Flecainide

Flecainide

by AgentX86 - 2021-03-06 22:14:44

If you look at the list of side effects of any drug, you'd think that your doctors are trying to kill you.  All antiarrhythmic drugs are toxic and have a list of side effects as long as your arm. The toxicity is roughly in the reverse order of their effectivity.  Flecainide is one of the lesser of these drugs and very commonly prescribed. 

I assume that you have some arrhythmias that you're trying to stomp out.  It's a good drug for the purpose but, as with any drug, watch for the side effects.  If you think the "cure" is worse than the disease, talk with your EP.  He can lay out the alternatives and their problems and, even what happens if you  take none.  \

For most arrhythmias, there is no requirement that they be treated at all.  You must treat the side effects of the arrhythmia, however.  An anticoagulant and something like a beta blocker to keep the heart rate below 100bpm is essential. There are many who are not "symptomatic" who don't take any antiarrhythmics and are on what's called "rate control". 

Antiarrhythmics, for most, is a quality of life thing.  Some of us are highly symptomatic and simply cannot stand the arrythmias.

Flecainide is generally a safe first anti arrhythmic med to try

by Gemita - 2021-03-07 06:40:05

Jam,

I was taking Flecainide for several years without any harmful side effects.  In fact it is an excellent first anti arrhythmic to try and many do extremely well on it.  My doctors checked me for heart disease initially since in the presence of heart disease (blocked arteries) Flecainide is usually not recommended.  The only side effect I got was slightly blurred vision occasionally but I also had cataracts at the time which added to the blurring!

I agree with everything already said by AgentX86.  Anticoagulation and rate control meds are vital to protect you from harm and once you receive this treatment (if it is needed), often nothing else needs to be done especially if we are not getting troublesome symptoms.  Sometimes a rate control med like a beta blocker/calcium channel blocker is as effective as an anti arrhythmic med in calming our symptoms from an arrhythmia and these meds are usually a lot safer than an anti arrhythmic med according to my excellent medical team.

My doctors first wanted to try me on a beta blocker before Flecainide, explaining that all anti arrhythmic meds have the potential to induce other arrhythmias (the pro arrhythmic effect).  I believe Flecainide eventually triggered another arrhythmia (Atrial Flutter) because I was not protected by an AV nodal blocking agent (like a beta blocker) at the time..  My doctor recommended I take a beta blocker with Flecainide but I failed to follow his sound advice because I was more fearful about taking a beta blocker than the Flecainide which was foolish, but I have learnt my lesson the hard way.

I expect your doctor has told you about all your options to control your arrhythmia, including an ablation which can be the most effective way of stopping an arrhythmia, often far more effective than taking an anti arrhythmic med like Flecainide, but of course it is more invasive as a treatment option.

Jam, I believe providing you have no structural heart disease, you are taking a rate control med to slow conduction through your AV node and you start on a low dose of Flecainide, I can see no harm coming to you.  Many patients do extremely well on Flecainide as a first anti arrhythmic med without the side effects, some of them potentially harmful, of many of the stronger, more powerful anti arrhythmic meds like Amiodarone for example.  Good luck

trust your doctor

by Tracey_E - 2021-03-07 11:33:00

Your doctor knows the side effects and risks and has determined the benefits outweigh those risks. You can have a discussion with your doctor, but if it was prescribed, it's best to take it.

Flecainide

by Flo - 2021-03-07 13:10:27

I have been taking Flecainide 50mg 2 X a day almost 4 years now and it has worked well for my afib with no noticeable side effects. Best regards to you.

Beta blocker

by Jam - 2021-03-07 14:09:50

Thank you all for the helpful comments! I forgot to mention Imam on a Beta Blocker Toprol xL 75. It took care of my PCBs . I Also have a pacemaker since oct 2020. Have been having strange things like shortness of breath a feeling of weakness feelings in my neck throat are like I am not getting enough oxgen. Pacer pacing at 94% which I was told is normal. Went to another Dr and he doesn't know what is wrong. Normal EKG and blood pressure good. I have sick sinus sindrum and bradycardia. I do not get those feelings everyday! May go two or three feeling ok! So strange. That is why I am thinking should I take Flecainide and maybe get bad side affects or not and hope this goes away! It's a hard decision as I am afraid of taking meds!

A difficult decision

by Gemita - 2021-03-07 14:42:17

Jam,

It is a difficult decision and of course it is your decision since you are the one who will ultimately be affected by any side effects from the medication.  However if your arrhythmia is getting worse and causing the symptoms you say it is, shall we say every couple of days, causing breathlessness, weakness, then clearly your body is telling you that you need extra help to manage your symptoms.

To help you decide, I will explain what happened to me.  When I started getting worsening symptoms (from Atrial Fibrillation):  breathlessness, weakness, chest pain, dizziness, faintness I told my doctor I wanted something done because I couldn't tolerate my symptoms any longer.  Only when he heard from me "that I couldn't tolerate my symptoms" was he prepared to step in and prescribe an anti arrhythmic med like Flecainide.  He also offered me an ablation as an alternative treatment.  I chose Flecainide.

Do you have a good, friendly relationship with your doctor?  Take the problem back to him/her and explain honestly that you are afraid of taking Flecainide because of potential side effects.  Let your doctor help you to decide on the best course of action for you.  The doctor may decide to increase your Toprol for example, since you know the med and I suppose you feel fairly safe on it?  As I said in my earlier post, my doctors suggested beta blockade or a calcium channel blocker would be a safer option than giving me an anti arrhythmic med.  However low dose Flecainide was excellent for me for a couple of years.  I also have SSS (sick sinus syndrome - tachy/brady).  I hope you come to the best decision for you.

By the way your symptoms sound very unpredictable and very much like an intermittent (paroxysmal) arrhythmia like Atrial Fibrillation.  Often our EKG, blood pressure, heart rate can be perfectly normal one minute and the next we can be experiencing an abnormal rhythm, heart rate, blood pressure and EKG!!  Frustrating I well know.  

Jam, may I ask just what, if any, arrhythmia has been diagnosed?  Of course bradycardia is an arrhythmia (a slow arrhythmia) but now controlled by your pacemaker (or should be if the settings are correct for you).  If you have a fast intermittent arrhythmia (tachycardia) or an intermittent irregular arrhythmia like Atrial Fibrillation, it doesn't always show up when we are tested.  From your discussions with your doctors it all sounds a bit vague and I certainly wouldn't start an antiarrhythmic med like Flecainide until and unless an arrhythmia has been diagnosed.  I would definitely go back to your doctors and ask some more questions.  I see you have PVCs (premature ventricular contractions) and I see you say the Toprol effectively treated these?  You could ask your doctor if this ectopic arrhythmia is thought to be the cause of your worsening symptoms?  Flecainide can be successfully used to treat PVCs.  Maybe this is the reason why they want you to try them?  

Alternatively, what is your lower pacemaker rate set at?  You could ask your doctor if an increase in lower rate might help control your arrhythmia (?PVCs) better than Toprol/Flecainide.  Higher pacing (70 bpm) certainly works for me to help outpace rhythm disturbances.  You have nothing to lose by asking Jam

Fllecainide

by Jam - 2021-03-07 16:39:01

thank you for your comments! Very help information.