Flecainide, also know as Tambocor is an antiarrhythmic that is prescribed for life-threatening as well as nonelife-threatening irregular heartbeats. It can be prescibed for things like atrial fibrillation, AVRT, AVNRT, as well as VT. Flecainide is a Class 1C Sodium Channel Blocker and works by controlling the flow of sodium in your heart, prolonging or slowing the electrical signals in it. This is one serious antiarrhythmic, and hospitalization is recommended so that you can be closely monitored as your dosage is set. May I ask what this is for?
My doctor prescribed Flecainide (along with the Verapamil I was already taking) a couple weeks ago for what he diagnosed as atrial tachycardia. My holter report indicated more PAC's and PVC's than anything else. The Flecainide made my arrhythmias much worse, so I asked him to change meds. I'm now on Atenolol only and my symptoms are much, much better. I still have mild PAC's, but they are almost unnoticeable. I'm glad your doc is suggesting hospitilization because in some cases the Flecainide can cause undesirable side effects.
I have a very long history with flecainide. On a normal dose for a-fib i always did fine, no side-effects. After my ablation last Sept, it was the only drug that stopped the a-fib while my heart was healing. I was on a very high dose of 400mg a day. I had some peripheral vision disturbances but that was about all....oh, and my ECG looked worse than usual, something about the QT elongation or PR interval.
This drug seems to work quite well for a lot of people and not so well for others. It, like all other anti-arrhythmics will eventually become pro-arrhythmic. If you have structural problems with your heart you should not take it at all.
Does he want you to try it because your pvc's are bothering you so much that you can't function (believe me I have been there) or because he feels you need it based on your test results? I'm only asking because my cardiologist just talked to be about not using anti arrhythmic drugs for pvcs and pacs unless they were causing so much distress that you can't live your life. He did say that if I was having over 10,000 then they do treat with these types of drugs prior to ablation.
My mom was put on this for a-fib and could not tolerate it. (if you want to know the entire story, email me either from medhelp or facebook)
They switched to atenolol and some calcium channel blocker and it worked great for her.
I know how hard this decision is for you. We are so afraid to take any kind of medication.
How many pvc's are you having? I know you were going through a really rough patch, but did they determine how many? Sorry if you posted that somewhere. I haven't been on medhelp often over the last few months.
She is in trigeminy for almost a month now.
If your heart beats 100,000 times a day (not sure if it does)...I thought thats the average I heard...that is about what...33,000 a day? Wait...is that right?
Deb...what did the doctor say? NO ablation? Is it pvcs or pacs?
Do they keep checking you for heart failure? .(not sure how often they do that)
Ok, folks, please help. I finally got in to see the Big Wig. Personally, he was great, someone I could really work with. He suggested I email him with questions, issues and that I will never have to wait that long again for an appointment. He told me his theory on why we have pvcs and pacs, it has something to do with embryonic development - I'll save it for another discussion, but it made sense. Anyways, here's the back story:
- diagnosed 18 years ago with benign pvcs, they came and went for 5 years
- re-diagnosed 12 years ago with persistent bi and tri geminy. On my Holter monitor at the
time I had more than 17K, but that was on a slow day - all tests were negative - echo,
stress, etc. Was given rhythmol in a hospital setting - worked like a charm, was on it for
6 years - not one pvc. My EP moves to Canada and I am handed over to another EP in
the practice, Dr. B. He immediately took me off rhythmol and said it was too dangerous
and that an ablation was less risky. Nagged me till I relented. Then he put me on ver-
apamil (which worked, but I had breakthroughs) for 4 years.
- 2 years ago pvcs came back with a vengeance. Dr. B put me on metroprolol. It worked
sporadically, lots of breakthroughs, but I tried to control everything with diet, avoiding
triggers, etc. Again, all tests were negative. Throughout all of this Dr. B constantly tries
to encourage me to have an ablation but I'm a scaredy cat. He tells me that I am a good
candidate because my pvcs are unifocal and left (I think) ventricular. Dr. B is very well
known and respected by the way.
