I know many in the group take flecainide. I’m curious about experiences of people who take it without a beta blocker?
Background: I was on flecainide for a few months after my first ablation about 8 years ago. I remember feeling great and it controlled my symptoms. That EP took me off it after the blanking period. In the intervening years I’ve been with a different EP and on other meds that worked for a while, but left me feeling tired. Currently on dronedarone, it does control my tachycardia fairly well, but leaves me dizzy and with very low blood pressure after exercise or in warm weather. So, I’m going to try Flecainide again. But without the beta blocker (blood pressure goes far too low).
Curious about experience people have had taking it without a beta blocker.
Edited to add - my afib is gone thx to 3 ablations. I’m on meds for tachycardia/SVT at this point.
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lovetogarden
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Beta blockers and calcium channel blockers are often prescribed with Flecainide for safety reasons. That's because they act as nodal blocking agents and theoretically can prevent dangerous arrhythmias from developing like 1:1 flutter.
That said many reputable electrophysiologists, think the study data for those guidelines is flawed, and that Flecainide is a lot safer then it's made out to be. These ep''s often prescribe Flecainide without nodal blockers like bisoprolol.
My current experience is 11+ years on 200mgs Flecainide without any BB. It has worked. Always had HR around 55-60 and BP 120/68. I am now 71yo, male, sporty, BMI around 22/3 and have no other co-morbidities. I also made a lot of better lifestyle choices following AF diagnosis.
Over the time since AF diagnosis, I have questioned my cardiologist 3 times on his no accompanying BB decision. Initially, he said 'a BB would make me feel unwell' and he has not changed his mind over time. Last year at my annual check-up he said dangerously high HR risk is less not more when I get into my 70's, notwithstanding this I requested and got Bisoprolol to hold as a PIP just in case.
Interesting about the over 70 info. I have just a few months till I hit that benchmark. And good to know you’ve been on flecainide that long without any problem. Thanks for sharing that.
I was feeling tired on both so reduced my BB metoprolol to 10mg which is about 1mg Bisoprolol twice a day and 20 Flecanide, though currently in sinus I had an AF episode last week and upped the Flecanide to 50mg for 10 days and told to then reduce to before and see how I go. On the low dosages I’ve felt really good and I’ve gone 10 months no AF and just a few ectopics here and there
It’s over 10 years since I took Flecainide, originally with Beta Blockers but they made me so ill I couldn’t take them so took Flecainide on its own. I developed Flutter and long QRS so stopped. I then had an ablation, following which I took both again and again I became very ill so had to stop abruptly. Meds just didn’t work for me but Beta Blockers were the worst!
Everyone reacts very differently and so it is sometimes a matter of suck it and see. I also think that men react very differently to women on these drugs.
I agree the beta blockers are awful. And it is amazing how differently we all react. My sister-in-law take metoprolol for high blood pressure. Her dose would have me in a coma. My brother (her husband) is like me, he takes the same med, but at her dose, his blood pressure dropped way too low.
Initially I was given flecanide in hospital following emergency admission, for AFib without a BB. Within a week I was blue lighted into a different hospital with ATrial flutter.Put on bisoprolol as well as Flecanide. Controlled the AF pretty well,but not the flutter. Apparently flutter doesn't respond well to meds.
Eventually had an ablation which killed off the flutter and almost entirely ended AF. 2 years ago.
Now on flecanide still to steady the AF,but no bisoprolol and all is well.
My god daughter had svt and had a successful ablation for that,she was only on flec previous to ablation,which generally kept her steady, although breakthroughs occurred and she was cardio converted 8 times before she was 12 and had the op.
So treatment with BBs varies according to circumstances I believe.
Back in the day 2008/9 I was given flec as a pill in the pocket but I had to go to the Heart emergency centre on the first three occasions that I used it ,to be monitored because flec can cause atrial flutter.
The pill in the pocket was successful each time for atrial fibrillation and my permanent atrial flutter was cured by an ablation. Had an ablation for the afib which was not successful though this reduced the length and severity of the attack . I tried every lifestyle change under the sun and eventually had to give up my job as I had to go back on shifts as the attacks were almost daily but I still treated it like other people treat a headache . Though the loss of job had a detrimental effect to begin with the attacks reduced over time and are now very rare once a year and I still live a normal life and eat and drink ( no more than 5 pints) . Though I don’t have the money I was use too I now realise it was a small price to pay . I even found out ( on holiday ) that a couple of pints of lager did the same trick as the flec. It’s a peculiar disease.
