Flecainide on demand

My Electrophysiologist gave me Flecainide for the first time, as my afib is back after 14 years of relative bliss after my ablation, (Cleveland Clinic). He said I could take it "on demand"... any thoughts/experience as to how effective it can be?

I just recently started on 200mg as needed. It stops my episode of afib after about 3 hours vs my usual of 20 hours - hence very helpful. Good luck! Jeff

That's what we call a PIP. PIP stands for "pill in pocket."

It either works for you or it doesn't. If it does, then count yourself lucky. Sounds like you're in the lucky crowd! :-)

[www.afibbers.org]

Please read

My last cardio version was in 2014, thanks to the PIP of Flecainide and sometimes a BB with it. I dont waste time waiting or attempting to convert on my own, with supplements or small doses of AA.s. The quicker you get out of afib the better and chewing 300mg of Flec with warm water does the trick once or twice a year in usually less than 4 hours. Beats the ER.

I've used it successfully for 16 years. Max is 200 mg if you weigh less than 154 pounds, 300 if you weigh more.

It is commonly prescribed with a low dose beta blocker, to be taken first, then the flec. That being said, I've never done that. I weigh around 170#'s so take 300 mg. As soon as I know I'm in afib, I chew (tastes bad) 300 mg flec. My goal is always to be out of rhythm as short a time as possible, so chew it to get it into my system as fast as possible. My first use 16 years ago was to convert a 2 1/2 month episode. EP said it wouldn't work. It did take 20 hours. Most conversions for me, take an hour or two. Loading with magnesium and potassium citrate just before I take the flec may accelerate the conversions. Many of my conversions convert to a regular rhythm in the 90's BPM. Over the following few hours, the rate reduces into the 70's then to my normal 50's. With the mag and potassium, I tend to convert to a rate in the low 70's. Not sure why this is, unless the 90's rate is flutter. In 2009, I converted to a regular rhythm around 130, possibly flutter. A loading dose of magnesium caused this to drop to a rate in the 90's over about 10-15 minutes.

Original study [pubmed.ncbi.nlm.nih.gov]

Recent article: [www.heartrhythmjournal.com]

Thanks to you all for the great info....

So as it turns out, last night shortly after posting this I went into an afib "pattern"... so I tried it for the first time. I did NOT chew it as I did not know at that yet....I swallowed 200mg with water.

Around 3 hours later....I was in NSR with no ectopics! Note these "episodes", ( a mix of mostly atrial tachycardia eventually leading to some afib)... have been lasting between 10 - 34 hours... this one was terminated in 3.

Wow is that nice... something to fight this with other than supplements.

Welcome to my life Flecianide... I'll take what I can get! Thanks again to everyone for the feedback.

Any reason you don't get another ablation touch up and put it to rest for good again?

SDweller, Good to hear. We must be drinking the same water. I woke up Tues early am with my CPAP feeling dry and noticed an extra beat. It was my second time this year. I forgot the Mag and Potassium which should hasten the conversion by a few hours. I am a spring/summer fibber with zero episodes in the "Ber" months, so hopefully this year has past. FYI, the cpap reported 3.32 hours and 0.0 events, so I cant blame that. Hot days working outside and dehydrating maybe. Glad the Flec works.

Actually I am schedling for another ablation...hopefully in a few weeks. Nice feeling that the Flec is there if I need it however, as I've never used a drug for this before, and heard bad things about some of them.

Sounds like our pattern is very similar, (up to now anyway)... seasonal afibber summers mainly. Dehydration was always a big trigger for me, living in the Florida Keys makes it difficut to maintain the electrolytes. Thanks for response

Quote
Sdweller
My Electrophysiologist gave me Flecainide for the first time, as my afib is back after 14 years of relative bliss after my ablation, (Cleveland Clinic). He said I could take it "on demand"... any thoughts/experience as to how effective it can be?

I was almost successful on flecainide for 15 years until it wasn’t effective.
af free 9-2004 to 8-2009–five days after starting flecainide after daily af.
Af free again until chemo 5-14
Af free again until food poisoning/vomiting 1-17
Af free again for a year-stress of moms health declined 9-18 to 3-19...every few months to monthly af, I was a frequent Er ecv patient.
3-2019 was the worst af —the day she died when I got an abrupt insensitive call with two Loud yelling words “she’s dead”. He was shouting thinking talking international I couldn’t hear him. Obviously he wasn’t trained well at hospice for tack. He should had said “i have some bad news” first...imho..shocker to my heart to say the least.
8-19 after many yo-yo ecv’s I listened to PIP (I don’t weigh that much) and got a flecainide overdose. 3 days in icu.
Off flecainide obviously and had index ablation in 9-19.

So it was safe as long as your dosing matches your weight and you have a compliant EP who you trust. Many on the site uses pip and suggests it. Just be aware if you weigh less than 154, the maximum flecainide in a 24 hour period is 200mg.

Flecainide kept me in nsr longer than multaq that I started after my ablation.