- Last March - Dr. B (the head of arrhythmia/cath lab at Brown) "retires". I hate his office
staff (lazy, uncaring, mean, etc.) so I go to another cardiologist, who sends me for a
Holter and Stress Echo. Stress Echo is negative.
HOLTER Results - who knows?????? I went to a local EP who read it and disputed what my cardiologist said. This EP (who I don't think much of btw), said that he thinks the 9K pacs were really pvcs and that the extra beats were multifocal (wtf??) The EP said in conclusion that I needed another Holter and that this one was "bogus".
So, my husband, who works in Boston (I am from Boston but currently living in RI), said, let's get out of RI!!! Let's go up to Boston, the center of great healthcare in this country. So that is how I found the Big Wig. But now I am questioning the Big Wig, why?
- Unlike Dr. B, he discouraged an ablation.
- He didn't have the Holter in front of him (even though I had it faxed, it was received, they couldn't locate it) - he did say he would look at it and call me if he needed to.
- He wants me to take 50mg twice a day of flecinade. He tells me this is a very small dose.
- He says I do not need a hospital induction for this drug. He told me that in people without heart disease this is a good drug (same story I heard when I successfully took rhythmol).
My questions for you guys and I guess my cardiologist on Friday.
Should I try it?
If I do, do I need to be in the hospital?
Should I have more tests first? Is a stress echo the same as an echo?
Do I need another Holter and what DOES my Holter reveal for heaven sakes???
Why did the local EP dispute the results?
Why did Dr. B encourage an ablation all those years and never antiarrhythmics and now the Big Wig is saying the opposite - both doctors are top in their field!!!!!!
Sorry for the confusing post. I'm a little emotional!
I meant to say in my first post above that he wants me to go on flemicade WITHOUT monitoring in a hospital setting.
Try it? I would ask whats the risks if you do not do anything.
If you do...I would INSIST on being in the hospital(cause I react terribly to drugs)
I would insist on they say WHY the holter was bogus.
Dr. B...was too excited to do ablation in my opinon
Antiarrhythmics can cause you more serious rythm issues down teh road..I would avoid
Doctors are confusing...they need to all go to the same school...lol
I think I'm going to just start taking klonopin round the clock!
Ok....HOLD THE DRUGS.....I know klonapin is not an ssri...BUT LOOK
here...I have been trying to warn people that antidepressants can be bad on the heart...
quote below by doctor.....
At this stage, at the current level of QT, I would suggest it is wise just stop zoloft for few days, let’s say a week, and recheck QT. If it normalizes, and especially if it gets prolonged on reintroduction, then it proves the causal hypothesis. You will need to stop and avoid zoloft and preferably all SSRIs if possible.
Wow. This is tough. I think I would ask for one more holter. Or at least wait until he reviews your last holter. This sound a lot like what my cardio just told me. Ablation for pvcs just isn't a sure thing. Meds are always the first choice unless the Ejection Fraction is low or has dropped. But he also told me he stays away from the anti arrythymic drugs and uses them as a last resort.
If you did great on ryhthmol then why can't you take that again? A stress/echo test is different than just a normal echo. I just had one done. This test can help determine CAD. They do the echo, then the stress test, then immediately do another echo to check blood flow and to determine if there are any blockages.
How about trying another beta blocker or calcium channel blocker? I think they work pretty well, and if you have breakthroughs, then maybe you can ask them if you could split the dosages up during the day. I have found this to work and I know another friend that also does it this way and he was in bigemy for close to a year. Atenolol is what he and I use, but the dosage is split up and taken 4 times a day.
IF you choose to take Flecinade, I would start it in the hospital. My mom had a horrible reaction to that drug. She took it for afib. Now she takes Atenolol.
I like the klonopin idea LOL
Seriously, get one more holter or make sure he reviews your last holter results with you.
