i posted the other day that i was worried about taking an extra 50 mg of flecainide as pill in the pocket ( advised by cardiologist ) ive still not taken one yet as when i read the letter sent to myself and one to my GP he states that i should only take it if my rate is 140 , i told him on telephone that i am getting beats of up to 130 for hours on end quite a few evenings a week , i am on waiting list to see an ep and i know it will be a long wait he said this and i said yes i understand but i am now confused as to why my heart rate has to be 140 before i can take it as its bad enough when its at 130, i use a finger oximeter to measure rate , does anyone else take extra flecainide with heart rate around 130 ? i currently take 50 mg in morning & evening and 3.75 bisoproparol twice a day.
extra flecainide as pill inpocket. - Atrial Fibrillati...
extra flecainide as pill inpocket.
it’s a difficult one to answer, but if I was in your position I’d take it. There is little difference between 130-140 and I really don’t know why this magic number of 140 has been said to you, you’re in AF, it’s over 100 and you’ve been given the go ahead to take a PIP.
Don’t be alarmed if you take it and it doesn’t work for a while, or doesn’t work. Everyone has different strengths for a PIP and an extra 50 mg is still well within the maximum amount per day for fleconaide, alongside your daily dose.
If you can push to it, it might be worth referring yourself privately to an EP at your hospital ( they usually also work for the NHS) easy to find them through Google and you contact their Secretary for an appointment. Usually £200-£250.
Thank you Yes i might see about going private to an E P.
Are you still in AF?
Hi Teresa, yes its up and down i rang the secretary of cardiologist today and he rang me back and told me to take 5mg of bisopropolol in mornings and 3.75 in evening as well as my usual flecainide so i will see how that goes for now Thanks
Keep in mind that I'm not an electrophysiologist, but neither is a GP. In fact, the GP's I've encountered know squat about atrial fibrillation.
As to PIP Flec, it's not the rate, but it's the rhythm. In other words, you want to make sure you're in atrial fibrillation before you take it. In my case, I use my experience and my Kardia or Apple Watch to confirm.
Once I know I'm in afib, I take my PIP dose of Flec, whether my heart rate is 130 or 180 and I've had that range. Those are the instructions I got from my ep.
Jim
you know your body for something like this. I will also state even a Cardiologist is not a PE. I discovered that last week I have lost faith in mine and he has been covering because my PE has moved away and there is none right now. I will be meeting with my new in a couple of weeks. I can’t wait and then I will see about going to the works with. Special doctors are strange people sometimes, and they also form unusual relationships with each other. In Florida, I had a great team. They worked in separate places, but they supported and relied on each other and always seem to be on the same page. I haven’t had to deal with my cardiologist very much. It’s been all about the PE for two years because of getting a pacemaker and all the other problems. I’m very glad that that’s how it played out.
a lot of put more into it because it’s our body and if we use our right way we learn what we need to n It’s very odd how they come up with their own golden rules sometimes. I have always really respected my doctors so no need to question until now. I’m not afraid to ask questions.
if you are uncomfortable enough to need your PIP and you’re that close and range I agree with you
PS I do have to say one thing about PIP. I have never had any such thing here in the states never heard it until being on here.
the closest I had to one was nitro. I only took that in the beginning because I didn’t usually get that type of pain and it gives me horrid headache. If I am having my flutter, which is usually what I get now not a fib. I usually just ride it out. I have been very lucky and it’s usually more annoying than anything.
I might have to argue with you that you aren’t a doctor lol I’m beginning to think several people on here could probably get their license lol
Thank you mjames1
I would ditch the cardiologist and get to see an Electrophysiologist asap. Daft to stipulate a magic number of 140! Very little difference, and in any case normal range is 60 to 100!!Flecanide is very useful,I can't tell you what you do but I took it as a PIP for a long time. Never been told to wait for 140bmp!
yes its very strange, thanks for replying wilsond.
Hi Chickenmouse.
Great user name. Do you cluck when you are excited and squeak when you're nervous🤣🤣🤣
My personal experience of using Flex as a PIP was a good one. I was on 100mg twice a day and told to take 100mg as a PIP if/when needed. I had been in sinus for quite a few months when 'bang' I went back into AFib. I didn't even bother taking my HR as I knew AFib was back the exact second it started.
Within maybe an hour to an hour and a half I was back in sinus. My HR at rest was 55ish before AFib hit but went up to about 85bpm at rest for around a week afterwards.
It worked for sure. However, I made the deadly mistake of taking an extra 50mg a few times a week to ward off future attacks - a sort of proactive type of thing. That was a bad move as I ended up in A&E with Flutter.
Rgds Paul
Hi, Paulbounce, the name came from a cat we had , we named her chicken and she was always catching mice so then it was chicken mouse , i couldnt think of a name then that came into my head , thanks for your reply.
hi there it’s been a long road for me. I had a stroke about 3 1/2 years ago at that time they found out I had an irregular heartbeat and I wore a heart monitor for a few months. I saw an EP and my journey started out with a watchman which would prevent blood clots from forming, so I wouldn’t have another stroke.
The heart monitor monitored me by Bluetooth in my home….. my heart rate was only at 35-40bpm and they couldn’t treat my Afib because then I would bottom out on the other end ,so then I had a Pacemaker put in so now my heart rate never goes below 70 which been awesome and I’ve been on Flecainide 75 mg in the morning and at night and carvedilol for my blood pressure. It’s been tough because they make my stomach nauseous, but I’m a lot better than I used to be.
I’ve changed up my whole diet and exercise because I believe diet has a lot to do with how our body works
You know your body better than anyone if it doesn’t feel right get a second opinion I was blessed to have the cardiologist in my life that I have they work together 3 1/2 years later I’m finally starting to feel like a human being again Thank God!
