Paroxsmal afib

[alfrae13]

I have paroxysmal afib which occurs every 2 to 3 days. I take bata blockers so the bpm are normal. When it occurs I get weak, tire and shaky and lie down and sometimes sleep. I am retired so this is OK. I then take 100g flecainide and am back to NSR within a few hours. But it disrupts daily living.. I don't want to take amidarone or have an ablation. I already tried flacinide for maintenance but there were side effects. What other options do I have

[John3333333]

If flecainide isn't for you, I guess you could try propafenone. If you are worried about amiodarone being too toxic, why not give dronedarone a try. However, It sounds like PiP flecainide is working reasonably well for you. Maybe try to reduce your AF episodes by taking magnesium glycinate or magnesium taurate supplements.

[JOY2THEWORLD49 in reply to John3333333]

Hi

Magnesium Taurate is in the Bisoprolol. Get blood levels first. Toxicity with supplements can be dangerous on your life.

Have a banana a day.

cheri JOY 75. (NZ)

[opal11uk]

There are other drugs that can be tried. I was told years ago that drugs for P/A/F only worked for around 1 year then you needed to change and this happened to me early on so there are others that you can be prescribed that may suit you better.

[JOY2THEWORLD49]

Hi

BBs didn't control my heart rate Day - Night OK at 47avg bpm.

Whilst regime includes now 2.5mg PM Bisoprolol PM for BP.

Day AM CCB Diltiazem CD which also acts as a anti-arrhymic med 120mg CD, settles my rapid at rest to 60s.

Been on this regime since visit to private heart specialist.

2.1/2 years!

Include my choice PRADAXA 110mg twice Day. Sweet as.

I was diagnosed with Stroke - Embolic with Rapid & Persistent AF & Papillary Thyroid Cancer.

All controlled.

cheri jOY. 75. (NZ)

[Buffafly]

Pace and ablate - pacemaker plus AV node ablation, atria still fibrillate but don’t affect ventricles.

[Ppiman]

My AF is not as regular as yours, although I have a great many ectopic beats on the days in between. I have put myself on a waiting list (the UK way!) for an ablation. Why are you not keen to take that route?

I am giving it second thoughts, in fact, as my episodes have reduced in intensity, even as they increased in frequency, with a rate often now in the 85-130bpm range, with occasional bursts higher. I take bisoprolol, a beta blocker, but only 1.25mg daily as I also have a bundle block (LBBB) and this causes a slow heart rate, with daily bradycardia.

Steve

[Vonnegut]

When I was first prescribed Flecainide by an EP, it was to take 100mg when I first felt my heart was in AF ( checked with my Kardia) and only to add 1.25mg Bisoprolol if my heart rate exceeded 140 twenty minutes later which it hardly ever did. Now that I take Flecainide daily, 50mg and 100mg, it has put an end to episodes! Only had one over a year and a half ago around the time I must have been infected with covid with no other symptoms but a positive test!

[wilsond]

What side effects did you have on the maintenance dose of flecanide and what was the dose level?Sometimes these things wear off after we get used to them.

I progressed from pip dose to daily and it worked well mostly for a long time ( some times requiring an extra 100mg if AF / Flutter broke through)

Eventually it lost efficacy, or AF got stronger and I had a double ablation.2022

I have had a few isolated incidents ,which means I remain on med but now working.

[Novak54 in reply to wilsond]

How long were you okay with Flecinaide?

[wilsond in reply to Novak54]

7 years

[ozziebob]

Firstly, you don't say what your flecainide PIP dose is. Often a larger initial dose is more effective, as it is for me (100mg rather than 50mg, but others have even higher initial doses), although I appreciate your events are more frequent than mine. Best ask your medical team about this protocol if you think it might be appropriate for you.

And, secondly, following Vonnegut , it's vital to take your flecainide PIP as soon as possible after discovering the start of your AF.

I had to learn both these lessons about flecainide PIP after trial and error and the reported experiences of, and medical recommendations to, others on the Forum.

Good luck in finding a better way to live with your AF.

[Tomred]

Hi, if you dont like the thought of amiodarone you could enquire about dronedarone , same thing without the iodine.

[marcyh]

Why not have an ablation? My episodes weren't as often as yours but just as debilitating. Propafenone worked after a few hours but I never knew when they would happen and I didn't like the idea of having one in public or while driving. I would have had to pull over.

I would much rather have an ablation than take rate control meds. After two ablations, I am AF free, only on a BP med and apixaban.

[alfrae13 in reply to marcyh]

I am 95 years old and no way will I have an invasive procedure done

[Buffafly in reply to alfrae13]

Maybe just be happy you have got to 95? This is very encouraging for those who fret about AF being fatal/leading to early death. But I hope you are able to find a drug regime to improve your QOL, best wishes!

[Karendeena in reply to Buffafly]

My mum has afib and is 96!!

[marcyh]

I'm 80, so no spring chicken either. But fair enough. Best wishes!