WONDERED WHAT YOU THOUGHT

[SilverliningsForNow]

I was first diagnosed with AF in 2021 when I had an ablation. Since then I manage my situation with 50mg Flecainide twice a day and Apixaban. I found some papers today (2022) where my EP said I was doing well with maybe 3 incidents a year. I get my heart checked every year and its of sound structure. I am 64. The thing is I keep a spreadsheet and this year I’ve had between 1 and 3 attacks a month they never last longer than an hour (2 months there was nothing). Usually my burden is about 0.25% in the month as a whole. I manage it mostly well and it doesn’t interfere with my life buts its obviously increasing. If it isn’t bothering me should I carry on or get it looked at before it gets worst? Thanks for listening to me.

[Hidden]

What does your GP think?

[SilverliningsForNow in reply to Hidden]

Honestly I am ashamed to say this but my GP hasn’t got a clue. A couple of years ago when I presented at A&E when my heart beat dropped really low before an episode (this is now the pattern before an episode) they asked me what I took to control it and one of the attending doctors said he’d never heard of Flecainide. I live on an Island but have a great EP in London which I can contact. I was just wondering if people thought it was a problem.

[Hidden in reply to SilverliningsForNow]

I’m intrigued that you live on an island, burst out laughing when I read that one of the attending doctors had never heard of Flecainide. You’re not responsible for any inadequacies of your GP.

I find your answers confusing. You should not seek solutions to your questions here. I recommend a private video consultation with your EP.

[SilverliningsForNow in reply to Hidden]

You made me laugh. To be less confusing I had an ablation in 2021. For the following two years I had three incidents per year. This year over a period of seven months I possibly have one to 2 incidents a month. Admittedly my burden is on average 0.2% of that month in time. The only question I was asking and I fully accept that I have access to my EP and can ask him is whether I need to trouble anybody with my increase in burden if it is not troubling me. Yes my heartbeat is raised to about 160 BPM with each incident, but they never last more than about 1.5 hours. It was a general question seeking general answers. ❤️

[Hidden in reply to SilverliningsForNow]

Subtly put in my place. Symptoms in permanent AF/AFL are dependent on heart rate and degree of functional degradation of individual cardiac chambers, to which I imagine your acquaintances will attest. Pompous or what.

A gentleman is never unintentionally rude (Wilde)

[SilverliningsForNow in reply to Hidden]

🤣 Have a great weekend and thank you for your replies 😘

[BobD Volunteer]

You are anticoagulated which otherwsie is the main concern and your AF burden does seem quite low but you do not mention what rates you see during an event. Rate control is important to reduce the risk of complications and you do not mention any beta blocker which would be normal alongside flecainide. If your heart rate during events goes much above 100 then you shsould be talking to your medical team, GP or EP .

[SilverliningsForNow in reply to BobD]

Thanks Bob. No I am one who certainly feels it. I range between 160-150 bpm for the full hour. I take Bisoprolol but a tiny amount because it makes me so sluggish (half a tablet) and I tried 100mg x 2 but again that made me feel like walking through treacle so I just remain status quo.

[secondtry]

I would discuss with your trusted medic trying 100mgs Flecainide twice a day. This is a medium dose and worked well for me for many years coupled with many lifestyle changes.

[SilverliningsForNow in reply to secondtry]

Thanks ❤️

[Vonnegut in reply to secondtry]

I’ve actually reduced mine to a 50mg first and then 100mg in the evening and it seems to be working as well as the 100mg x 2 but as I have chronic fatigue too, I don’t do much in the way of exercise or much else!

[secondtry in reply to Vonnegut]

I wanted to try reducing my dose to 150gms per day (when a different AF pattern, ectopics & pauses began) but my cardiologist is not in favour of rocking the boat and to be fair to him it has worked for the first 11 years!

[Vonnegut in reply to secondtry]

I just suggested it to a doc I’d never met in a phone call and he agreed and it’s working fine so far but I’m 80, and I suggested it after I’d missed the first dose of the day the previous day with no I’ll effects. It’s working fine so far - but as I wrote, I have chronic fatigue too so can’t be anywhere like as active as I used to be and we are all different!

[Ppiman]

I suspect most people just press on with occasionally checks from their GP. AF is noted for increasing in frequency and eventually settling as permanent with the atrium fluttering away merrily while the important part, the ventricles, carry on satisfactorily, even if not optimally. My elderly friend is 91 today and has had permanent AF for many years now and remains well.

Steve

[SilverliningsForNow in reply to Ppiman]

You are absolutely right. So many people I know have permanent AF and it doesn’t bother them at all. Mine has always been the fast (160bpm) feeling type. I couldn’t live with that. I’d need another ablation 🤣🤣🤣

[Ppiman in reply to SilverliningsForNow]

I can sympathise. Mine used to be 160-180bpm but now comes much more frequently, maybe fortnightly, yet, thankfully has generally slowed to around 135bpm maximum (85-135bpm according to my trusty Apple Watch). I can cope quite well at that rate. I often wonder how much anxiety wasn’t responsible for that earlier fast rate, and now that I’m more sanguine about it, it’s slowed to its “background” rate.

How much do you think stress pushes your rate up, if at all? If I do anything physical during an episode - whoosh!

Steve

[Halfheart]

I would consider a second ablation.

[wilsond]

I think you'd be wise to contact your trusted EP ,as there is a change in pattern of AF for you. They need to know this so they can advise you. Givern the absence of decent GP care apparent your Island ( Wight?) even more important! Probably a Vet might be more knowledgeable! Never heard of flecanide indeed 🤔

No need to be over concerned I'd want to get this investigated. Best wishes ❤️x

[SilverliningsForNow]

Thank you for your kind and considered reply. I have requested a zoom call with my EP in London x