PIP ends with Atrial Flutter

PIP ended up in Atrial Flutter for me recently and I had to get cardioverted back to NSR, I had been weaning off Flec for a couple of months while maximizing the Essential Trio for about 6 months.
Went into afib while taking just 35 mg. bid, I was hoping to at least get it totally out of my system but things happen so I did the 25 bb and 200mg of Flec. Should I have taken less for a better outcome?

Thanks, Tom C.

Arthur, I believe that the rate was about 144 and then it would reduce from that to about 60 sporadically and that is when the skipped beats were very pronounced.

Yes definitely flutter, I usually feel my neck for pulse and in flutter the missed beat was farther apart and there were no extra beats.

I take Flec PIP although I'm taking 50 mg a.m. and p.m. for the last week per the advice on this Board after having a short AFib episode. I get confused when I read about the different types of heart beats on this board. I've only been told by my EP that I have AFib and that's all I know. However I too, have episodes that feel like a flutter rather than AFib that will last for 2-3 hours. At that point, I will usually take 50-100 mg of Flec and it goes away in about 20 minutes. After reading the above posts about the danger of flutter I'm wondering if I need to be getting more tests from my EP?

Yes, what IS flutter? How can one possibly tell taking ones own pulse what is happening? Very unreliable. I take Flec PIP, 300mg, and convert in less than 70 min.. Maybe I am not always having AFIB, but flutter instead? how can you tell.
brian

AFib - irregularly irregular - as in all OVER the place - 3 fast, 2 slow, 6 fast, 1 slow, 7 fast, 3 slow, 5 fast, 2 slow etc. etc. Ventricular response rate can be fast, slow or neither.

AFlutter - REGULAR with NO variation beat to beat. Atrial rate 250-300 and can be conducted through from the atria to the ventricles at 4:1, 2:1 or, and what no-one wants - 1:1.

That's my take! No doubt someone will chime in if I'm wrong (-:

Mike

It seems clear from anecdotal & literature input & personal experince that successful bolus dosing with flecainide for AF conversion is an art form. Too little or too slow or too late & the AF sustains. Too much and the risk of organizing & the conversion is to AFlutter. And, just because the flecainide seems to have lost its controlling efficacy, if it had been working in the past one need not despair. AF, as any experiencer can relate, is a fickle fibrillation -- a flecainide failure does not preclude future continued effectiveness.

Joshua

Most doctors always recommend taking a beta blocker for rate control when taking Flec. to guard against the 1:1 conduction, even when using the PIP method.

Tom C.

Thanks Tom, my Dr only has me taking Flec so I'll have to ask him about a beta blocker. Any suggestions on which one is most effective/safest?

Teri, I use Metaprolol, 25 mg twice a day, but it does make you tired. I am going to ask my cardio doc if once a day is theraputic enough against 1:1 conduction. Some here feel that if you are a vagal afibber that the bb will make you go into afib. This has always been a topic for extensive discussion on this forum, I have talked to people who are only on bb to ward off afib. I had an interesting conversation with a new friend of mine who told me that 15 years ago he went into afib and he could not cardiovert or go back to nsr, so he has been in afib with coumadin all this time. He told me he eats and drinks whatever he wants and at 70 years old he looks good. I would think that he probably has an enlarged heart due to his condition but his quality of life seems decent enough. So hang in there, its not so bad after all.

Tom C.