Diltiazem v Flecainide

Being a newbie to AFib and the drugs for it I have a question. When I went I. The hospital back in March for AFlutter I was put on diltiazem. I was already on Bystolic for HBP. The diltiazem did a great job bringing my rate down and the flutter stopped. Since then I had ablation for the flutter and it was discovered I had easily induced AFib. My EP prescribed stopping the diltiazem and starting Flecainide. I didn’t like the diltiazem but it was much more tolerable than the Flecainide is. As I mentioned in another post the Flecainide is causing some SOB, mostly at night. Didn’t have it with diltiazem. Question: can diltiazem be used for the AFib in place of Flecainide? I have not had any flutter or fib since the ablation, at least none that I have noted.

Do they prescribe Flecainide alone?
I thought it was always prescribed with either dilitiazem or a beta blocker??

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allofus
Do they prescribe Flecainide alone?
I thought it was always prescribed with either dilitiazem or a beta blocker??

He's already taking Bystolic for hypertension and it's a beta blocker, so no need for the diltiazem.

Pokey, when was your ablation? If it was more than couple of months ago you could try just stopping the flecainide entirely. If your ablation was successful, you don't need it.

Carey the ablation was 4/17 and was in the right atrium for AFlutter. During the ablation the EP was able to induce AFib on the left side as I understand very easily just with placing the catheter in the right atrium. He did the right ablation only, converted me out of AFib and in recovery told me to start Flecanaide and stop the diltiazem but stay on Bystolic. My regular cardio said Monday I could stop the Flecainide. My question here, which I failed to ask my cardiologist at the time is I go into AFib after stopping Flecainide can I go back on diltiazem instead of Flecainide , or do a single dose of Flecainide. I don’t want to be on Flecainide all the time. I can’t tolerate it, makes me feel pretty crappy.

Okay, now I understand better. He did a right-sided ablation for AFL, found AF while he was at it, but didn't try to ablate it. A shame he didn't go ahead and deal with the AF the time, but maybe he didn't have prior authorization for that with your insurance company.

What I would recommend is 1) take advice on this matter only from the EP who did your procedure, not a general cardiologist; and 2) stop the flecainide and ask the EP for instructions on using flecainide as a PIP. The usual procedure is 300 mg chewed and swallowed with warm water (but if you're a small person that dosage may need to be adjusted downward). See how it goes. Worst that can happen is you go into AF or AFL and need to start a new drug and/or do a cardioversion. There are also other choices than flecainide. Talk to your EP.

PS- You've got questions on two threads about this going, which makes it kind of hard to keep track of. How about we stick to this one?

Neither has the EP or my regular cardiologist has taken the time to share with what expect going forward from having being diagnosed with AfiB. They haven’t said this is what life may look like, what to worry about, what not to worry. Thus far it scares the hell out of me. I also have mitral valve prolapse but my cardio says hes pretty my valve is not causing my AFib since all my numbers on that are all very good. But they haven’t said what to do or expect if I go back into AFib/flutter. What do I do if my HR goes way like it did when I went to the ER with this back in March. Frankly it all scares me. My cardio says none of this will kill me but it sure as hell can affect my quality of life. The Flecainide has been causing me SOB which kept me awake most of last night and I feel like warmed over dog poop today. I need to know what I’m facing in the last 15-20 years of my life( fingers crossed) but they have not told me and so I have find out myself like I’m finding it out here and other websites

It's not going to kill you.

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Pokey
I don’t want to be on Flecainide all the time. I can’t tolerate it, makes me feel pretty crappy.

What dose of Flecainide are you on? Side-effects usually increase with the dose. That is my experience and others have said the same. I am on 75 mg twice daily and while I tolerate that, when I tried 100 mg twice daily, that was hard to tolerate.

Pokey, on my post, you asked for Dr. Natale's contact info. I'm new at this but I'm not sure anyone will see it.

Here's what i found online:

Andrea Natale, MD
Cardiologist in Austin, Texas
Address: 3000 N Interstate Hwy 35 Ste 700, Austin, TX 78705
Hours:
Closed ⋅ Opens 8AM Fri
Phone: (512) 807-3150

Thanks for Dr Natales contact info and to answer Daisy’s question I’m on 50mg of Flecainide 2x/day

In case you didn't see this, Cary sent this to you. It's a link to Dr. Natale's website

[tcainstitute.com]

Lani. No I did not see that link. Thank you as well Carey.



Edited 1 time(s). Last edit at 05/02/2020 04:18PM by Pokey.