New afib symptoms after flutter ablation and changing meds

After about 12 years or so very well controlled afib on flecainide I developed racing heart over several months. My doctor didn't EKG and said that I needed to have a flutter ablation. The procedure really well, but within a few days I started having some odd symptoms. After doing some EKGs my cardiologist said that I have AFib. That my heart speed was well controlled. He took me off flecainide and Diltizem extended cold turkey today.
After my heart rate hit 120 and was short of breath, I called my cardiologist office but they were pretty well closed up and no one called me back. I went ahead and took my missed morning doses, things calm down quite a bit within an hour or so. He's wanting me to start on sotalol in a few days. Usually I thought recognize a taper down medication? I'm not sure if he thought since it wasn't working anyway that I should just stop taking it but I'm not happy with the results. Any suggestions on how you would switch meds and anybody have good experiences with the sotolol? I was also looking for information on electrolytes? I saw some post on that somewhere. Recommended minerals etc? I think so much! I'm new to the Forum and hopefully this isn't a redundant question but don't have the time to go through everything, thanks

You don't need to taper off flecainide or diltiazem. You can just stop them cold turkey without harm. But they really should have given you a bit more instructions. There does need to be a gap between the flecainide and sotalol, perhaps a day or two. So I would continue what you're doing now until you can speak with them and get an actual plan in place. Just telling you they're going to switch you to sotalol in a few days isn't a plan.

Since you've been on flecainide many years, what they probably suspect is it has stopped working. It does that sooner or later and if you've gotten 12 years out of it, you've gotten more than most people do. Sotalol is a reasonable next choice. I've taken it, but that's not going to tell you anything. For some people it's utterly without side effects and for others there are significant side effects. That's true of all the antiarrhythmic drugs available, so finding a replacement might require some trial and error.

You referred to your doctor as a cardiologist, but not an electrophysiologist (EP), which is a cardiologist with additional board certification in treating arrhythmias. Is your doctor an EP?

Sorry for your predicament. Not fun. At all.

I'll tell you what my experience is, and that was a week after my ablation. I had to go the ER because my heart was all over the place. They diagnosed AF. Long story short, I was placed on Amiodarone. The first week was the loading period of 800mg/day. After that, for three weeks I was on a maintenance dose of 400mg/day. After one month from my ER stay, I was to drop 50% to a single tablet once a day, or 200mg.

I was eleven days into the two week period of 200mg when I found myself back in the ER. Same problem. The internist put me back on the maintenance dose of 400mg for two more weeks. Then I was to drop to 200 again. When I discussed this with my siblings, one of them suggested splitting the pill into halves and taking them about 12 hours apart so that there would always be some in my system, even if only 100mg at a time. I considered it, but decided on my own to take two days at 300mg, down from 400, and then went to 200. At least there was a gradient for a couple of days. I am splitting the tablets as suggested. So far, at the end of the second day, it is going well. I don't know what to expect tomorrow, or over the next seven or eight days, but I guess the nice people at the ER know me pretty well if it goes sour.

I had to stop Flecainide suddenly after many years on it (no taper necessary) due to severe side-effects. All that happened was that the side-effects disappeared. Since my EP wanted to make sure that all traces of Flecainide were out of my system, she waited a week before starting me on Multaq. But yes, you need specific instructions! Multaq is working pretty well but is a stop-gap until I get an Afib ablation in November.

Yes he's an EP as well

Thanks for the info, I was on multack years ago it didn't work at all then went on to flacaide which was great!

Actually went back on my meds today and had a much better day. I also started the day with two large glasses of Gatorade to get some electrolytes in my system. Not sure if that was what helped. I heard that electrolytes and AFib are good combination and I probably am low on potassium. Took my meds again late today so far so good. If I keep having good days on these I'm going to ask my doctor about staying on them. I have an ultrasound next Tuesday and then my doctor next Thursday so we will visit about it.