Sorry sweetie.....this *****. Hopefully people that have had luck with Flecinade will respond. But THAT drug scares me and if you don't have heart disease, and your EF is good and your other tests are normal, then I would try to figure out another route.
I can't type much right now but will later...please think about another opinion - they want you to take it w/o hospital which may or may not be dangerous; what's it off their back if it's dangerous? nothing...but to you it may mean alot. I'd either find another dr and ask many more questions or tell him no way unless you're in the hospital to be monitored.
I know there are those out there who do take it and are fine, but my thinking is why chance it? My first EP said no way anti-arrhythmia's are just too dangerous and too many side effects and at that point I had no heart damage...on the other side I've heard too many with horrible side effects from Flecinade. (really any med could have a bad side effect)
have you been to mayo or cleveland clinic? I'm sorry I just can't remember :( sounds like this bigwig needs to get his act and office together...sounds like he wasted your time and money and is trying to placate you with treating a symptom instead of finding a cause.
Why not request to be put back on the Rhythmol if you did well on it before? My cardio prescribes antiarrythmics as a last resort, but I was in the hospital twice in 4 months for afib and had to be electroconverted, so I went on Norpace CR. He said if I don't have an episode for a year, he will take me off the Norpace and the Coumadin. You might want to seek another opinion. I hate the way we're treated at these appts. Sometimes I get in to see my doctor, sometimes I have to make do with whoever is covering for him.
I just went on 100mg on Flecainide after a Cath Ablation did not work.
My physiocardiologist said that he would not have me take it without hospital care but since I have a "Life vest" (exterior defibulator) strapped to me 24/7 he said that I would be ok. If it put me into Cardiac arrest, then this thing would zap me back, comforting huh?
I decided not to take it that night, but the next day at work. I got there at 7:00am, and put off take the pill unit 11:30 reluctantly ja ja ja. It made my feel little funny, I think it was the nerves as I was waiting to drop like a fly, but now it actually seems to give me a little more energy.
The night before I read that it puts about 5% of peole in C/A while a placibo put 2.3% (or something like that)
Later that day after taking the stuff, I went to the regular Dr for some Anxiety stuff, she said that I should not read those stats because typically people that take Flecainide are 80-90 years old so the results are skewed. In one way that made me feel better, in another way I thought- I'm taking meds of a 90 year old!
If your going to take it without hospital care, you could take it in the hospital waiting room.
I would have no problem talking to the people there and saying, "Im taking this here, just incase" If I don't look good, wheel me up.
Please keep in mind, I'm probably the last one that you should listen to on medical advice.
Good luck and take care
Just a quick note here....Klonapin is not an SSRI, it is a benzodiazepine. You can take as needed. On to other things. I would NEVER start Flecainide without hospital induction. Chances are you wouldn't need interventions, but wouldn't HIS face be red, if you weren't in a hospital.....and you did? I have been offered this drug tons of times. I don't think I'd ever go on it, but that is just me. Good luck with everything. Doctors are exasperating.
No...I know that its not an ssri..It just got me on the subject lol
I decided not to take it. I went back to my cardiologist and he wants to review my Holter monitor (BUT, since his secretary faxed it to Big Wig, it's been missing, now he has to track it down! UGH!). Anyways he said if they show pacs, flecinade won't work anyway. He agreed that I don't need a hospital induction, but he doesn't like the drug and discouraged me. He said I should maybe go on a toprol (the generic xl is his favorite, I am already on it, but don't know how to spell the generic)/verapamil combo. Other than that he said go back to Big Wig and insist on an ablation if he can get a hold of my Holter strip and see where all this originates. He said the number alone indicate that I would be a good candidate - about 15K per day now. I'm waiting to hear from him this week, can you believe the incompetence of losing my report??
Oh....this is so frustrating! My quesiton is this...pvcs come and go. You have 15,000 right now, but what if they sudenly stop in a month and then you dont have them for a couple years again? So sorry for your agrivation!