Hi all - I’m back on the list for a second Ablation. I’ve had 4 episodes of AF since September and I’m in one now.
I took Flec at 4am (150g) and it has not worked as of 9:40am. I know I can take another dose at 10am.
if that doesn’t work, any suggestions?
I really don’t want to go to A&E and I guess they wouldn’t do much anyway?
Can I keep trying with the Flec?
Maximum 300mg in any one twenty four hour period. DO NOT EXCEED!
Yeah I see that now on here, related posts. Thing is I lived with it like this for 5 months before … I just don’t think I can again.
Hopefully my second dose works.
You will be amazed at what your body can cope with if your brain will accept it.
I ended up going to A&E after being in AF for about 36 hrs whilst on the waiting list for my second ablation. I’d only ever been in AF for a maximum of 12 hrs previously and I couldn’t get my HR below 140. Flecainaide did nothing and I took 200 on both days. I would say if you’re feeling breathless, feint or worried or you can’t get your HR around 100, I would go to A&E. I was admitted to a ward. The cardiologist at the hospital who saw me also expedited my place on the waiting list for my second ablation, due to what I was experiencing. I ended up going back to NSR in hospital, in just under five days.
My advice too would be to not live with it for five months this time round, especially as you’re waiting for a second ablation.
What did they do?
They did struggle. They did blood tests that showed I had very low sodium - I had been ill just before I went in, which probably did contribute and low sodium can also cause arrythmia, but when your susceptible like us, to AF, it just makes it worse. You never know, there might be something going on with your bloods ( especially electrolytes).
They basically had me on drips for a few days and I think that once my sodium levels improved, so did my heart, but they also upped my bisoprolol, which was slowly taking my HRback to just over 100. I was resistant to that, but to be honest, it has only increased slightly and I actually feel better on it, since the raise.
I’ve also just had my second ablation, this week and only on the waiting list for three months in total. It would have been November, but it was cancelled.
How you feeling? Thanks for the helpful advice. Really appreciated
It was Friday and I’m feeling ok, though I had the dreaded migraine that is expected which has thankfully passed. So far, I’m glad I’ve had it done, as they look at where you had your first ablation and check - three areas had rejoined on mine, so he ablated them again. He also ablated A flutter which he induced during the procedure. I knew I still had that going on after the first ablation as they didn’t touch it. So hopefully 🤞
See how you feel, but honestly, if this persists, I would consider just getting checked at A&E. Heart problems are usually priority and you should be seen quickly.
I would like to jump up that list too but I can’t see that happening.
Hopefully you’re done now with 2. Hopefully me too!!
I know you didn’t ask me but when I was in A&E with HR going up to 167 they gave me a big dose of digoxin to reduce the rate and hopefully convert, didn’t convert in A&E so they admitted me and I immediately went back to NSR - they threw me out before I’d eaten my sandwich 😂 I’m not supposed to take Flecainide.
lol 😂 well I’m gonna take my second Flec and see how that goes. Seems like I better go to A&E then if nothing changes.
Good luck 🤞
Let us know how you get on. If you do end up going in and get admitted to a ward ( hopefully it won’t come to that) a tip: ask to see a cardiologist. They are usually generalist wards and you see generalist doctors. Once I saw a cardiologist, things improved in there. It’s common sense really, but they never suggested I saw one. If you have an arrythmia nurse still from your last ablation, let them know you’re in there as well, if it happens.
My episodes used to last 36 hours every couple of months. I had an ablation in March last year, do far so good 🤞
And long may it continue for you Karandeeba 🤞
It was quite scary as I ended up in AF for nearly 5 days in hospital and with an HR constantly wobbling around 110-20 at rest and I don’t really want to be in that position again. The hyponatremia I had didn’t help though.
Long may our ablations last ❤️
I meant to add too, flecainaide worked for me in the past as a pip, but not since. They also tried it in hospital. It did nothing unfortunately.
I think I’m back in NSR. I feel it but machine says it too!!
I have a pounding headache now. I wonder if that’s the stress or the flec! Maybe neither but I daren’t take anything else!
Oh that’s good news. Hopefully your headache will go soon and yes, could be either of what you said.
When is your ablation? How long have you been on a list?
I am only just on the list. A year he said, I waited less last time though. In 2020.
You may be a bit dehydrated - arrhythmia makes us go to the loo a lot
You could be right there! I drunk a lot of water yesterday just in case!
Keep drinking water, and I second the recommendation for deep breathing. On the one occasion in the last few years when I was admitted to the cardiology ward as an emergency, they recommended deep breathing. (And did what A&E do: kept me under observation until my heart rate settled down, then discharged me.)
If you do want to push it through, you could ask if you could go on a cancellation list? Might be worth a try.
Also going out of town. I was offered a slot in the next county from my usual hospital, which speeded up my wait by at least 6 months. I jumped at it.
I wanted to go on Flecainide PIP but my cardiologist said it was too much of a roller coaster for the heart, so daily 200mgs/day it was. Worked great for 10 yrs.
150 mg is not enough. I take 250 or 300 and that reverts my rhythm to sinus in between 3 and 6 hours usually. My cardiologist said that the maximum is 400/day, but I would advise not to take more than 300, because 400 resulted in an unpleasant pre-syncope just before the reset to sinus.
I have an instruction to take 150 first then try 150 after 6 hrs if it doesn’t work.
