reply toFight-the-good-fight

I'm actually not a "bobo", but a bob.

"bobo" sounds a little too much like "bonobo", that well-known endangered great ape.😄😄😄

Fight-the-good-fight profile image
Fight-the-good-fight in reply toozziebob

Opps apologies for typo. 🤦‍♀️

Vonnegut profile image
Vonnegut

When I was first prescribed Flecainide as a Pip by an EP, it was for 100mg. You are taking half that!!

Fight-the-good-fight profile image
Fight-the-good-fight in reply toVonnegut

Yes, 50mg is the initial dose, I can take another if symptoms don’t abate within 3/4 hours.

Vonnegut profile image
Vonnegut in reply toFight-the-good-fight

If you took 100mg as I was prescribed by an EP, expert in such things, the episode would be over in two hours. I was only told to add 1.25mg of Bisoprolol if my heart rate was over 140 twenty minutes after taking the Flecainide, which hardly ever happened. Guess the dosage you are on is ok if it works but sounds as if it might be more stressful.

JOY2THEWORLD49 profile image
JOY2THEWORLD49

Hi

? do you have any structural abnormality of your heart? This will shw on ECHO.

If you do DO NOT TAKE FLEC...

cherio JOY. 75. (NZ)

Fight-the-good-fight profile image
Fight-the-good-fight in reply toJOY2THEWORLD49

Hi, no structural abnormality with my heart. Had CT and Echo before prescribed Flecainide.

Sixtyslidogirl profile image
Sixtyslidogirl

I was told to take 50mg of flecanide. The first time I took it, like you I was worried. Absolutely nothing happened, to me or the AF. It reverted in the normal way after a night’s sleep. After that, I was advised to take another in an hour if I didn’t revert but haven’t had cause to do that yet.

Ppiman profile image
Ppiman

Well, we are in the same boat. My AF is, these days, usually around that heart rate. My last episode, lasting five hours, was two days ago. I didn’t take flecainide for just the same reasons. In fact, I’ve only taken one tablet since being prescribed it six weeks ago.

I’ve been told to take it daily and that it will be safe but my episodes aren’t bad enough, I suppose, and my fear of the drug makes me reluctant.

Steve

Hi Steve,

Despite my initial anxiety, I am happy to report I suffered no negative side effects after taking Flecainide.

One 50mg tablet reduced my AF symptoms and NSR resumed within 4 hrs, meaning I was able to sleep.

I feel much better this morning than I normally would after an episode.

The dilemma I have is: On the advice of my cardiologist My GP prescribed 50mg as a PIP, if symptoms continue take an additional 50mg, if symptoms occur twice a week continue to take twice daily.

However, GP contradicts this by saying if I have no symptoms speak to GP to reduce dosage?

My arrhythmia team want me to take this drug on a daily basis 2x50mg regardless.

Like you, I do not want to take this drug when I am asymptomatic.

I have an appointment with arrhythmia team early September where I intend to discuss further.

Hope you are well

AustinElliot profile image
AustinElliot

Hi Fight the good fight,

Personally, I would not be happy with being in AF for 4 hours with Flecainide as a PIP. My EP also started me at 50 mg, which IMO was not effective (but I did not wait 4 hours)

I badgered them a little, 50 mg is a starting dose, most folks on here take way more than that.

Now if I have AF, I try to get it to stop ASAP, i.e. I take 100 mg and than if its still AF in 1 hour I take another 100mg, and so far that has stopped it in 1-2 hours. My last episode 100 mg stopped it at 30 minutes. (after waking, probably had been in AF longer while asleep)

Hope that helps

Fight-the-good-fight profile image
Fight-the-good-fight in reply toAustinElliot

Thanks Austin, am I correct to assume you do not take flecainide on a daily basis?

I have a meet with my arrhythmia team early next month. I intend to discuss further.

AustinElliot profile image
AustinElliot in reply toFight-the-good-fight

That's correct. I take 180 mg Diltiazem, and have Flecainide as a PIP.

Did lots of lifestyle changes - no caffeine, lost 18lbs, cut back on added salt. So far pretty decent, last episode in March. Hoping it will go longer, but know it can come back whenever.

Fight-the-good-fight profile image
Fight-the-good-fight in reply toAustinElliot

Glad it is working for you.

I take 60mg Diltiazem.

Like you, I tweaked my diet.no added salt, no alcohol and no caffeine.

Despite this, my episodes occur every two to three weeks. I guess we are all different.

Maymuna profile image
Maymuna

Hi, I was in the anti- medicine camp and used Pip occasionally as a pill in the pocket but never found it effective. I was getting episodes once a week for 12-24 hrs which was tiring me out and messing up with work plans etc. Last November I had a stroke, so I had no choice but to take flecanide and apixoban on a daily basis. Now my life is back to normal whatever that is ! The meds work for me, 100mg flec twice a day and apixoban 5mg same. I wasnt happy at all at first but I had to get on with it as I recovered fairly quickly from the stroke with no long lasting side effects. I'm so grateful for that, it feels my heart is better than before and means I can do my job without collapsing in the middle of it (I run a cycling club in the community which means a lot of physical work) Just sharing the story because I was like you, my afib worsened over the years but I remained stubborn and afraid to take medicine. Now I see it as my lifeline. I don't know how long it will last and I'd like to reduce the flec at some point but don't want to go back to how it was before. May

Responsable profile image
Responsable in reply toMaymuna

Hi! Some 5-6 years ago, a member of this forum has written this sentence: "Isn't it funny how many of us here are cyclists!?" Since then, I am trying to rexearch the influence of physical activity on arrhythmias. Since you are running a cycling club, may I ask you how often were you personally using the bicycle. I mean how often and for how long a day, approximately... There are other physical activities which are also arrhythmia generating, like running, rowing, basketball playing, football playing (to the point of Sudden Cardiac Arrest) etc.

Responsable profile image
Responsable in reply toMaymuna

Forgot to say... I am also against taking medication, especially if they are "safe and effective", lol. Despite being 72 years old, I refuse all the medication, including the ones for high BP. I live with AF for the past 20 years (attacks mostly at night), but my symptoms are mild and I do not see the reason for taking medication. My BP is pretty high, goes as high as 180/90, but I feel perfectly well without the medication. As we age, the output pressure of the pump (heart) has to be increased in the course to provide for good blood circulation in the clogged pipeline (blood-vessels). I feel and function far better than my acquaintances who are on BP medication.

Maymuna profile image
Maymuna

And I honestly haven't noticed any side effects except initial tiredness. I'm in the middle of running a 5 week children's cycling programme right now so get extremely tired but sleep is my recovery. To me it's a miracle when I think back to last November...

Fight-the-good-fight profile image
Fight-the-good-fight in reply toMaymuna

Thank you Maymuna, very encouraging. Thankfully your stroke did not leave you with any long lasting side effects. May I ask, were you taking apixoban prior to your stroke?

I believe I am heading in the direction of daily Flecainide Currently my episodes occur every 2/3 weeks lasting around 5 hours if I take additional diltiazem.

Stay well.

Maymuna profile image
Maymuna in reply toFight-the-good-fight

No I wasn't taking apixoban, my consultant had agreed I was only 1 on that scale thing, for being a female, so he said it wasn't necessary

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