I have taken flecainide 75mg twice a day for almost 3 years. I have noticed no side effects from it. It has been really given me my life back after afib had taken over. I was having an episode 2-3 times a week. The first 6 months on flec I had 2 small episodes and have not had another in over 2 years.
I also thought an ablation was the answer, and my EP also wanted to see how I would do on an antiarrythmic first. I am so glad he was right.
Flecainide doesn't work for everyone though....give it a try and if you have problems with the med changes he suggested give him a call and then I am sure he will have other options for you. Best wishes.

Here comes marikays twin :)
I have taken Flecainide 50mg twice a day for almost 6 years.....I have noticed absolutely no side effects from it ever. I too have my life back after a fib had taken over, I had a couple of episodes briefly when I first started but have not had another in over 3 years.
As a nurse I also wanted to jump on the ablation wagon but am happy I listened to my cardio/EP guy as well.
I also agree fully its not the drug for everyone but if it is the drug for you , you will be very happy , there are always options.
Very best wishes

Thanks so much for your very heartening input. It's so appreciated. And I do see further down that there are some related posts under a different topic that I found very informative. Need to keep my eyes open, been a long week.

Junie,
Oh, so sorry you didn't get to meet with the brilliant Dr. Calkins! In any case, as many here can confirm, ablation is still not a first line treatment. I forget the exact requirements, but I think they are along the lines of...you must be able to prove you had at least 2 incidents of afib, you must fail at one drug treatment, or be unable to tolerate the drugs, or other variable circumstances. When I first went in, Dr. Calkins suggested that I try the drug treatment first...however, when I was on metoprolol and flec, I couldn't move off the couch, I was so incredibly tired. In addition, I was 3 years from a military retirement, and the Army isn't too fond of people who go into afib...they are used to dealing with young and in shape people, not old men with afib. So Dr. Calkins agreed to put me into the Hopkins study. But even he didn't recommend it as first line treatment. Many on this site as well support the idea of drug treatment first, ablation much later. Remember also that they are making incredible strides in surgical treatment, thanks to the folks in Bordeaux and the likes of Dr. Natale and Dr. Calkins. Hopefully in a few years ablation will be like taking out your tonsils...the problem of afib will be easily solved (fingers crossed!). Best of luck with your treatment! NSR forever!

Bill just down the road in Severn

Best of Luck with this....I'm really hoping it is the solution for your afib management!!!!!!

Hi juniebe,

I've been on Flecainide 50mg 2x per day for 5 months and have not had any repeat AF episodes. It sometimes makes me a little bit tired but not always.

I also have a friend out of state who's also been on Flecainide 50mg x 2/day for a year and 4 months and believe there has been no episodes.

Flecainide is said to be among the best-tolerated and effective anti-arrhythmics around.

As for the pro-arrhythmia aspect - as long as your heart is structurally healthy, the probability is very low to nil. My cardiologist had me undergo both a myocardial perfusion study (that's "nuclear stress test" for laymen) and an echocardiogram study. Both turned up normal. I presume your doctor has given you similar tests and they turned out normal. If so, the risk is supposedly very low. Drs will not give Flecainide to patients with cardiac issues, those who have had heart attacks, those with more serious valve issues, etc.

Per my research, catheter ablation yields a higher success rate (around 85%) for those patients with paroxysmal AF which stem from ectopic foci in the pulmonary veins (PVs). They ablate the PVs at the junction where they enter into the left atrium. For those patients with persistent AF (the kind which needs intervention (pharmacological or cardioversion) to terminate, ablation has a lower success rate because the ectopic foci are elsewhere in the atria and there are usually several of them and they all have to be found, isolated, and then zapped with the RF probe.

Ablation isn't a minor procedure from what I understand it. One would need a fair amount of recovery time and it may not find and destroy all of the ectopic foci that exist.

So what Dr. Joe Marine told you is consistent with my research.

BTW, I have an appt with Dr. Marine but it's to ask him some questions, including genetic aspects of AF.


P.S. By "ectopic foci" or ectopic pacemakers means those abnormal excitable areas in the atria which fire off impulses like the SA node does but they are not supposed to. No one knows why they appear in AF patients. I call them "rogue pacemakers".

Flecainide is a sodium ion channel blocker. It slows down the inward rush of sodium ions from outside the cardiac cells into the inside in the depolarization portion to generate an action potential (an electrical spike) that triggers a series of events to make the muscle to contract. It can terminate AF by prolonging the action potential duration to discourage any spurious current loops which occur during AF.

Thanks again for all the excellent input. Even though it's true doctors must know what is good for us, I always find other people's experiences to be very educating. And much more personal too.


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The fact is that no doctor can tell you with 100% certainty how any given drug is going to affect you. All he can tell you is how a given drug affects *most* people, according to studies and clinical trials.

In the end you have to decide if you trust this doctor and his advice sounds logical to you. Even afterwards, you have to listen to your body.

you'll find they love beta blockers and why not they have been proven to be more effective than other blockers in preventing heart attack, but it seemw the doc's are more concern in playing the odds than how you feel, so you'll have to decide what's best for you.

oh yeah, there is no wizard of oz out there. When it comes down to it, find an EP that does a lot of ablations if you can't live with symptoms and side effects. The cardio's are just going to test drugs on you.

So I'm looking for a "wizard of EP" hahaha! Seriously, these most recent drugs were prescribed by a very highly respected EP.

Thanks for your comments, all!

I find Duder's comments quite reasonable.

My experience with Flecainide for the last 7.5 years has been wonderful. My life is back. I wish I had not paid attention to my first cardiologist who argued against antiarrhythmatics in 2005 . I spent the first two years of this afib adventure getting worse and worse. Then in 2007 I visited an EP and Voila! no afib unless I have a late night meal or an alcoholic drink more often than twice a month.

I hope you have the same results as me.