Flecainide for Arrhythmogenic Mitral Valve Prolapse?

Hi all! I'm 37 and I have Arrhythmogenic Mitral Valve Prolapse (and an ICD). I saw my cardiologist for my annual visit today and he recommended to change my medication a bit...because he has seen other female patients (with the same condition) do well on the combo he's recommending. The idea is that I would change the medication and then do a Holter in 3-4 months to see if there's any improvement with my arrhythmias. He's mainly concerned because at my last device check (which I do every 6 months), there was a run of 9 beats...which, if had gone to 20, I would've been shocked. For 4 years, I have been taking 5mg Bisoprolol twice a day. He wants me to reduce my Bisoprolol to 5mg once a day and add Flecainide (150mg) twice a day. I guess my question is...does anyone have experience with Flecainide? I feel like I've read negative things about it on here in the past...

P.S. The good news is that my most recent echo says that I have "mild regurgitation," so no surgery for me to fix my valve (yet!...and hopefully many years to come!)

1 Comments

Flecainide is a good starter anti arrhythmic med. Worth a try

by Gemita - 2023-10-19 23:38:16

Lildanishgirl, I successfully took Flecainide for atrial fibrillation for several years with minimum side effects until it became pro arrhythmic when I developed Atrial Flutter.   The only side effect I had was blurry vision.  At first I thought this was caused by my cataract, but it was due to Flecainide, particularly at higher doses.

Looking at your proposed dose, 150 mg twice daily is a fairly high starting dose.  They started me off on 50 mg twice a day.  You could ask if you could start on a lower dose and build up gradually to the desired level?  

I have attached a couple of links, not to scare you, but to help inform you of the potential effects of Flecainide.  I was told it is a great starter anti arrhythmic med for many of us and usually well tolerated and I certainly found this to be the case.  Have a read of the attached first link.  Flecainide is contraindicated in patients with structural heart disease, coronary artery disease or heart failure.  

https://www.ncbi.nlm.nih.gov/books/NBK542291/

Flecainide can rarely interfere with pacing therapies resulting in inconsistent pacemaker capture (see second link), particularly if toxicity occurs.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8302776/

I was told anti arrhythmic meds are certainly not as safe as a rate control med like a beta blocker or calcium channel blocker, since all anti arrhythmic meds have the potential to become pro arrhythmic.  Are you saying that you had a run of 9 beats of non sustained VT and your doctor wants to prevent these from becoming prolonged and more frequent?  I have runs of NSVT too, as well as more persistent atrial tachy arrhythmias.  I am treated with Bisoprolol alone now.  I have had a great response to pacing.  Very rare I know, but I am not complaining.

Anyway, good to hear from you again and I hope the little one is doing well?

You know you're wired when...

You can hear your heartbeat in your cell phone.

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I'm 35 and got my pacemaker a little over a year ago. It definitely is not a burden to me. In fact, I have more energy (which my husband enjoys), can do more things with my kids and have weight because of having the energy.