Hi. I am new to H.U. I am a 69-year-old male in relatively-good physical health though a bit overweight, perhaps 20 lbs. In the Summer of this year, when still 68, I had my first episode of what was diagnosed as Afib after eating some chocolate that day, a Hagen Das dark chocolate and vanilla ice cream bar, and late-night sex. It happened in the middle of the night. Since then, I have had about 5 or 6 episodes, all of which "converted" to Sinus (normal) rythm on the second day. (Thank God.) My doctor did the usual routine of tests, including blood work, a Nuclear Stress Test, and Echo Cardigram. Those tests showed normal heart structure and no underlying heart disease. This was my first known "cardiac" symptom or event.
My doctor then put me on 25 mg daily of Metoprolol and a low-dose aspirin. From the first episode until now, I have calculated an average of 16.5 days between episodes although there was a 32-day gap between the 1st and 2nd one. I am now up to 75 mg. of Metoprolol and have discovered, due to the fact that ALL of my episodes happened at night, I have no underlying heart disease, and my symptoms also include digestive issues, and I haven't had the very rapid heartbeat experiences I hear about, I most probably have what is called "Vagal Afib" which means I am triggered by an imbalance in the vagal nerve rather than cardio issues. That would mean that Beta Blockers like Metoprolol are strongly counter-indicated for my condition as they can actually CAUSE arrythmias and cause paroxysmal Afib, which I have to become persistent or permanent. I have emailed my cardiologist about this but have not heard back yet. We had previously discussed that, if the Beta Blockers didn't sufficiently prevent my symptoms, we would move on to an anti-arrythmia drug such as flecainide which appears to carry more potentially burdensome and possibly dangerous side effects than the Beta Blockers.
So, that's where I am at present with this situation. I continue to try and stay healthy, performing cardio exercise and soon beginning a resistance program. I would like to hear the experience of folks with anti-arrythmic drugs like flecainide, etc. Thanks for reading this
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willec49
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Hi, I was around 40 when first diagnosed with a similar version of AF ie Lone Paroxvsmal with only a minor increase in heart rate. Treatment with Betablockers worked for a few years but as the frequency of episodes increased Flecainide was added. A brilliant drug but the side effects caught up with me and it was losing effectiveness. At age 69 I decided to have an ablation. Three and a half years so far with no AF at all. A wonderful new lease of life for me.
Why not start Flecainide and ask to see an electrophysiologist to enquire about ablation. Waiting times can be long especially if you get somebody who is highly experienced in the procedure (essential) and better to start early rather than wait until you are desperate.
I started on Flecainide a week ago and, after a few days of feeling ill, I felt like I'd stuck with it and gotten past those initial side-effects. However, yesterday, I went into a kind of arrythmia I'd heard about but never had before...rapid heartbeat between the high 70's and 130 and probably higher. (This is apparently a common issue with Flecainide and is called "proarrythmia.") It had to be the Flecainide because I'd never had RHB as part of the Afib or ever. Actually. It really scared me and I was close to going to the ER. I took an additional dose of Flecainide as I'd read that many people get conversion to Sinus upon taking a full 50 mg. tablet. I think it made the tachycardia (rapid heart beat) worse. I decided to just stop the Flecainide and go back to the Metoprolol 25 mg. 3 x daily. I converted around 8:00 am today so was actually in arrythmia less than 25 hours. My pattern has been to convert to Sinus on the 2nd day which my Cardiologist says is a positive. It's interesting that there is actually no evidence that the Metoprolol OR the Flecainide has had any measurable effect on the frequency of Afib episodes as I keep a complete record of the dates, times of Conversion, etc. of every one. I feel I'd probably been doing best on the 75 mg. Metoprolol daily.
H, I have tachycardia and have come out of hospital today after being in for two days. My episode lasted 11 hours. They have upped my plecanide, after giving me an extra one in hospital to bring my heart rate down, the extra 50mg worked after trying everything, ice water, vagaries manoeuvre etc. I now take 100mg in the morning and 50 mg at night as well as my apixaban . I am due my ablation on 3rd Jan so hopefully will come off them if it works. Having said that I have never had side affects with flecanide.