Great you were able to have the flutter and afib ablated. That’s the situation I’m in now. But still having tachycardia. The locations triggering it have been mapped, but RF ablation would have Nadine some serious nerve damage. Hoping pulsed field ablation might help. What a trauma your poor niece has been through a t such a young age, hope she’s doing well now.
I have been on 2x50 mg Flecainide without any Bisoprolol for over 2 years without any problems since my cryo-ablation in June 22. I have a naturally slow HR anyway.
Treat my very occasional episodes of AF, 3 this year so far, with an extra 100mg Flecainide which resolves them within about 3-4 hours. My cardiologist was happy to prescribe Flec without any beta blocker. Of course, we are all as different inside as we are on the outside so your body may react differently.
The reason they prescribe the beta blocker is in case you get atrial flutter at around 300bpm in the atria and then the flecainide allows that to get conducted at 1:1 ratio to the ventricles, which would be dangerous. But if you are older, your ventricles probably aren't capable of responding that fast, so the risk gets lower.
I have taken flecainide for long periods (years) without a beta-blocker, and even when I had flutter it was still not a problem. The flutter was conducted at 2:1 or slower, never 1:1. I definitely appreciated not having to take the beta-blocker, as I found I could not do any exercise.
It is a risk/reward thing, but the risks aren't very well studied. If it was me, I would skip the beta-blocker.
Glad to hear that it’s worked well for you. Like you, I couldn’t exercise when on a beta blocker. In fact, I found it difficult to even walk as far as the back of our garden, I remember having to sit down in the lawn for a while before I could get back to the house. Never has 80 feet felt so far.
I took Flecainide daily for 12 years, prescribed without a beta blocker, as I also have asthma. Flecainide worked very well to reduce AF episodes to one or two ten-minute episodes a year. After 12 years of Flecainide, and 22 years of AF, I was found to be in Persistent AF, now agreed permanent AF, it is without symptoms.vFlecainude was stopped
During an operation a few years ago to remove my grumbling appendix, my heart rate rose to over 190 bpm . Subsequently a hospital doctor, status unknown, put me on 2.5 Bisoprolol.
After 7 weeks of Bisoprolol I started to have painful rashes. Diagnosed by a GP who had dermatology qualifications, as a reaction to Bisoprolol
Put on antihistamines. After 4 years of treatment rashes stopped
While being weaned off Bisoprolol I had a sudden exacerbation of asthma. I was in a pharmacy at the time.. An ambulance was called and I spent 3 days recovering in hospital.
thanks all for your replies. Very helpful. And now I’m seeing some other “Flecainide with or with Beta blocker” posts highlighted in the “related posts” section. Will ex0lore those posts for more info. Great to know many of you are doing well without the beta blockers! Makes me more inclined to give it a whirl.
Though surprisingly, I’ve had an intersting change in symptoms over the last week or so. I started drinking an electrolyte drink on days I know I’ll be working hard on my treadmill. What a difference! No more plunging blood pressure at the end of the workouts. It seems that electrolyte supplements can help compensate for the vasodilation effects of dronedarone. I’ll try this approach for a few more weeks before I decide to try moving to flecainide. For me the acid rest would be to try the electrolyte drinks in a really hot environment. None of that to be had right now in cold snowy New York though, excuse for a trip to the tropics? 😂
I beg to differ. I was taken in after a suspected TIA a few days before( I was away from home) I had an Af attack en route home,taken to hospital again,given Flecanide intravenous. Calmed AF down,eventually. No BB given.A week later,blue lighted into 3rd hospital ( thankfully a good heart centre) with highly symptomatic Aflutter 230 beats per minute.
So as well as AFib,I now had AFLUTTER which was far more debilitating and awful than AFib,AND much more resistant to medication.
Thankfully abated 2022.
So yes...
Definitely DOES occur! I'm surprised at your comment as its sadly not unusual, as I have seen and also read about
Atrial flutter 1:1 AVC is rare. There are plenty of academic studies to back this claim. Flecainide can trigger 1:1 AFl, which is also rare. If you had IV flecainide one week before your rapid atrial flutter episode, then it certainly did not cause it. You are possibly just predisposed to 1:1 AFl, which is one of the most unusual tachycardias to occur in adults.
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