PACs / flecainide I'm 62 and generally healthy..except for this afib thing. Been on very low dose metoprolol 5 years after a couple of afib/flutter events. PACs have increased from a couple a day to several every minute. My cardio doc ignores them. PACS might be induced in part due to bradycardia: my resting HR is high 40s (ex runner). I am concerned that PACS accelerate the progression of afib and, separately, atrial damage. For that reason I want to try flecainide, but without a betablocker to avoid bradycardia (which will probably be worse). Any experience out there with flecainide without a rate control drug? Flecainide affect on PACs? Any experience/knowledge of progression of PACs at this level (20,000 a day)? thanks. sven https://www.afibbers.org/forum/read.php?9,186442,186442#msg-186442 Tue, 22 Sep 2026 08:57:54 +0000 Phorum 5.2.23 https://www.afibbers.org/forum/read.php?9,186442,186755#msg-186755 Re: PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186755#msg-186755 swhanson AFIBBERS FORUM Sun, 21 Aug 2022 23:33:29 +0000 https://www.afibbers.org/forum/read.php?9,186442,186747#msg-186747 Re: PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186747#msg-186747 anneh AFIBBERS FORUM Sun, 21 Aug 2022 16:36:34 +0000 https://www.afibbers.org/forum/read.php?9,186442,186492#msg-186492 Re: PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186492#msg-186492 bettylou4488 AFIBBERS FORUM Wed, 03 Aug 2022 01:08:22 +0000 https://www.afibbers.org/forum/read.php?9,186442,186477#msg-186477 Re: PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186477#msg-186477 sldabrowski AFIBBERS FORUM Tue, 02 Aug 2022 13:55:58 +0000 https://www.afibbers.org/forum/read.php?9,186442,186458#msg-186458 Re: PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186458#msg-186458 I have had many posts about this in the last few weeks on other threads so you can find them easily with much more detail.

I know being Pac Hell/Jail is horrible....i personally would rather be back in lone Afib with around 10 episodes a month then have 20K Pac's a day or more as you can KO the Afib quickly with a PIP + then you have relief for 2 or 3 days anyway but it is much harder to treat/deal with Pac's of that many a day.

GL]]> vanlith AFIBBERS FORUM Mon, 01 Aug 2022 20:22:47 +0000 https://www.afibbers.org/forum/read.php?9,186442,186455#msg-186455 Re: PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186455#msg-186455
Quote
swhanson
Any experience out there with flecainide without a rate control drug?

There is a risk there that most EPs don't want to take. It is possible for Flecainide to allow a one to one beat conduction between the atria and the ventricles. This could be very dangerous. I'm sure Carey could explain this better.]]> Daisy AFIBBERS FORUM Mon, 01 Aug 2022 19:37:19 +0000 https://www.afibbers.org/forum/read.php?9,186442,186445#msg-186445 Re: PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186445#msg-186445
I have been on Flecainide for many years for this. It does help control these extra beats, but over time can lose effectiveness, so dose adjustments are common and sometimes combined with BB (so many to choose from) or Calcium Channel blocker . Everyone is different. This drug has been around for many years, and for a lot of Docs first go to. Unfortunately, as my EP told me, when comes to meds, trial and error to see what hopefully works. More EP's are doing ablations for these because of recent research.

Here is one research article to get you started. [pubmed.ncbi.nlm.nih.gov]
There are more recent ones than this.

Hope this helps.]]> sldabrowski AFIBBERS FORUM Mon, 01 Aug 2022 12:53:23 +0000 https://www.afibbers.org/forum/read.php?9,186442,186442#msg-186442 PACs / flecainide https://www.afibbers.org/forum/read.php?9,186442,186442#msg-186442
Been on very low dose metoprolol 5 years after a couple of afib/flutter events.
PACs have increased from a couple a day to several every minute. My cardio doc ignores them.
PACS might be induced in part due to bradycardia: my resting HR is high 40s (ex runner).
I am concerned that PACS accelerate the progression of afib and, separately, atrial damage.
For that reason I want to try flecainide, but without a betablocker to avoid bradycardia (which will probably be worse).
Any experience out there with flecainide without a rate control drug?
Flecainide affect on PACs?
Any experience/knowledge of progression of PACs at this level (20,000 a day)?

thanks. sven]]> swhanson AFIBBERS FORUM Mon, 01 Aug 2022 11:47:58 +0000