Back in Afib again now for 7 days. Took max 300mg flecanide over 24 hours 5 days ago. This time hasn’t worked. Should I try the flecanide again now ? Previously (twice only in last 12 months) the flecanide as pip has worked.
Anyone tried the pip approach twice for same Afib episode?
sometimes Flecainide is not the answer. It only worked for me for a very short time. It sounds like you now have persistent afib (over 7 days).
My ep put me on Tikosyn when the Flecainide failed, and my afib had lasted 16 days, though it did require a three day hospitalization for observation. I reverted on first dose and it worked pretty well for over six years with no side effects. I recently had an ablation and no longer need a rhythm medication. Best of luck.
Thank you 37 Polly. Did you ever have cardioversion(s)?
How long did you take Flecainide before it quit? And if the Tikosyn works, why did you have an ablation? Thanks.
I took Flecainide for four months. I was also taking diltazem and felt just awful, and had frequent episodes. Finally the flecainide totally failed and I was in persistent afib with very high heart rates. After being hospitalized and chemically converted to normal rhythm I took tikosyn pretty successfully for about six years , until it began to fail. (My doctor told me it likely would eventually fail or I might have a bad reaction and need to either go to amiodarone, or try an ablation). No one was urging ablation because I had atypical aflutter, afib, and high rate tachycardia, and a single ablation didn’t look promising.
I did have a pacemaker inserted in 2020 and that helped too, but by spring 2024 I was again suffering persistent aflutter and afib so decided on ablation after pulse field ablation was approved for the US. Had it done by a superior ablation team in top US hospital in Boston. Seven months today . No afib or flutter, very short runs of tachycardia occasionally, but mostly declared successful so far. It feels great . Beginning real exercise and hope to play golf soon!
Hope this was helpful.😊
Why do you think the Flecainide and Tikosyn failed and what do you think is the source of the heart difficulties? And besides medicine and other medical interventions, what have you done to solve your problems? Thanks.
when that happened to me, I went to emergency and was cardioverted by into NSR. After needing that twice, my EP moved me way up his list for the pulsed field ablation.
That was almost a year ago. I am off all drigs and thank God, no afib episodes since.
Congratulations. Isn’t it amazing when it actually works? And the PFAblation itself is pretty benign.( If I hadn’t developed pneumonia from the anesthesia..can happen in any surgery, a roll of the dice, especially in elderly..me!..I had no pain or even what I would call discomfort from the ablation) I asked my EP the morning after if he really did it, because I felt nothing.
I would advise anyone to go for it..
However get the best team with the best success record!
Occasionally I have needed to take a 2nd dose of 300mg on day 2 for it to work. Once it took a 3rd dose on 3rd consecutive day. Used to take 2x50 in 3 lots, 2 hrs apart. Generally now take 3x50mg which usually works with a 2nd 3x 50mg if necessary.
That happened to me in 2022. I probably took too much flecanaide and was like a zombie. Following that I became persistent and am now permanent but much happier than before always wondering when the beast would strike. I have never been offered a cardioversion or ablation. I'm nearly 80 so will take my chances but I still do yoga cycling swimming canoeing in the summer golf ( sometimes find 18 holes walking is a bit long but stop to catch my breath)Hope it all works out well for you.
Wow!Your activities are so impressive! I’ve had to give up all the activities I enjoyed as chronic fatigue struck me with the PAF after a virus when I was unable to get help from my surgery!! But happy that my brain still works and grateful for this forum.
Wow I am impressed, but don’t give up should the afib begin to be too much. I am celebrating 7 mo since my PFA today and I am 84. I am working out in the gym now and fully plan to play golf this summer! Over the past few years I could do less and less. And I no longer walked the course..but at my age a cart is no sin.
And this ablation technology is moving fast! So don’t count it out.
we are all different. I found that the PIP of 150mg then followed by 100mg a few hours later couldn’t do the job. I’ve had 3 cardioversions over the last 3 years. Before each cardioversion I was prescribed Flecanide and a beta blocker. My first CV was in Sept 2022 after being in AF for 4 weeks. The drugs controlled the AF that well that when i returned from overseas the technician doing the ECG thought I was in Sinus however Cardiologist pointed out the subtle differences. After being in AF for a month I stayed in sinus for 11 months and no drugs so there is hope.
I now am on daily low dose metoprolol and low dose Flecanide and apart from initially feeling exhausted I now have absolutely no issues on the drugs and live a normal active life. Hopefully I stay in sinus!
If you have access to cardiac rhythm management nurses, talk to them.
What follows is mostly to let you know that you are not the only person for whom flecainide is not a magic bullet. My sister also has AF and takes just 50mg as a PIP, which cardioverts her within a few hours.
Not me.
I have tried going up to 300mg as an acute dose and still taken up to a week to cardiovert, but have never taken it twice for the same episode. I was in persistent AF for probably 14 months after having Covid, with very long waits to see my cardiologist, go for DC cardioversion and then to have my first ablation. This may explain why my AF is recalcitrant despite my being relatively young (60) with no other health problems.
In the long run of persistent AF while waiting for treatment, my first prescription for flecainide was for a daily dose of 2 x 50mg. It did nothing for the first four months -- I was still in persistent AF (and should have chased this up with the CRM nurses much sooner). DC cardioversion was successful but failed after 3 days. Then I went up to daily 2 x 100mg flecainide, and after about a month I finally cardioverted, but continued to bounce in and out of AF until I had the ablation three months later.
Six months after ablation, I am still taking flecainide twice a day and still having breakthrough episodes of AF. I have had episodes lasting up to 10 days.
Under advice from the CRM nurses, I've taken 100mg + 100mg within 2hrs for fast AF (with a final dose of 100mg at bedtime), then reverted to my normal 200mg/day the next day -- it still took four to six days to cardiovert. For the next episode, also under advice, I tried 2 x 150mg (reverting to 200mg/day the next day). I felt so 'off' that I was on the verge of calling an ambulance all that day, and it still took four days to cardiovert. I won't do that again.
As of today I have been in NSR (with some banging going on overnight) for three weeks, which is the longest I've stayed in it since the first three weeks post-ablation.
Good luck, and start by talking to the CRM nurses.
Yes, I have. Sometimes--maybe for emotional, digestive, or other physical or anxiety-related reasons, the first 24 hrs of dosage doesn't do the trick. But if flec has always worked for you in past. I would try again--maybe 200 mg first, then within an hour, if you haven't converted, take the other 100 mg. AF can be weird... & because it is "rogue", hopefully this may just be a one-off long episode as opposed to persistent. Best wishes for conversion!
Many thanks to one and all for your experiences and advice. I am very grateful.
Flecanide daily
First time using Flecanide
Flecanide as a pill in the pocket
flecanide extra dose
