Help!

[Trout7]

After being told yesterday to up my flecainide to 100mg twice daily along with one Bisoprolol 2.5mg i had a good day, with no episodes. I didn't have a great sleep last night, maybe 6 hours. I got up about 6,30am and almost instantly went into AF which lasted about 15 minutes with a heart rate of 132bpm. I went to work feeling very tired and during the day i once again went into Afib with a rate of 152bpm . I at that point decided to take my tablet which i would normally take at 8pm.

My question is, is this normal while my body adjusts to the higher tablet dose ? And is it possible to take a third tablet if it comes on again later in the night ?

[Trout7]

p.s I took my morning tablet about 7am.

[Paulbounce]

Hi Trout.

The max dose of flex in any 24 hours is 300 mg - has your cardio told you take an extra one as a pill in the pocket (PIP) in the event of an Afib episode? If not avoid doing so - it can lead to problems such as flutter (as I know through personal experience). It's best to talk to a medic about this.

Paul

[Trout7 in reply to Paulbounce]

Thanks for the reply. I think I'm maybe expecting miracles with these tablets. I thought they would suppress the high heart rate and keep me out of AF. My cardio put me on 50mg twice daily last week as my episodes are more regular now. That didn't do the trick so he has now upped it to 200mg a day. And still I'm getting episodes of high BPM.

[Buffafly in reply to Trout7]

Be careful, those could actually be caused by the Flecainide. I am not sure if Flecainide lowers your rate - it’s an antiarrhythmic. That’s what the bisoprolol is for. How do you measure your rate?

[Trout7 in reply to Buffafly]

Hi , I use a kardia.

[Buffafly in reply to Trout7]

Depending on your resting rate you probably need more bisoprolol but of course you should not mess about with that either! Give it a few more days as prescribed. I’m sure you know Flecainide works best on an empty stomach.

[Trout7 in reply to Buffafly]

hi, my resting rate is usually around the late 50s -early 60s. I actually didn't know flec was better on an empty stomach, i was sure i read it can be taken with or without food. Would taking my Bisoprolol make any difference if i took it at night instead of morning?

[Buffafly in reply to Trout7]

You’re right! But apparently originally the instructions were to take a hour before or three hours after food (tricky) but now they don’t. However many people feel they are more effective if taken as first advised. You could change your bisoprolol to a night time dose and see if that helps but then you’d have to miss one dose or take two in a day so you’ll have to work that one out - half doses to adjust? Best wishes.

PS It’s very understandable you feel very stressed but that is the worst thing for AF so try to go with the flow for a few days.

[Trout7 in reply to Buffafly]

Thank you 👍👍👍

[Paulbounce in reply to Trout7]

Hi Trout.

I always took Flex on an empty stomach. As Buff says, it works better on an empty stomach as it is absorbed into the bloodstream more quickly, so you get more of a hit. One hour before food and no sooner than four hours after a big meal worked for me.

I tried the slow-release version when I was abroad but it was pretty useless. I haven't heard of anyone using it in the UK.

Paul

Edit - My cardio told me it takes a few months to really take effect. After this period I had a spark (cardioversion) and this kept me in sinus for two years. That's good for a CV.

[Trout7 in reply to Paulbounce]

Thank you , i will try that tomorrow morning.

[Vonnegut in reply to Paulbounce]

But I thought large meals are not a good idea for us! Fortunately, I’ve never liked to eat like that!

[Paulbounce in reply to Vonnegut]

Hi Vonnegut.

Quite correct - little and often is key. This doesn't apply to Christmas day. Talking of which!!!!!!! Not long to go.

Paul

[Vonnegut in reply to Paulbounce]

We tend to avoid much of that too!

[secondtry]

I have always taken 200mgs/day Flec 3 hrs after eating and 1hr before eating again and was AF free for 10yrs. I found this also helpful for my gastric system as it stopped me snacking between meals. The first 3 months I felt a bit odd but things settled after that.

I would also commit to make better lifestyle choices as often discussed here.

[Trout7 in reply to secondtry]

Thanks for the reply Secondtry. I have started the new regime this morning so will see how it goes. As soon as I got out of bed once again the AF started. It only lasts a short spell so at least that's a bonus.

i think my lifestyle is probably pretty good. I have a good diet and haven't touched alcoholic for two years, prior to that I would hardly drink it at all.

im a gardener so I'm getting enough exercise every day.

[secondtry in reply to Trout7]

A while ago somebody suggested to reduce stroke risk: When you wake up lay in bed for 30 secs, situp in bed for 30 seconds, get out of bed and sit on bed for 30 secs before standing. Maybe worth a try for avoiding your AF, no side effects 😁.

[Pommerania78 in reply to secondtry]

I wonder why that would help? It certainly would be easy to do. Thanks.

[secondtry in reply to Pommerania78]

Jump out of bed & burst a blood vessel! Wonderful getting older 😁.

[Auriculaire in reply to secondtry]

I fell out of bed this morning! I was nearer the edge than I thought when I got up .

[Camelia23 in reply to secondtry]

Help I didn't know that!!

[Buffafly in reply to Pommerania78]

Leaping out of bed is a shock to the system…..

[wilsond]

Take bisoprolol last thing at night. Take flecanide on an empty stomach. Slow release was no good for me,check if yours is and perhaps ask to change.Good luck

[TracyAdmin Partner]

Good morning, I would discourage taking any extra medication without prior consent from your doctor.

Kind regards

TracyAdmin

[Vonnegut]

You should have taken another 100mg tablet of Flecainide as the maximum daily dose is 300mg, and you would have reached but not exceeded it! And the EP who first prescribed it for me as a Pip said I should only add a Bisoprolol 1.25 if my heart rate exceeded 140 twenty minutes after taking the Flecainide which it hardly ever did. Of course, we are all different and must find what works for us as individuals. Good luck!

[wwatson280283]

Hi there Trout7. Like you my Flecainide has recently been increased from 50 to 100mg twice daily. I am unsure what the difference is symptomatically between an ectopic beat, AF trying to break through the Flec or Atrial Flutter. I gather from previous comments I've read that flutter is more serious and can be brought on by Flec. How would I know how to distinguish between these 3 different events symptomatically without it being captured on monitors?Hope someone can assist

[Buffafly in reply to wwatson280283]

Flutter is a (usually) fast regular heartbeat but can only be distinguised from other types of tachycardia by an ecg. Most monitors do not diagnose it. It usually runs at a fraction of 300 bpm, so 150, 100, 75, 60. An ectopic beat is a beat out of place so you will feel a little thump. I am not sure what ‘AF trying to break through’ feels like but sometimes when I am aware of a number of ectopics or very short runs of tachycardia those are a lead up to AF.

[wwatson280283 in reply to Buffafly]

Thanks

[listerines]

Don't lose hope Give it a few weeks and see how the higher dose works. I know from experience that it took a few weeks for my heart to better stabilize on flecainide 100mg X2 going from 50mg (though some do see faster effects). Please discuss with health care providers re increasing your dose if you are having an episode. Technically, 300mg max 24 hour dose for flecainide.

[Trout7 in reply to listerines]

Thank you. I will give it a bit more time.