Gosh yes that is a long road, but you got there in the end , i hope i do too . Thanks
Thank you.
If funds allow (£250) I would book an early 'second opinion' consultation with a trusted cardiologist to discuss pill options; most medics seem to have their favourite options with no clear standard.
If your medic is sure you are having regular AF episodes rather than other arrhythmia then I would ask about trying Flecainide 100mgs x2 daily as important to stop the AF dead; your current dose is low and didn't work for me.
Thank you.
Your cardiologist would have carried out a risk assessment of your condition and probably spoken to an EP before prescribing Flec. Risk assessments of this condition are not easy to get right but is the best for you given your symptoms and cardiologists experience. It really is a balancing act, too little meditation will be ineffective, whilst too much may lower your heart rate too much and your own bodies healing system will kick in (your heart will automatically turn muscle cells into signal cells and this in turn could set of arrhythmia). Personally I would be reluctant to use Flec in any other way than recommended as it is a powerful drug that if used inappropriately could lead to the worsening of your condition (just like many drugs). That said I may be biased as Flec made things much worst for me and risk assessments by their very nature are not an exact science. Basically I am saying that no one can advise you better than your cardiologist until you see your EP.
Thank you.
As mjames says, you need to know you are in AF before taking Flecainide PIP which primarily affects heart rhythm not rate. How are you measuring your heartrate? High heart rate does note necessarily mean AF. I used Flecainide as PIP for a number of years and it worked well. If I felt I'd gone into AF (very irregular heartrate that felt like "a box of frogs" randomly hoping around in my chest) I'd check with my Kardia mobile (which gives a diagnosis). If it showed AF diagnosis, I'd take my Flecainide PIP dose (200mg). Followed by another 100mg 6 hours later if not reverted to NSR. It worked well for me. However, over the years AF episodes became more frequent, so I was then put on daily 2x50mg Flecainide (12 hours apart) to prevent attacks. This worked well at reducing the number of attacks for several years. If I did get an AF episode I took an extra PIP dose of 100mg. Which worked.
Thank you.
How different we all are! When I was first prescribed Flecainide as a PIP by the private EP I saw after the lowest dose of Bisoprolol proved too much for me to take daily, it was to take 100mg when my Kardia confirmed that my heart was in AF with 1.25mg to be taken if my heart rate exceeded 140 twenty minutes after taking the Flecainide which rarely happened. Episodes were always ended in a few hours, tracked with the Kardia he introduced me to. Now, I just take 50mg a few hours after breakfast and 100mg late at night which has ended episodes for me. Of course, we are all different and I hope you find what works for you. The maximum daily amount which should not be exceeded is 300mg.
Thank you.
yes I take extra. As long as you don’t take more than 300gm in one day that’s is fine. If you look at Bob posts you will see there. 130npm is quite high for a long time
Remember bisoprolol is a rate control drug and flecainide is a rhythm control Unless you have low BP I personally would have thought bisoprolol would have brought your rate down more quickly combined with your normal dose of flecainide
However I am not a cardiologist or EP or doctor, just my own experience
Do you have an arrythmia nurse as she will advise you
All the best to you
Thank you.
As an oximeter is not very accurate at measuring rate in AF I should think 130 is near enough 140. I would just try the small extra dose and see if it helps.
Thank you.
I would try my best to see a private EP before I would do anything else. Also try to get advice from the NHS cardiac team. A lot of posts advise you take the flecainide but this medication is not a harmless pill by any means. Like a lot of anti arrythmics it can be proarrythmic and carries a black box warning so can do the complete opposite of whats its meant to do. Given the proper advice you should not be afraid to take it but peoples opinions are not relevant to you on this forum. Is it not possible to go to A&E when your heartrate is 130bpm which is indeed high and is usually lowered with a beta blocker. That is nonsense about the 140bpm vs the 130bpm as they are both equally concerning so please have yourself looked at whatever way you can.
Thank you.
I was told to take PIP as soon as I know I’m in AF I’m very symptomatic and have Apple Watch. My HR in AF is between 80-90 at rest. I’ve changed to full time Flecanide now 25mg day and night and take 150mg PIP and if not converted after 2-3 hours another 50mg. In any case last time I didn’t convert and cardiologist put me in a few days later for a cardioversion. As others have said we are all different and your cardiologist should work out appropriate PIP
Thank you
I no longer suffer from AF since my mini maze but before that I would take 50 to 100 Flec as PIP at heart rate if 130-150. It stopped the episode within two hours. I would not hesitate at all. Flec was my best friend. Also noting I couldn’t take it daily as it caused me other arrhythmias but as PIP it worked like a charm.
Thank you.
I have taken Flec as PIP when on twice daily. It is safe to do if only take 1 extra pill a day. That worked well until it didn't. I went into permanent AF while on that protocol. So now I'm off rhythm control and using rate control only....at least for now. Do you also take a rate control med?
Yes i have just had my bisoprolol upped from 3.75 mg to 5mg after phoning hospital and cardiologist said to try this first before the extra flecainide so i will see if that helps. Thanks
if your rate is still as high as 130 perhaps dial 111 who will probably send an ambulance and with any luck you could be given a cardioversion.
Hopefully the extra bisoprolol will lower the rate.
Thank you.
Switching from 100mg Flecainide twice daily, to Pill in the Pocket. Has anyone done this?
Flecainide question for persistent AFib
BLOOD PRESSURE TOO LOW but HEART RATE TOO HIGH - SHOULD I TAKE BISOPROLOL or NOT?