I'm happy to hear that your tachycardia got resolved. I'm also very happy to hear that you didn't have side effects with flecainide. That's very encouraging as I will probably be starting on that soon. Best of luck with your ablation! That would be the next step for me if medications don't do the trick.
I had a phone consult with my cardiologist today who said that, after consulting with his electrophysiologist colleague, he is prescribing Flecainide 50 mg. x 2 daily plus Metoprolol 25 mg. x 2 daily to control any flutter possibly caused by the Flecainide. So, we'll see how this flies. I've heard both stories of side-effect free success with Flecainide and stories of horror. Fingers crossed. Thanks everyone for your responses and insights.
Also 69. Over a period of almost 4 years, took flecainide. Kept me in rhythm after a cardiovert. Kept me solid for Yin yoga, back-packing & staying in back country of national parks & basketball with men 30-40 years younger. No discernable side effects.
MoundMan, Thank you for your response. Your experience is what I hope to duplicate. I start today with 50 mg. twice daily along with 25mg. of Metoprolol twice daily to decrease any chance of flutter, etc. Question: Did you take anything else, like a Beta Blocker, along with the Flecainide? Thanks.
During that period of time, was also on blood thinner Xarelto. Cardiologist told me at outset of beginning this combination of 2 scripts, he was confident that in the future the benefit of flecainide would run its course. Which it did. After the 4 years or so of taking both. Underwent ablation last January. Insufficient counsel about how long it would take to recover accustomed stamina. 6 months later with concerted effort, it returned. Then pushing too hard in heat and humidity in early August on beach sand , flutter flared up. Was cardioverted into rhythm. Now, have most of conditioning back. No prescriptions. Smarter this time about recovery pace.
Hello I had paroxysmal Afib about 18 months ago, I initially went on beta blockers but changed to calcium channel blocker (as I found out they are not compatible with epipen use) which worked a lot better for me, I had always been cardioverted when in Afib using flecainide, so did ask if I could take a samll dose daily as this seemed to work so well, My GP was not keen as they are quite concerned about using flec, however I saw the local Consultant privately, and he said this was good idea. He wrote a letter to my GP, and since then I have taken 2 x daily of Tildiem and flecainde, last 18months no afib at all and no side effects, so fingers crossed it continues to work,
custard1, Glad to hear you are doing well of Flecainide. What is your dose of Flecainide? This is my 3rd day of 50 mg. of Flecainide twice daily with 25 mg. of Metoprolol twice daily. The first dose of the Flecainide caused some of the side effects of dizziness, etc. but after that mostly OK except that last night, I felt my heart rate was slow, around 51. I will have an EKG in a few days, per my cardiologist's orders. I have my own little EKG machine and app on my phone which shows a normal rythm so far.
hello willec49. yea I have a kardia device as well . I'm taking 25mg once in the morning and once in the evening. as i say so far so good. trying to lose a, few pounds as well. as any excess weight is not helpful from what the consultant told me. to be fair Xmas hasn't helped
After being only on the Beta Blocker, Metoprolol 25 mg. x 3 daily, and not being afib free, my doctor put me on Flecainide in addition to the Metoprolol. After one week on Flecainide 50 mg. x 2 day and Metoprolol 25 mg. x 2 day, I went into afib at 11:05 am on 12/28 with the kind of ragged, wild, rapid heart beat I'd never had before. This one scared the hell out of me and, came close to going to the E.R. The only new variable was the Flecainide which I thought must have caused the rapid heart rate, I'd heard that some people take Flecainide to return the heart to Sinus (regular) rate so I took another one. I felt pretty bad the rest of that day but, converted to Sinus relatively quickly around 8:00 am the next morning. (My pattern is to convert to Sinus either the next or second day.) So, concluding that this event was caused by the Flecainide, I stopped taking it and went back to my earlier regimen of just Metoprolol 25 mg. x 3 daily. Then, only FIVE days later, on 1/2/19, I went into afib again around 2:30 am. I went back to the Metoprolol/Flecainide regimen and converted to Sinus on 1/4 at 2:00 am. (36 hours) My cardiologist has been out of the country for two weeks to return on Monday, Jan 7. I wonder what his observations and advice will be. I know that, if afib can't be blocked by meds, the next usual step is ablation.
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