Arthur, Whilst I'm obviously primarily looking for input from other daily Flecainide users here, thanks for the additional info anyway (-: I did take a look at Flecainide and Verapamil and must say that I found two articles warning of potential drug interactions between the two - one of which being at: Q. Which drugs interact with flecainide? A. Flecainide may increase blood levels ofby Mike - AFIBBERS FORUM
Yes, for the vagal ype of AF, given that you do not change the refractory period, which you can do with a potassium blocker (sotalol, amiodarone, tikosyn,etc) or a sodiumblocker (flecainide,propafenone, disopyramide, etc) and to a certain extent a beta-blocker or calcium-blocker. Note that the potassium-blocker slows the raising phase of the domino brick, the soidum-blocker the initial fall, theby Gunnar - AFIBBERS FORUM
I have had vagal paroxysmal atrial fibrillation since 2002. It really freaked me out, but my EP/Cardiologist has been treating me successfully for the past 8 years with disopyramide (Norpace) - 300 mg/day for about 5 years and now 600 mg/day since 2007. I have been having short break out episodes lately so I anticipate that my doctor will increase my disopyramide to 900 mg/day which I understandby MisterG - AFIBBERS FORUM
Hi Tom, I also developed tinnitus at from the very start of my AF in 2004. I was on Atenolol (felt very sick and had no benefit as I discovered later that I was vagal). I then commenced Disopyramide, which is when the tinnitus started. This drug did not really do much for the AF. After I was cardioverted with Flecainide after one prolonged episode (I was back in sinus after 20mins with 500mg intby Michael Goldberg - AFIBBERS FORUM
Judi, An SVT procedure has a very high rate of success and is much less complicated than a PVI. The following excerpt from the October 2009 issue of The AFIB Report may be of interest to you. "Effectiveness of flutter and SVT ablations BURLINGTON, VERMONT. A team of researchers from Vermont College of Medicine, Beth Israel Deaconess Medical Center, and Johns Hopkins University School of Mediby Hans Larsen - AFIBBERS FORUM
You can read about digoxin here: Digitek was subject to a recall in 2008; I suppose the problem has been cleared up. Beta blockers are contraindicated for vagal AFers. Here is an excerpt from the 2006 ACC et al Guidelines: "Vagally mediated AF is the more common form, and in such cases adrenergic blocking drugs or digitalis sometimes worsens symptoms and anticholinergic agents such asby Dick - AFIBBERS FORUM
Norpace CR is a brand name for disopyramide.by Gunnar - AFIBBERS FORUM
Charles, Before my ablation I was on Plavix & Toprol plus - Tambocor for a short time then - Disopyramide for a short time then - Norpace CR for 3.5 years, 200 mg twice a day When I went into afib (2-3 times a month, 2-30 hrs), the combination of the above drugs worked really well. I only noticed that I was in afib when going up stairs or doing anything physical. Sleeping on my left sidby Ken - AFIBBERS FORUM
You may be interested in this excerpt from the June 2003 issue of The AFIB Report. "In the May issue I concluded that afibbers who took preventive drugs (antiarrhythmics or beta-blockers) during their first year of afib had significantly more episodes (median = 6) than did those who did not take drugs (median = 2). From this response I further concluded that taking these drugs during the fiby Hans Larsen - AFIBBERS FORUM
Pam: Rythmodan and Norpace are trade names for Disopyramide. The data I remember from drugs.com on it say you should be in the hosptial for 3 days when you first start it to be sure it doesn't affect your ventricular rate adversely. Other than that, if you don't get any bad side effects from it, it looks like it might be worth a try before an ablation. I, too, would be reticent to hby Gordon - AFIBBERS FORUM
Hello all, History in brief: Male, 48 yrs, 6'4", 220lbs, vagal AF otherwise healthy. Heart checks out AOK. Episodes Oct99, May02, Oct03, Nov03 (these first four all nocturnal and self-converting after several hours), Nov06 (converted 300mg Flec in Hospital after 10 hours), THEN Jan08, Feb08, Mar08 all three of which converted with 300mg Flec in one hour or so. 100mg Flec BID since Marcby Mike F. - AFIBBERS FORUM
Hello Valda, Glad you found the statistics. I would think the success rate for a third ablation in Bordeaux would be pretty close to 100% unless of course the first two procedures really messed up things - hopefully, they did not. You may find the following description of Pr. Haissaguerre's procedure (in 2004) of interest. "Haissaguerres method explained BORDEAUX, FRANCE. In 1998 Dr. Michelby Hans Larsen - AFIBBERS FORUM
From: LONE ATRIAL FIBRILLATION TOWARDS A CURE - Vol I "Propafenone (Rythmol) and beta-blockers are not recommended for people with vagal LAF" p 35 "Some antiarrhythmics also have beta-blocking properties. Among them, propafenone (Rythmol), amiodarone (Cordarone) and sotalol (Sotacor). So where does this leave us? The optimum would clearly be to use a drug that reduced vagal acby GeorgeN - AFIBBERS FORUM
Published in 2003 by the Cleveland Clinic Foundation, and in an article about atrial fibrillation, "Approaches to restoring and maintaining normal sinus rhythm by Electrophysiologist, David Martin, MD,MPH, et al the following information was provided on flecainide: Im duplicating it here just for information. You should discuss any concerns or conflicting data with your prescribing physicby Jackie - AFIBBERS FORUM
Lesley, I do not know the details of your situation, but from what I can tell, you will be undergoing a somewhat invasive procedure in exchange for around a 40-70% chance of remaining in NSR (after a successful CV followed by an AAD) after 6-12+ months follow-up. I wonder your EP considered the use of AAD or other medication to increase the likelihood of success? ...or from the 2006 ACCby dick - AFIBBERS FORUM
