Atrial Fibrillation (AFib) Support Group

Atrial fibrillation (AF or afib) is an abnormal heart rhythm (cardiac arrhythmia) which involves the two small, upper heart chambers (the atria). Heart beats in a normal heart begin after electricity generated in the atria by the sinoatrial node spread through the heart and cause contraction of the heart muscle and pumping of blood.

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tvanslooten 10/21/2014

Well my afib has officially spun out of control. After 9 years of only having an episode every 1-3 years, I'm having them weekly now. Up until now, I've been doing the PIP approach (300mg of flec), however the EPs I'm talking to here locally are recommending I go on flec daily - 100mg twice daily - to hopefully prevent any further episodes until I can get an ablation done - which is 3-4 months out from today.

I've got several concerns about going on daily medications but what can I expect taking flec daily? Will it make me tired? I have low blood pressure and a low resting heart rate to begin with - around 52 bpm.

The other concern I have is that one doctor is recommending I take only the daily flec. The the other doctor is recommending I take metoprolol or diltiazem with the flec to prevent what he's calling 1:1 atrial flutter.

Why would one doctor recommend the flec alone and the other recommend an additional drug? I'm not even sure I want to take the daily flec let alone an additional drug! And what the hell is a 1:1 atrial flutter?

The timing of this couldn't be worse. I'm hoping I'll be able to get an ablation scheduled with Dr. Natale down in Austin, TX by January but it will likely be February or March. I was hoping I was going to be able to stay relatively "afib free" until then. Now I'm having weekly episodes and I've got doctors wanting to put me on daily drugs.

I'm not sure what I should do here. I literally just need to be "held over" until I can get this damn ablation done. Is daily flec plus another drug going to be o.k. for the next few months? Should I just skip the drugs all together for now and just take my usual 300mg of flec when I have episodes?

Travis

tcaepayguy 10/21/2014

Travis,
Sorry this is happening to you, just when you are about to be done with this forever! (well, hopefully, anyway). I am far from an expert on this. When my afib hit they put me on daily flec and metoprolol. I could hardly stay awake! My chiropractor, who HATES prescription drugs, told me ablation was much preferred to these 2 drugs. So I emailed Dr. Calkins and asked him if I should stay off those 2 until my ablation and hope I didn't have an episode b4 my ablation. He said "NO WAY!" He had me stay on them until he weaned me off..I think the flec came first, 90 days post ablation, then the metoprolol 6 months after the ablation. Now the medical reasoning behind this? I haven't got a clue. U will have to wait for a response from one of the medical folks on the site. I hope your heart remains calm until you burn the crap out of it and get rid of this nasty thing!

Bill

Paul60 10/21/2014

Travis ... I don't know what's good for you, I can only report on my experience. I've never taken any rate control drug, but was on 25 mg metoprolol daily for five years. I also had a slow resting heart rate, so I couldn't tolerate the minimum recommended dose of 50 mg. When AFIB started getting more intense and more frequent towards the middle to end of 2013, I was have more than 4 serious events a week. Then I started passing out, then I had a stroke. So.... based on my experience, when the AFIB suddenly gets much worse you had better pay attention. You didn't mention being on an anticoagulant. You should strongly consider this. Also, get the AFIB under better control, too many bad things can happen in the six months that you wait for Natale ... just one guys opinion.

acrossthepond 10/21/2014

Travis sorry to hear your AF has gone ballistic. I can imagine if you had asked 3 EPs for advice you would have gotten 3 completely different answers! At least you can be sure AF and what to do about it is NOT an exact science. I have never been on flec or ditiliazem so I cant share any personal experience there. All I can say is to go with whom you trust the most: if it is your body go with that, if it is one of the EPs then go with that. But from my experience you have to be happy with and stand behind your decision and it will be the best.

All the best in finding the right decision for you Im sure it will turn out well!!
Take care,
atp

lchandless 10/21/2014

Hi Travis my husband took flecainide and Diltiazem prior to his ablation 2 years ago. The flec actually made his events worse. He's prehypertensive so he still takes Diltiazem. He was having 2 events per day prior to his ablation then a week before his procedure he was afib 24/7. He is 50 now and has had a great experience with the ablation. Chris was able to get his ablation 2 months ahead of schedule due to a cancellation. Maybe that is an option for you. Anyways I hope this helps. Take care. Lisa

daisy0808 10/21/2014

Oh no! So sorry to hear it has gone out of control. I took Tikosyn and a calcium blocker before my ablation to help control the afib and rate and was able to get off both 4 months post ablation. i can only speak for myself but I think it was the best course for me and of course I was on an anticoagulant and still am because I am high risk for stroke. I would prefer to try and control it if I could if I was making this decision and hopefully you will be able to get off them after your ablation as most of have.Good luck!

SameDayNurse 10/21/2014

Travis, first of all I am sincerely sorry about your increase in episodes but am hoping at your young age this will lead to a "cure" for you with Dr Natale. I may not be the best person to talk about Flecainide since it has been an awesome drug for me.....I take 50mg twice daily and have never had any side effects , absolutely none.....if I have an episode I take an extra 50mg of Flecainide up to 300mg if necessary every hour and have never gone to that dose, I also take a Beta Blocker if I have a slow to respond episode , when I take a Beta Blocker my BP bottoms out for a bit and I am more or less side lined til it wears off , I also have a low resting heart rate ( 50-52) and it has never been affected one way or the other by my Flecainide. I will think very positive good thoughts for you and if there is anything I can answer for you just let me know.
jan

tvanslooten 10/21/2014

Thanks everyone for your replies and positive thoughts. I exchanged emails with one of my EPs and he said that we can try a number of combination of drugs until we find what works best until the ablation is done. I'm still not totally sure I want to take the plunge so I told him I need a few days to think about it. What I like about this particular doctor is that he totally puts me in control. He said the decision is ultimately mine. He said we can continue the PIP approach too if that's what I want to do. I will keep you all posted. Thanks again!

Travis

EddiePittsburgh 10/21/2014

I take flecainide 50 mg 2 times aday no side affects but when I was 100mg 2 aday I was very very tired..iv been on it since the 10th of oct..im all new to this..im also on 120 mg 24 hour er once aday diltiazem now that on the 50 mg 2 times aday..I cant even tell I take the meds..

sevennnn 10/21/2014

when i had my first episode they game me diltiazem it was the worst my body rejected it the side effects for me was horrific i was bed bound for weeks the nurse said i had a allergic reaction so it depends on your body im one of them type dudes thats sensitive to meds in my case surgery will have to happen i have come to grips with it

Hwkmn 10/27/2014

I tried the Flec 100mg for 2 weeks when Cardio upped it to 200mg, with no new episodes. Closest Ive felt to death in some time. Got a second opinion from someone familiar with AF, and weaned off meds while adding some good things, and so far, no AF. Sorry to hear things have taken a serious turn for the worse for you. Wish the best for you in your ablation. Keep us posted.

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