Should 73F w/ new pacemaker be taking Flecainide?

[eubanksd]

My grandmother (73/f) has paroxysmal a. fib.  She's taken a bunch of different meds for it over the years, most recently Metroprolol and Flecainide (and Lisinopril for b.p.)

She was told to stop taking Metroprolol three months ago when she was hospitalized for a low heart rate.  She stopped taking it, but had a bad a. fib episode again about a week ago and took one.  The a. fib. symptoms left, but I had to take her to the cardiologist for an "emergency visit" the next morning and she was hospitalized again, this time for extremely low blood pressure.

She was told she needed a pacemaker, and would leave the hospital the next morning with one.  Not asked, but told.  Not forcefully of course, but very politely.  I was there, and didn't like that, but she was ok with it and thought the pacemaker would help.  Mind you, her blood pressure was so low that she was being manditorily hospitalized at the time.

I concluded that the pacemaker probably would help, so I held back my reservations about the doctor's assertivenes.

She has been recouperating from the implant for a couple of days, and seems pretty much back to normal with her new equipment.


I'm just wondering if anyone can advise me on the drug Flecainide as it relates to the elderly?  They told her to stop taking the Metroprolol and continue taking everything else (including Flecainide) and I am wondering if that is a good idea?

I've read quite a few articles that say elderly should not take Flecainide, as the side-affects can be fatal.  Especially for elderly people with CHD -- a condition that, from what I understand, often goes undiagnosed.

She hasn't been diagnosed with CHD or ischaemic heart disease, but she FOR SURE has a really bad ticker in there.  She gets dizzy, has chest pain and palpitations after walking only about 10ft., or even just standing up too fast.

Any help = greatly appreciated.  Thanks.

[Rabbit221835]

I am 62....have had LAF (Afib) for 18 months. I take beta blocker and coumadin for it. I had a dual chamber pacemaker put in. Like you, I did not get a great deal of explanation for it except it would be there to prevent a heart beat pause that had taken place when I naturally converted back from Afib to regular heart beat. Also, my normal HB rate is low (around 50). As far as I understand Pacemaker does nothing for controlling afib and in fact flecinide may be needed by me.

Joe H

[Jerry_NJ]

I believe the pacemaker was installed to keep the heart from beating too slow, from stopping.  That would not address AFib, I think, and so the doctor left her on Flecainide.  It is a strong arrhythmic drug, but widely used and safe.  I have no information on its use relative to age of the patient, but I'm certain the doctor took that into consideration.

Given you mother has been taking the medication without bad side-effects, it seems reasonable that she can continue.