Julie, It is generally not a good idea to start on drugs after only one episode of afib - especially not if the drugs are beta-blockers like atenolol or digoxin. For more on this you may be interested in this excerpt from the June 2003 issue of The AFIB Report. "Number of Episodes During First Year Revisited In the May issue I concluded that afibbers who took preventive drugs (antiarrhythmicby Hans Larsen - AFIBBERS FORUM
Curt, I have no experience with taking Rythmol. I've only used flecainide on-demand. All I know is what I read. Here is a quote from p. 77 of Hans' book, Lone Atrial Fibrillation Towards a Cure - Vol I. Some antiarrhythmics also have beta-blocking properties. Among them, propafenone (Rythmol), amiodarone (Cordarone) and sotalol (Sotacor). So where does this leave us? The optimum woby GeorgeN - AFIBBERS FORUM
Read the list and check with your Dr. or Pharmacy-I will repeat the list again below- Drugmaker recalls dozens of generic drugs (Ethex Corporation) UPDATED 2009-01-28 Drugmaker Ethex Corporation is recalling dozens of drugs, including generic formulas of OxyContin, Toprol XL, and Norvasc, because of potential problems with manufacturing conditions. Also included in the recall are prenatal vitby Jerry - AFIBBERS FORUM
FYI-THIS ONLY INVOLVES THE GENERIC VERSION OF THESE DRUGS MADE BY ETHEX CORP., AND NOT THE BRAND VERSION-Jerry Drugmaker recalls dozens of generic drugs (Ethex Corporation) UPDATED 2009-01-28 Drugmaker Ethex Corporation is recalling dozens of drugs, including generic formulas of OxyContin, Toprol XL, and Norvasc, because of potential problems with manufacturing conditions. Also included inby Jerry - AFIBBERS FORUM
George S, I thought this was a very interesting article. Although it was published in 2000, I think its general experimental approach to manipulating vagal-sympathetic tone would still be of special interest to vagal AFers. ... as would this linked article: I wonder if other medications could be used to damp periods vagal activity ... or if beta-blockers could be used by adrenergic AFer'by dick - AFIBBERS FORUM
I have taken Norpace off and on before and after my ablations. Yes, I needed two ablations. Norpace was the only med that held my AF at bay. I had no side effects from it and did use it as PIP, too. Best wishes, Jeanneby Jeanne - AFIBBERS FORUM
George, I took it for more than a year. It had no side effects for me, but neither did it appear to have any beneficial effect either. I should note that I did not respond positively to any medication... at least disopyramide was the only drug that I did not respond negatively to. Russby Russ Ward - AFIBBERS FORUM
My question originates from a discussion in the above link. A doctor states "One need not necessarily prescribe disopyramide continually or long-term if the arrhythmia is primarily related to certain activities. Instead, this drug could be prescribed as a sustained-release nighttime dose for the older patient with nocturnal atrial fibrillation caused by increased vagal tone, ...."by George S - AFIBBERS FORUM
Mark, This excerpt from the November 2008 issue of The AFIB Report may throw some additional light on the antiarrhythmic vs ablation debate. "HAMILTON, CANADA. Current guidelines for the management of atrial fibrillation (AF) recommend first-line treatment with antiarrhythmics. However, the efficacy of antiarrhythmics such as sotalol, propafenone, and flecainide in preventing recurrence overby Hans Larsen - AFIBBERS FORUM
Robert, pursue your physician to get a different medication for your afib. Verapamil is not really an afib drug, you would be better with flecanaide or propafenone hydrochloride or possibly disopyramide. Verapamil is notorious for "stopping working" and can also be very pro-arhythmic, more so than the other medications. Kateby Kate - AFIBBERS FORUM
elena, Your risk of stroke does not depend on the presence or type of AF but on other risk factors, as indicated here (see Table 1 for your risk): The 21-day monitor will give you an estimate of your AF burden, which, if significant, will lead to the changes Jackie mentioned, unless stopped by anti-arrhythmic (AR) medication -- or a successful ablation. There is no reason not to try medicatiby Dick - AFIBBERS FORUM
Sally, When I was diagnosed with LAF, my Dr. started me on Tambocor. I started on 50 mg/day & then upped it to 100 mg, but neither did much for me after only one month. We then tried disopyramide (Norpace CR) at 150 mg/day and worked my way up to 450 mg and then back to 300 and then to 200mg which I was on for a few years. It worked great! The point is - your Dr. should be trying a varieby Ken - AFIBBERS FORUM
Josiah, You may be interested in this excerpt from my first book "Lone Atrial Fibrillation: Towards a Cure". "The AFFIRM Trial Cardiologists have long debated whether it is best for persistent afibbers to stay in fibrillation and just take beta or calcium channel blockers to keep their heart rate down (rate control) or whether it is best to attempt to convert them to sinus rhythm and maintain tby Hans Larsen - AFIBBERS FORUM
I think the 17% success with antiarrhythmic drugs (AADs) is a little low indicating a biased trial setup. Here is another study (reported in the November 2008 issue of The AFIB Report) which I believe is better balanced. "Antiarrhythmics vs. ablation HAMILTON, CANADA. Current guidelines for the management of atrial fibrillation (AF) recommend first-line treatment with antiarrhythmics. Howeveby Hans Larsen - AFIBBERS FORUM
Hi Mike, I was just put on disopyramide/Norpace last week. So far so good. I was glad to find your post and wondered how you're doing on it? I'd like to compare notes. Thanks, Juliaby Julia - AFIBBERS FORUM