Flecainide

Well I guess im about 8-9 weeks post ablation. After the first two weeks I havent has afib. Well I have a few occasional short runs of something ?? Not sure.
I knew before, that my use of flecainide caused a rate dependent Left bundle Block. Typically it would trigger if my heart rate gets up to 115 or 120. Earlier years I actually had a sharp chest pain at on-set proven during stress testing.
Most peops do not feel LBBB however I do. I can actually feel my heart fight a little to go faster but the heart retarding the beat (58 bpm_). It makes you think your heart is out of rhythym and fast but the pulse is slow and steady. at some point the natural rhyth kicks in and bumps the heart up (80 bpm).
I do feel a bit out of breath with it.

Well this past week all of a sudden the LBBB is happening just at low exertion, like sometimes at 90 bpm. driving me insane.

My EP post ablation follow-up is May 21
I am thinking about cutting my Flec from 100 2x day to 75 2x. I suspect for some weird, god only knows why reason I am super sensitive all of a sudden this week to the Flec ?????

Any thoughts on Flecainide side effects, cutting the dose or what I am experiencing are appreciated.

Be sure to read the entire article. And then search for contradictory articles. You haven't stated how long you've used flecainide, so whether or not the effect you're experiencing might be bradyphylaxis or tachyphylaxis is unknown. Or, if it can be related to the ablation or to some other factor or combination of factors, including the ablation along with bradyphylaxis or tachyphylaxis.

From the article:

"On the other hand, transient LBBB at a heart frequency of 100 bpm on a “resting” ECG and echocardiographic confirmation of interventricular dyssynchrony (80 ms difference in aortic and pulmonary preejection time) have been described in a patient with flecainide self intoxication, both have resolved after discontinuation of the drug[21]. None of our patients was on flecainide therapy."

[www.ncbi.nlm.nih.gov]



Edited 4 time(s). Last edit at 05/06/2014 03:13PM by morpheus.

Thanks yes I'll check that article out. I have been on Flec for about 6-7 yrs 100 mg 2x

I have experienced these spells some in the past rare occasion but just seems really weird this time

Were your historic spells related to other procedures that may have required general anesthesia [www.ncbi.nlm.nih.gov] ? Note that, as always, "correlation does not imply causation". [en.wikipedia.org] . If you can, try to remember the circumstances of the prior events and compare them with the most recent occurence.

Also consider: "The Impact of Psychological Stress on Wound Healing: Methods and Mechanisms"

[www.ncbi.nlm.nih.gov]



Edited 1 time(s). Last edit at 05/06/2014 04:43PM by morpheus.

Why wouldn't you send a note to your EP describing this and asking the best course of action. She/he knows a lot more than we do.

George, some of us supply what might be referred to as "augmentative suggestions" such as occurs in the following:

TomC [ PM ]
Minimum effective daily dose Flecainide
January 19, 2014 06:34AM Registered: 2 years ago
Posts: 109
"Does anyone know the least effective daily dose of Flecainide?"

A respondant:

GeorgeN [ PM ]
Re: Minimum effective daily dose Flecainide
January 19, 2014 02:28PM Registered: 1 year ago
Posts: 546
"Tom,

I'm sure it is very individual. My suggestion would be to slowly titrate down, being prepared to terminate an afib episode with a PIP loading dose. If you get an episode, then go up a bit.

George"

I suspect that we all already realize that primary information, etc., should come from the physicians that have access to the complete anamnesis and catamnesis.

Morpheus,

If I were in the situation, I'd probably just cut the dose and see what happens. Some might attribute that approach to my being deficient in the frontal lobe category, hence I restrain from suggesting it to others. In this case, tsco has recently had an ablation and is seeing something different. An EP's advice might be useful.

George



Edited 1 time(s). Last edit at 05/06/2014 05:10PM by GeorgeN.

"An EP's advice might be useful."

I'm in total agreement!

"Some might attribute that approach to my being deficient in the frontal lobe category,..."

LOL, I don't think so, Ive read many of your posts. And some have fired off an activation of my right hemisphere anterior superior temporal gyrus! And in general that's pretty hard to do considering my thick head!



Edited 1 time(s). Last edit at 05/06/2014 05:36PM by morpheus.

I have successfully gotten off the Flec twice now, the first after an ablation that probably was not that big a deal, however the second time was a bit more interesting as the afib episode was caused by medicatiions that sapped my Magnesium stores, the PIP method would last only 36 hours then back into afib. So at the advice of my cardiologist I stayed on a minimum dose of Flec and Metoprolol for a couple of months while I built up my Magnesium, then I slowly cut the Flec level down in minute amounts over 4 weeks. This worked well although during the reduction I would have occasional runs of missed beats that I would remedy with chewable Papaya tablets. After I was off of the Flec I slowly cut down the small dose of Metaprolol to nothing for a week( I was advised to not cut down on the beta blocker while scaling back on the Flec). This protocol worked well for me as it has been a few months now with no significant issues. So now armed with a Cardymeter and my bottle of Magnesium caps I will make the best of living with the possibility of recuuring afib.

George,
thanks. I am asking on here because I get better answers from those of us that have experience. An EP can answer some questions but from experience I know I got the "goofy glare" when I told my EP I was having a sharp chest pain on exertion and a weird sensation (LBB 15 years ago and was told it is not possible to feel LBBB. After my own research and providing the data and some verification thru monitoring and stress testing they determined maybe it is possible it's not in my head. We found it is from Flecainide. Another EP I talk to experienced one episode of Afib and flecainide for a month agrees the drug is good but can have some bad effects in certain persons. So Im asking if anyone has had my experience or another , thats all

Most EPs have never experienced ANY disturbance in their heart and certainly have no idea from personal experience how these drugs make us feel. Yes my EP can say definitively here is what you are experiencing and here is how most people describe how it feels but he/she doesnt know how my body translates that symptom.


thanks Tom thats interesting. Why did you want off the drugs ? side effects or just personal preference?

The reason I had an ablation was to be off of the drugs, they do have side effects.