AF Chemical Cardioversion Flecainide

[Daisy2908]

I am new here recently diagnosed with AF. Just wondered if anyone has had a chemical cardioversion? Has been recommended to me as something cardiologist says I can try by taking flecainide twice daily. This is because I am having to wait till Covid 19 situation improves so I can have normal cardioversion. If chemical one doesn't work then would still be able to have the procedure. Feel physically fine now with meds but very anxious about the whole AF diagnosis.

[Hidden]

I was diagnosed with AF about 4 1/2 yr ago. At diagnosis in the ER I had a chemical conversion with IV meds then sent home next day on antiarrhythmic meds. Later I came off the meds and only took them on the rare occaisions the AF returned. The meds always worked for me taking anywhere from 2 hr to 12 hr to stop the AF. Flecainide was and is a good drug for me. Luckily I havent had any AF in over 2 yr now.

[Hidden in reply to Hidden]

One more thought, you should check out the AF page here on health unlocked. Good group. Your anxiety over AF will get better over time. It feels like you are going to die when its happening but you wont. Learn some relaxation techniques like controlled breathing, stay well hydrated, leave smoking and alcohol alone, get plenty of rest and decrease stress when you can. It should get better.

[Daisy2908 in reply to Hidden]

Thanks for replying...sounds like it can work well for some people. And thanks for the tip re the AF page - I will check it out.

[ILowe]

Hoski is right about the AF page.

"Chemical Cardioversion" can mean several things

1/ PIP ie Pill In the Pocket. You take some pills when you develop symptoms. Most people who are at risk are taking a betablocker such as bisoprolol. In addition, on demand, they take some flecainide. If you are not taking a betablocker, then PIP means you take both. This is very important since a small amount of bisoprolol helps to counteract the main dangers of flecainide.

2/ In hospital, intravenous, usually amiodarone or flecainide, but I have seen sotolol mentioned. Afterwards you stay on one of them.

3/ High dose, orally, of amiodarone, followed by several weeks of amiodarone then probably replaced by something like flecainide. I have reported on this in AF forum, since it seems to be almost unknown in Britain. The idea is that you shock the heart with a 'bolus' of chemical. This high dose can be taken at home, in the morning, since by activity you can counteract the temporary low heart rate you may get. Best taken in hospital where they can monitor you.

4/ In your case, it seems that the term is being used for dosing you with flecainide in the hope that you will revert. This is definitely worth doing. Flecainide is one of the safest medicines in the cardiologists toolkit. Also, if you do not spontaneously convert, when you get your electrical cardioversion, then the chances of success are higher.

[Daisy2908 in reply to ILowe]

Hi thanks for replying. Very helpful. Yes option 4 sums up what the cardiologist wants to try I think. I hadn’t come across this being suggested before.

[ILowe in reply to Daisy2908]

The chances of the shocks working are higher when under flecainide, and your chances of avoiding reversion are increased. Success breads success.

The only tricky bit about flecainide is the dosage. Too little will not work. Too much will cause irregularities. Do try to keep in touch with your cardiologist on that one. Many people with AF purchase a small ECG machine and send results to their cardiologist when they feel something new.

[Daisy2908 in reply to ILowe]

Thanks I’ll talk to the cardiologist again and also check if he’ll accept ECG’s from my Apple Watch which would be handy.

[Palpman]

There are 2 types of cardioversions.

1. A chemical, Adenosine is injected into a vein that stops the heart for up to 6 seconds. This is used for SVT tachyarrythmias such as AVNRT and not AFib.

2. AFib is cardioverted with an electrical shock and AVNRT as well if the chemical conversion is unsuccessful.

[Spinbiker]

Hello I’ve just had a cardioversion aided with flecainide 100 twice a day and it was successful it’s early days yet ( previous cardioversion without chemical help never worked) best wishes and good luck

[Daisy2908 in reply to Spinbiker]

Thanks - really good to hear a success story. Get my prescription next week I think so fingers crossed mine will work too!

[dawny1908]

I am currently on bisoprolol and have just started taking 50mg flecainide twice daily. I have taken the first tablet literally 5 mins ago. Here's hoping for less episodes of svt needing adenosine x fingers crossed