Had my latest Cardio outpatient app yesterday followed by a call today. Supposed to see the EP but he was called away so saw a Specialist nurse.
Had ablation last May and was on Flecainide 100mg x2 daily which was reduced on the 6month app to 50mg x2 daily. Next appointment in 6 months - well 14 months later and it was yesterday.
The Nurse was not well prepared with my history so I went through it and discussed coming off the Flec and use it as a PIP as before if AF returns and also the apixaban . I cant tell if the ablation has been successful really whist on the Flec as still getting ectopics and some SVT's for a few secs often throughout the day.
So after discussing it with the EP she phones today whilst I was out, saying to stop the Flec, and regarding the PIP, if I have another AF session to go to A&E for 300mg of Flec.
This therefore is not PIP, and I mentioned I was put on PIP at 100mg 8 years ago - she then replied this was not the correct way!!
So I thought the idea of a PIP was to keep me out of hospital. And I was also told that the max dose daily is 200mg which I forgot to mention to her.
If previously had to go to A&E with every AF just before the ablation I might as well have stayed in the car park.
I am waiting for the letter but hoping that I wont need the 300mg of Flec 🙄
Also anyone had any after effects of stopping the Flecainde?
Written by
ian16527
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Max 300 . Pip can either be 100,see if it settles,then 100. That's what I did previous to ablation. When I stopped flecanide abruptly,on the misguided advice of my GP, almost instantly back in to AF! This was 4 months after,awaiting my review.
So still on 200 mg per day but it works now.
Hmm I think I'd want to query your advice here. Is there a follow up review planned?
It was not by my Electrophysiologist, it was my GP, well meaning but.... I have chronic back pain. He thought because I was still on flecanide,I couldn't take NSAIDs, so told me to stop! ( actually nothing contraindicated with flecanide, it's the anti coagulation that's the issue!)Anyway,the abrupt cessation had an immediate effect.On a Friday night obviously 🙄
So I put myself back on it straight away,rang Arrthymia clinic Monday 8 am. The sharp intake of breath when I told her what occurred told me everything. I had done the right thing apparently.
A stiff letter was sent,which I have a copy of. EP agreed when I saw him 5 months later,said if not for that blip could have now tapered off.Tapered being the word !
So I would be wary,double check. Every case is different of course.
I stopped the daily 150 mg of slow release Flecainide a year ago and had no side effects whatsoever. When I have an AF attack now, I take 300 mgs of the fast-acting kind and that usually stops my AF within 2 to 8 hours.
Before, I sometimes had to take an extra dose of 200 mg fast-acting on top of my 150 daily slow-release when AF broke through that regimen, but these 350 mg in total often caused a pre-syncope at the moment of conversion to sinus rhythm, which felt uncomfortable.
It had to do with the QTc-interval getting too high (over 500) which poses a risk for torsades de pointe. So I would advise to stay below 350 mg max.
I only ever used more than 100mg once as recommended by my then Cardiologist during an episode, She said if not in sinus rhythm after 2 hours take another 100mg, but this made me feel quite ill, hence why I would be reluctant to take 300mg as a bolus dose
I found that if I took the 100mg straight away it didn't work, If I waited 2 hours then took it it would work within the next 2 hours. Strange
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Oh noooo it's back worse than ever....
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