That’s the first time I had to take 300 🙁
I have taken daily Flecainide for 10 years, low dose, I can up it when I have an episode to the 300 max/24h. Before I had very debilitating symptomatic episodes, HR well over 180, usually lasted 36-40 hours. Since Flec, an episode typically lasts 15- 18 hours, HR doesn't go above 120/130. In the early years, I think I went once to A and E when I had the first episode, then one other time when I felt very worried. Now I wouldn't go unless I had chest pain or felt faint. For me, the stress of being in that environment will, in itself, keep me out of rhythm even longer. I lie down quietly at home, knowing it will pass, I can even go to sleep as normal. Of course we are all different, some people would feel safe and comforted by being in hospital, and if that's you that's fine. For me, even visiting someone else in hospital is my idea of hell on earth, so I'm far better off riding out the storm in peace! But never hesitate if you are very worried. This whole Afib malarkey is an education, knowledge and feeling empowered is the absolute key to it.
I had no intention of going to A&E.
That’s more to do with what mine is like …. Hours and hours of waiting and 5 mins with a doctor and then home.
Teresa’s experience was enlightening and good to hear but I doubt my experience would match up.
It was all ok anyway as I went back in to rhythm!
Yes, my last A and E experience was about 8 years ago, and I'm pretty sure it has deteriorated massively since. Glad you're back in rhythm.
Im on my 1st and only ablation next monday. For some reason or other left chamber is to large so af ablation cannot be done only av node.
Hope it goes well. I had my first in 2020. It’s been ok up till the last 6 months so not bad.
There is, sometimes, a way around A&E. It is to get your GP to send you to the urgent assessment ward of the hospital. It is for people who's condition is known but who need urgent treatment. You may have to wait a short while but not as long as A&E. It is for people whose condition is diagnosed already but who need urgent help.
How different we all are! I used to take 100mg of Flecainide as a PIP with 1.25 mg of Bisoprolol if my heart rate was over 140 twenty minutes after taking it, which hardly ever happened. It always stopped episodes in a few hours and now that I take it regularly it has virtually put an need to episodes but I just take 50mg in the morning and 100mg at night, so altogether only half the maximum daily dose.
I am 81 today and was fit, and active until my mid 70s with a healthy diet and have never been overweight, until a virus did for me then!
@LordGabriel - Glad to hear NSR finally arrived for you.
As info.. Several months prior to my very successful PVI cryo-ablation (in 2018) I was having a lengthy AF episode with rapid HR and decided to go to Emergency (A&E). The extra flecainide I took didn't help and the additional beta-blocker (metoprolol) they administered in A&E didn't do anything for me either. After a couple of hours they gave me a calcium channel blocker (a diltiazem tablet), and within 30 minutes my HR began coming down to a much more agreeable level. About 30 minutes after that I was discharged from hospital - still in AF but having a very tolerable HR of about 80 bpm. I went home to bed and after a few hours awoke to find that I was in blissful NSR with a HR of 68 bpm. From that point onward (up until my ablation) my 'new' PIP was diltiazem.
I have had success with PIP but also failure.
Because my local hospital is a centre of excellence for Cardiology I have been told to go to A&E if the Flecainide PIP fails. The result has been a cardioversion.
Ultimately an ablation was planned but as I started my AF journey in 1990 I have had 7 ablations.
For the past 7 years I have been less and less prone to suffering AF but have a slow heart rate due to so many years of AF which has caused conductivity disease.
Pete
Hope you have got this sorted by now.Did you do the deep breathing ...holding your nose and blow out as if breathing in to a bag.Ive had two cardiac ablations done..The first wasn't successful and I was scared to have another but things got so bad I had to give in.Thank the Lord it worked . I take atenolol and magnesium regularly.
I'm in my 9th day of AF for January, having had an ablation in September: six days, one and a half days, now in day 2 of third series. I actually feel less awful with a heart rate in the upper 120s than I did yesterday at around 80 (my normal resting rate is 50s). Several weeks ago -- before my first AF of the month -- my cardiologist said that because my AF burden is less than it was pre-ablation (I'm 30% normal rather than zero), he would wait and see before putting me forward for a second ablation. It's now conclusive that I need another one.
I've only once taken 300mg flecainide in a day -- it didn't work. Ditto, an individual dose of 200mg.
Like you, I'm in the UK and I have found since the pandemic that nothing happens in A&E. Cardiologists are too busy to come downstairs and look at me, and there are no beds to admit me, so all they do on the emergency ward is keep me under observation until my heart rate calms down of its own accord. Then they want me to go home, and I'm very happy to do so. Unless I think something potentially life-threatening is happening (heart rate over 140--150, other severe symptoms), I've learned to wait it out at home, where at least I'm not going to be exposed to the four viruses of the winter "quad-demic" and I have a better chance of getting some sleep.
Good luck. If your heart rate isn't sky high and you're not experiencing serious dizziness/breathlessness, you should be OK. But it isn't fun and it can be scary.
Can I ask what makes you feel the need to go to A&E? That has never been suggested to me. My first AF episode did take me back to the ablation clinic, but 5mg bisoprolol soon brought me back to NSR and home. Looking back, I wonder how much of that was nerves. I’ll never know.
It seems the only reason to go to A&E would be if you suffered a big drop in BP with the AF making the heart output fall too far for safety. I never know just how we’d know that, though.
Steve
People on here put my mind on A&E from years ago when I first joined. My own prescription of Flecanaide says to if the PIP doesn’t work.
I was only given PIP after my first ablation. Before that I never went to A&E and I lived with constant AF until my first cardioversion.
However , I’ve paid in, if I feel the need to attend A&E I will. That would be on me.
Yes - I think you’re doing the sensible thing. Our local A&E is so badly overworked that I’d rather keep well away but better safe than sorry.
Steve
An elderly friend with permanent AF has had that happen three times, now I think on it, but the hospital, oddly have never blamed his AF, only BP.
How many ablations can you have? 
How many Ablations can you have, how many can you have 
palpitations everyday 
